House Republicans Struggling To Get Votes To Pass Obamacare Replacement Bill
With a vote tentatively scheduled for this evening, House Republicans appear to lack the votes to pass the American Health Care Act.
The House of Representatives is supposed to be voting later today on the American Health Care Act, the bill to ‘repeal and replace’ the Affordable Care Act that was introduced just two weeks ago, but it is far from clear that there are sufficient votes for it to pass:
The Republican health-care overhaul faces its greatest test ever Thursday as President Trump and House Speaker Paul D. Ryan (R-Wis.) work feverishly to persuade enough Republican lawmakers to back the measure and push it to a floor vote.
Late Wednesday, the White House and House leaders were still scrambling to boost support, and signaled at the 11th hour a willingness to rework the measure to mollify conservatives. On Thursday morning, House leaders postponed a 9 a.m. meeting of the entire GOP Conference, signaling that negotiations were still underway.
As of late Thursday morning, 36 House Republicans — mainly conservatives — had announced their opposition to the bill, known as the American Health Care Act.
After insisting for weeks that the changes sought by hard-right members would render the bill unable to pass the Senate, White House officials and GOP House leaders appeared to shift their thinking — and opponents agreed to keep working on a deal with the goal of holding a floor vote in the House by Thursday night.
Rep. Mark Meadows (R-N.C.), chairman of the conservative House Freedom Caucus, said he had taken personal calls Wednesday from Trump seeking a resolution, although he said no formal offer had been extended by the White House.
“We are working very diligently tonight to try and get there,” Meadows said Wednesday.
“The president has been profoundly engaged,” said Rep. Trent Franks (R-Ariz.). “I think things are going in a very good direction right now.”
Trump is scheduled to meet with Freedom Caucus members at 11:30 a.m. at the White House, and will then host a “listening session” on health care with truckers there Thursday afternoon.
Thursday marks the seventh anniversary of the Affordable Care Act, and Republican leaders are eager to mark it with a historic vote demonstrating its evisceration has begun. In a sign of how high the stakes are for both parties, former president Barack Obama issued a statement noting that more than 20 million Americans have gained coverage since he signed the law, while the rise in health costs has slowed.
(…)
GOP leaders can afford only 22 defections, given that one Democrat is expected to be absent Thursday. A Freedom Caucus spokeswoman said that “more than 25” members of the group oppose the bill.
Wednesday’s events laid bare party leaders’ struggle to muster enough votes for one of their defining goals: to roll back the 2010 health-care law that helped galvanize conservatives in the years since to wrest control of both the legislative and executive branches from Democrats.
If Republicans fail this initial test of their ability to govern, Trump and Capitol Hill Republicans may face a harder time advancing high-priority initiatives on infrastructure, tax reform and immigration. They might also find themselves navigating strained relationships among themselves.
For much of Wednesday, the Freedom Caucus’s message, spokeswoman Alyssa Farah tweeted, was: “Start over.”
At the same time, four more Republican moderates — Reps. Charlie Dent (Pa.), Frank A. LoBiondo (N.J.), Daniel Donovan (N.Y.) and David Young (Iowa) — announced their opposition Wednesday, increasing pressure on leaders to win over the conservatives.
Ryan summoned more than a dozen members of the moderate Tuesday Group to his office late Wednesday in an apparent bid to curb further defections. One participant, who spoke on the condition of anonymity to describe the private meeting, said Ryan and other House leaders described the potential deal with the Freedom Caucus, which would strip essential health benefits but leave other ACA mandates, such as those dealing with preexisting conditions and coverage of adult dependents, in place.
“People got to say their piece and react to the proposal. It’s safe to say people had concerns about stripping out essential health benefits, especially at this late hour,” the Tuesday Group member said. “I think they’re short [of votes], and I think they’re considerably short … I’m not sure where all this goes tomorrow.”
Conservatives are seeking to eliminate more of the ACA’s insurance mandates, known as “essential benefits,” which require plans to cover specific medical benefits, such as mental health care, prescription drugs and preventive care. That, conservatives argue, is the only reliable way to force down premiums.
Ryan warned in an interview Wednesday with conservative radio host Hugh Hewitt that fulfilling those GOP demands would violate Senate budget rules and leave the bill vulnerable to a blockade by Democrats.
“Our whole thing is we don’t want to load up our bill in such a way that it doesn’t even get considered in the Senate,” the speaker said. “Then we’ve lost our one chance with this one tool we have.”
