WASHINGTON — President Donald Trump and Republican leaders are still scrambling Thursday for a deal and looking for votes on their landmark bill to repeal and replace Obamacare.
House GOP leaders have already postponed their 9 a.m. meeting of the entire Republican conference, and Speaker Paul Ryan moved his regular press conference back several hours until late afternoon. The conservative House Freedom Caucus, whose members appear to hold the key to any agreement on a final bill, will meet at the White House later Thursday morning.
“This bill is collapsing,” one House Republican who declined to speak on the record told CNN.
The challenge for leaders as they count their votes is daunting: give conservatives too much of what they want and risk losing the moderates, but keep the moderates on board and conservatives could walk.
Leadership is keenly aware that every vote counts: Republicans can’t lose more than 21 of their caucus and still pass the bill, since no Democrats are expected to support it. According to CNN’s ongoing whip count, 24 House Republicans have said they will vote against the bill, and four more have indicated they are likely to oppose it, though negotiations were ongoing Thursday.
Trump is now seeing and feeling first hand what it is like to work with the Freedom Caucus, a top GOP source said, that they are incredibly frustrating because they don’t really want to get to yes — and keep moving the goalposts.
Alabama GOP Rep. Bradley Byrne, emerging from a meeting with top House leaders, blasted the move to continue talks with the hard right in the Freedom Caucus while leaving the bulk of other members in the dark.
“I think the window for making decisions is rapidly closing. We need a vote or go home,” said Byrne, a member of a large group of fiscal conservatives, the Republican Study Committee.
Negotiating with Freedom Caucus
For a brief window Wednesday night, there appeared to be a breakthrough, as the chairman of the conservative House Freedom Caucus, Rep. Mark Meadows of North Carolina, suddenly struck an optimistic tone and said a deal was being worked out with the White House.
A key element of the negotiations between the Freedom Caucus and the White House revolves around the so-called Essential Health Benefits. The White House is working to possibly include the repeal of Obamacare requirements that certain benefits — such as mental health coverage, drug addiction coverage and maternity care — be required in insurance plans.
Meadows told Fox News’ Sean Hannity late Wednesday that he was “really optimistic” and that his members had an agreement in principle with Trump.
Thursday morning, Freedom Caucus member Florida Rep. Ted Yoho told CNN’s “New Day” that he was still a no on the bill, but he was waiting to see what the actual agreement with the White House turns into.
“I haven’t heard the final details,” Yoho said. “We’re still open for negotiations. We look forward to having more discussions today on the health care bill and that’s why I think you don’t see a vote.
Change is scaring away moderates
Ryan huddled Wednesday night in his office with his top deputies and GOP moderates. But after several hours, no members came to talk to the reporters waiting outside the meetings. Most members used back exits to leave and the big sticking points remained unresolved.
A member who was in the late-night Ryan meeting said tensions were running high.
“A lot of people don’t realize what the implications of that are,” the member said of stripping out essential health benefits. “So we’re gonna railroad this thing through and there’s going to be even more people pissed off–our constituents, stakeholders.”
Many GOP members are frustrated with how leadership has handled the negotiations in the past 24 hours.
“I think the chances for getting a bill done this week gets smaller — doesn’t go to zero, no such thing as never or impossible — but I think the chances of passing this bill get a lot, they get a lot lower if we don’t do it this week,” one member said.
“The vast majority of us in the Republican conference have been left out of these discussions and we have no idea what’s going on, and I think that is a problem for our leadership and I think it’s a growing problem for the chances of this bill,” said Byrne, who is a supporter of the health care bill and part of the whip operation to help pass it.
Byrne complained that the Freedom Caucus continues to throw out an expanding list of demands and suggested there was little to be done to get some in that group on board and it was time to move on.
“Those members don’t change, so at some point, you’ve got to say there’s nothing in the world that’s going to change their minds,” Byrne said.
Pennsylvania Rep. Charlie Dent, who leads the coalition of GOP moderates the Tuesday Group and attended the late-night Ryan meeting, put out a statement that he would oppose the bill.
“I believe this bill, in its current form, will lead to the loss of coverage and make insurance unaffordable for too many Americans, particularly for low-to-moderate income and older individuals,” Dent said in a statement.
The difficulty of swinging the pendulum too far in either direction has been a persistent difficulty for leaders crafting the bill.
“It has always been the case — pull the bill one way, risk losing members on the other end,” a lawmaker involved told CNN.
At 8:27 a.m., an email landed in Rep. Richard Hudson’s inbox notifying him that the 9 a.m. meeting was canceled.
Hudson wasn’t the only lawmaker to miss the note. Several lawmakers, some with coffee cups in hand, were seen approaching the usual room in the basement on Capitol Hill, only to learn from reporters or colleagues that the meeting was called off until further notice.
GOP Rep. Randy Hultgren, who didn’t know the meeting was postponed until he was outside of the room, told CNN this kind of confusion was expected ahead of such an important vote.
“These are always interesting days when a big vote’s coming up and when we’re close but not quite there,” Hultgren said. “I don’t read into things. ”
Hultgren said he was still deciding whether to support the bill, calling the ongoing deliberations a “work in progress.”
Hudson, a member of the leadership whip team, went as far as to say the postponed meeting was “a good sign.”
“If they don’t need to pull us together to beat on us, maybe we’re getting closer,” he said.
“The passage of time is not good for the passage of the bill,” he warned. But he also said that because of his conversations with member as he’s been whipping he believes there is enough support to get the bill through today.
What’s in the bill
The bill introduced earlier this month would roll back many of the Obamacare taxes and eradicate the individual mandate. Instead of the subsidies available under Obamacare, officially known as the Affordable Care Act, the GOP plan provides Americans with refundable tax credits to purchase health insurance.
The bill also significantly restructures Medicaid and allows states to require able bodied adults to work if they want to be eligible for the program. After 2020, states will no longer be able to expand Medicaid like they could under Obamacare and states that haven’t expanded the program at all are barred from doing so.
However, the GOP bill still includes some of the most popular pieces of Obamacare, including letting children stay on their parents’ insurance plans until the age of 26 and including protections for people with pre-existing conditions, though insurers would be allowed to charge higher premiums to individuals whose coverage has lapsed.
The non-partisan Congressional Budget Office estimated that 24 million fewer Americans would be covered under this bill than under Obamacare by 2026 if the bill is becomes law in its current form.