That stance appeared to shift late Wednesday, when separate aides in the White House and the House GOP leadership said a new interpretation of Senate rules had raised the possibility that acceding to the Freedom Caucus’s request might not threaten Senate consideration of the whole bill. But both aides said the provision could still be stripped out once the bill reaches the Senate.
Democratic Senate aides insisted that would be the case. “What the proponents aren’t telling conservative House Republicans is that the plan to repeal essential health benefits will almost certainly not be permissible under Senate reconciliation rules,” said Matt House, a spokesman for Senate Minority Leader Charles E. Schumer (D-N.Y.).
As things stand right now, there are more than enough House Republicans on record as opposed to the AHCA to prevent it from passing the House today, mostly due to the opposition of the House Freedom Caucus and the fact that several conservative activist organizations are “key voting” the bill and threatening to primary any Republican who votes in favor of the bill. Additionally, and largely in response to a threat from President Trump that opponents of the AHCA would pay a political price in 2018, the Koch Brothers and other top conservative fundraisers are pledging to create a multi-million dollar defense fund for Members of Congress who vote against the bill. Given all of this, the most likely outcome today would seem to be either that the bill does not get placed on the floor in order to avoid an embarrassing defeat so early in the new Administration or the bill gets changed sufficiently to meet the concerns of the House Freedom Caucus that Speaker Ryan and the leadership end up getting the votes they need to get the job done. Absent that, or a last-minute change of mind by members who have already announced their opposition, the bill is likely to go down to defeat in the House and Republicans will be forced to return to the drawing board. This is why it’s likely that we won’t see a vote at all unless leadership is as sure as they can be that they’ll get the votes they need, and more, to pass the bill.
If Republicans do make changes to the bill to appease the Freedom Caucus, however, they may further doom whatever chance the bill might have in the Senate. As things stand right now, it’s not at all clear that the bill could pass the Senate even under reconciliation rules that would allow the GOP to get around the requirement for sixty votes needed to invoke cloture and end a filibuster. So far, several Senators have announced their opposition to the bill in its present form and have either united behind Kentucky Senator Rand Paul, who has his own ‘Repeal and Replace’ bill that is unlikely to get more than a handful of supporters in the Senate, or have announced their opposition to the AHCA for other reasons, including how it treats states that took advantage of the Affordable Care Act’s Medicaid expansion. Additionally, Republicans face the paradox that any changes they make to the current bill to appease the Freedom Caucus, which includes changes such as eliminating the minimum benefits requirements of the Affordable Care Act, make it more likely that Republican Senators will oppose the bill in the upper chamber, meaning that House leadership would essentially be asking members to put their seats on the line for a bill that has almost no chance of passing. Finally, there’s a good possibility that if the House makes the changes the Freedom Caucus wants it will change the bill so much that it would no longer qualify for consideration under the Senate’s reconciliation rules, meaning that it would be even more certain that the bill would die in the Senate.
As things stand, the leadership is planning for a vote around 7 pm tonight. Realistically, it’s more likely that if there is a vote it would be much later tonight if not early tomorrow morning. And even more realistically, my guess is that we might not see a vote at all this week and that Republicans will pull the bill while they try to figure out what to do next.
Update: Politico is reporting that a morning meeting between President Trump and members of the House Freedom Caucus failed to produce a deal:
President Donald Trump failed to reach a deal with members of the conservative House Freedom Caucus to amend the Republican Obamacare replacement bill ahead of an expected vote later Thursday.
Many lawmakers from the three-dozen-member caucus huddled at the White House with Trump and his senior leadership team, but they emerged without guaranteeing their support for the GOP bill. With little margin for defections and eroding support from moderates, House leaders need most Freedom Caucus members to support the bill.
President Donald Trump will engage in the most high-stakes negotiation of his young presidency Thursday, as he tries to sell hard-line conservatives on a GOP Obamacare replacement they despise.
Trump will huddle with the arch-conservative House Freedom Caucus at the White House, just hours before Speaker Paul Ryan is set to bring the bill to the floor for a vote.
There were daunting obstacles to a deal heading into the decisive meeting.
A number of Freedom Caucus members have suggested Trump’s latest concession — repealing Obamacare’s mandate that insurance plans provide a minimum level of “essential” benefits — isn’t enough. The group wants a complete repeal of all Affordable Care Act regulations — including popular provisions Trump promised he would maintain.
The conservatives’ target list encompasses a prohibition against discriminating against people with pre-existing conditions and a requirement that adults up to age 26 can remain on their parents’ health insurance.
“Repealing [essential health benefits], w/out making other substantial changes, would make the bill worse, not better,” tweeted Freedom Caucus member Justin Amash (R-Mich.). “It would hurt the sickest people on exchanges.”
If Trump fails to clinch an agreement with the group, the Republican effort to repeal Obamacare will be all but dead.
Additionally, White House Press Secretary Sean Spicer said in his briefing today that the White House has delivered its final offer to the Freedom Caucus and that there is no “Plan B” to amend the bill any further to try to get the votes needed for it to pass. As things stand now, this means the Freedom Caucus is not on board and the bill in its present form would not pass.
Update: Politico’s Capitol Hill Bureau Chief is reporting on Twitter that there will be no vote on the AHCA today:
NEWS – No AHCA vote today, per GOP source. Still possible tomorrow
— John Bresnahan (@BresPolitico) March 23, 2017
/2 Notice will be going out to members in a couple minutes. There will be procedural votes
— John Bresnahan (@BresPolitico) March 23, 2017
/3 GOP Conference mtg at 7 pm
— John Bresnahan (@BresPolitico) March 23, 2017
This would be a big, early political loss for Republicans and the Trump Administration.
I don’t think they will fall in line. Too many of them are aware this puts a noose around their neck come election time.
So now we will see how His Orangeness deals with the GOP not giving him carte blanche. Will he turn on them, tweet vicious rumors and incite the faithful against his (nominal) own? Will the GOP take that lying down or are they going to go back to their stubborn FU roots vs the King of FU gestures?
If there wasn’t so much at stake, this would be a great reality show.
The fact that they’re eager to shove this piece of cat’s hairball into law even before hearing what the CBO says about it shows that Republicans don’t give a crap about who will be thrown off the liftraft.
May they all get pre-existing conditions and have to try to buy health insurance from the New Improved health insurance providers.
The Trumpkins must be in a true muddle. On the one hand, they hate Paul Ryan, and this is his baby. On the other hand, they adore Trump, and he thinks it’s wonderful.
What to do, what to do….
I asked Sen. Roberts if he supports scrapping Essential Health Benefits. “I wouldn’t want to lose my mammograms,” he snarked.
Imagine being a politician and joking about how annoying it is for a man to pay for mammograms. He’s basically 12.
It should be easy. Trump said:
(Sept 2015, 60 minutes)
So, plan B: Single Payer?
I’ll not hold my breath.
FTFY
I have no idea why Democrats are too stupid to quote the numbers. “If you pass this bill, [X] people will die, in order to fund a tax cut for the rich. It would be more efficient to just go harvest their organs now and sell them on the black market.”
Make them own their manslaughter.
You know it’s a bad plan when the prime argument for voting for it is: “It will make us look bad if we don’t pass it” versus arguing the bill on its merits.
Also, they are all going to have to admit they didn’t have time to read it. They don’t know what are the financial and medical ramifications of the bill. And they will have to pass it to find out what is in it.
If it fails maybe they’ll recognize ryan as the incompetent catalog model he is and fire him?
Someone else said it best yesterday…I’m tired of all this winning, already.
@KM: Trump actually told the Republicans to wait until next year for health legislation and they went ahead anyway, demonstrating yet again that Ryan is a dope.
According to a Quinnipiac University poll:
56% disapprove of this bill
17% approve
26% don’t know
Imagine…more people don’t know, than approve.
61% disapprove of Trumps handling of it
29% approve
10% don’t know
That’s a lot of winning.
[full disclosure; QU is our firms biggest client, and I have worked almost exclusively on QU projects for over 15 years]
But I thought Trump was the greatest businessman of all time at closing deals. This is unpossible!
What a dud for President Pud!
@Modulo Myself:
The current Republican crew doesn’t even bother to mask their contempt for women’s health.
By the way, Senator Pat Roberts is a Kansas Republican, these are the “Back to Zero” people – like former senator now governor Sam Brownback, dedicated to deconstructing government programs at every level.
You know, It would have been good to hear a female senator come back with, “we left in coverage for Erectile Dysfunction drugs because we wouldn’t want our Republican male senate colleagues to have to end ‘relationships’ with their escorts… just kidding Pat, just kidding”
@al-Ameda: Same for the argument for maternity care. As if men didn’t have anything to do with the need for maternity care.
Vote postponed.
And down goes Ryan! Oh, he took a hard right to the chin and a weak left to the gut and he is down and bleeding on the canvas as in the first row of spectators John Boehner laughs and laughs.
You know how a sunspot is in reality very bright, but it looks dark because it’s right next to the whole sun? Paul Ryan looked like a wonk only because he was standing next to the other republicans.
They’re making noises about having a vote tomorrow but I wonder if this isn’t simply another case of bluffing.
Whatever happens, I hope it makes Trump mad enough that he goes after the House and Senate Republicans.
@grumpy realist:
Dead on.
I also hope that representatives of the Koch Brothers show up with briefcases of cash, and buy off Republican representatives right there on the floor of the House.
That Trump…he’s an amazing closer.
prediction: they will eventually pass something out of the house. but then it’s going nowhere in the senate.
here’s photo of people who want to take away women’s maternity coverage and mammograms.
https://twitter.com/VP/status/844977432713146370/photo/1?ref_src=twsrc%5Etfw&ref_url=http%3A%2F%2Fwww.vox.com%2Fidentities%2F2017%2F3%2F23%2F15041620%2Fahca-men-maternity-coverage
If they don’t vote before the “no EHB” CBO score, they never will. That combination will result in junk plans priced at subsidy level, so everyone will use the subsidies and the deficit “savings” will evaporate.
And here are some photos of a 70 year old man pretending to drive a truck.
http://nymag.com/thecut/2017/03/donald-trump-had-a-big-day-of-playing-with-trucks.html
Winning.
Didn’t they already vote to repeal Obamacare 73 times or something? I wonder what could be different this time around?
Roberts has a thing or two to learn. Men get breast cancer too, and mammograms are a means of detection. The American Cancer Society predicts 2,470 cases of breast cancer in men for 2017, with 460 expected to die from the disease.
The lot of them are horrid.
@Daryl’s other brother Darryl:
Love the pic of him with his little fists clenched and his face all screwed up in an epic toddler tantrum
Gawd, he’s loathsome.
@Daryl’s other brother Darryl:
Leave it to Trump to reprise that perennially embarrassing “Dukakis in the tank” moment.
Trump really is the most embarrassing thing American voters have done, ever.
@Modulo Myself: Roberts has a wife, Franki. I wonder what she thinks of this?
Of course, she’ll get regular mammograms because they’re wealthy and can afford it. It’s all the grubby poors and brown people who will suffer, and we know the Republicans don’t give a shit about any of them.
My mom’s a breast cancer survivor, 32 years since her mastectomy. A mammogram detected hers in time. Fvck the Republicans who want to take that chance away from women today, take them away from their sons for those 32 years (and counting).
I love this bit i saw somewhere:
“So the greatest dealmaker in the world can’t convince his own party to pass the bill that they wrote.”
Let me add my brief ideas here, which I have probably explained before.
If people like their Obama Care plan, then they should be able to keep it.
There should be a basic plan that is free to anyone who wants it: not a “Cadillac” plan, but “Ford ” if you please. Then offer options, much like the plans b, c, d and so on that go along with Medicare. These would be at a cost, of course, but would cover dental (orthodontics), vision, certain cosmetic – plastic surgery procedures, gym memberships, spas, and other items that some people would want. Much like the satellite tv channel options that I have or like buying a new car and you have all those options. This would bring more people in, more young people, and more money flow; which has been a big problem under Obama Care. You have to offer young people some exciting incentives and attractions in this deal. When I was young, health insurance was not on my mind. These would be tax deductible. Young people would still be allowed to stay on their parents plan if they wish. I think that this would bring virtually everyone some kind of coverage and protection. This would please virtually everyone.
The brackets are getting tighter.
It’s extremely disgusting that Ryan and his wrecking crew tried to get more Republicans to vote for this steaming pile of horseshit by actually being more cruel to more people regarding their health insurance options…Hillary should have directed her “deplorable” comments at Republicans in Congress, although “deplorable” isn’t a strong enough adjective to describe these incompetent ghouls…
I simply can’t understand why a man who was interviewed by the ghostwriter for The Art of the Deal is unable to finish this negotiation.
@Tyrell:
You must be an internet performance artist. No one could genuinely be that stupid.
Now Trump is really playin’ hardball: If the Republicans don’t pass the Trumpcare bill, then he’s going to…er, give up.
https://www.washingtonpost.com/powerpost/gop-health-care-plan-hangs-in-balance-as-house-leaders-push-for-thursday-floor-vote/2017/03/23/6e8bf05a-0fbd-11e7-9d5a-a83e627dc120_story.html
That will learn ’em. This must be the art of the squeal.
I have an idea. How about we all just accept the fact that Obama got all he was going to get at that point in time, and that he did a damned good job. Because for all the whining that’s what I’ve believed from the start. Of course it’s not flawless, nothing ever is, but it was good work. And the proof of that is that Republicans simply cannot figure out an alternative which is not catastrophically worse.
@Modulo Myself: Worse than that, although it’s rare, men DO get breast cancer. See Roundtree, Richard IIRC.
Yes! IDRC! http://abcnews.go.com/Health/OnCallPlusBreastCancerNews/story?id=4028791&page=1
@Daryl’s other brother Darryl: Ya know, considering what he pays for them, his suits are not particularly well cut or constructed.
@Tyrell: So basically, your in favor of changing health care to what we got with Obamacare except that people who are happy with the Obamacare that they have now should be able to keep it. Did I get that right?
Politics is weird. Barack Obama pulls off one of the greatest legislative accomplishments since the New Deal in passing health care reform and got less credit for that success than Hillary Clinton did for her epic failure at the same thing. Meanwhile, the Republicans literally spend 7+ years campaigning against what Obama did, only to demonstrate that they have no clue what to actually do about it.
Even as badly as the GOP screwed up immigration, and that’s what really gave us Trump, there were at least some people in the party who understood the issue and what needed to be done. They were just stymied by their years of demogoguery. But their stupidity on health care covers both the politics and the basic nuts and bolts of policy.
The dilemma going forward, however, is that for all the positive things the ACA does, it has some real problems…and it appears as if no one is going to have the political ability to do anything about them.
Mike
@Just ‘nutha ig’nint cracker:
Tyrell is either trolling or else is under the impression that he knows more about setting premiums than anyone who works in the health insurance industry.
If Tyrell ran a steakhouse, then he would sell filet mignon for 59 cents and would be shocked when the restaurant later filed bankruptcy.
1. Republican legislators (esp. in the House) can no longer do the actual process of crafting legislation that can pass both houses and be signed by the President. It is a skill and an art that none of them are adept at or have experience in.
2. Republicans are currently the natural opposition party. This rides on point 1; they have have great skill and experience at killing legislative goals and have no skill or experience at advancing legislative goals. You say: how can the Party that controls the House, the Senate, and the Presidency be the “opposition party”? Answer: they are built as a national party for “No” not “Yes”
3. Republicans cannot count votes. (They used to be able to, this point rides on #2: it is an upshot of casting your movement as the opposition. If you’re the embattled opposition counting votes is a crass abandonment of your principles and values.
4. Republicans cannot compromise. (See point 3). One must win absolutely and definitively and drive your opponent into dust. Anything less is an affront to the fore mentioned principles and values.
5. The animating principle and value that the Republicans treasure is pissing off liberals. (see cleek’s Law).
the websites i visit used to be about 10% trump supporters.
that’s down to like 2% lately.
@de stijl:
I don’t want to sound too negative.
Republicans rock at virtue signalling.
Just like any Social Justice Warrior should.
@de stijl:
Good post. The ultimate example, for me, has always been that moment in 2011 when Boehner tried to sell a bill raising the debt ceiling to his caucus on the following grounds: “President Obama hates it. Harry Reid hates it. Nancy Pelosi hates it.” And if you think that was just Boehner’s sad attempt to mimic right-wing logic, keep in mind that Allan West was soon echoing the same argument: “Boehner Plan is not a perfect bill. However, the fact Pelosi, Reid and Obama hate it doggone makes it perfect enough.”
Even now, it is the unstated principle fueling their entire hatred of Obamacare. Should they pass the current bill or something similar and it becomes the law of the land, historians looking back at this era will be scratching their heads. It’s not something that can readily be explained in terms of ideology.
Remember back to the 2008 Republican primaries, when John McCain was the RINO exemplar? A lot of people forget that the candidate whom the right was most enamored with at the time was none other than Mitt Romney. He was endorsed by virtually all the talk-radio gabbers–Limbaugh, Hannity, Beck, Ingraham, Levin, Prager, Hewitt. Limbaugh said that he embodied the “three legs of the conservative stool.” Not everyone on the right was convinced–his recent and unconvincing conversion on the abortion issue did receive some attention at the time. But his signing of the law that was to become the blueprint for Obamacare was barely noticed by anyone at the time. In fact, several right-wing stalwarts including Hugh Hewitt and future Tea Party star Jim DeMint suggested the Massachusetts law be a good basis for federal legislation on health care.
It’s true that in America there have always been conservatives and libertarians opposed in principle to universal health care of any kind, and before Obamacare health-care reform rarely placed high on the list of Republican priorities. (Bush proposed a sort of reform plan in 2004 involving tax credits, but he never bothered to pursue it.) But in terms of the basic policy positions of the GOP as a whole, the centrality and intensity of their hatred that has built up over the past 8 years is completely arbitrary. There is nothing, literally nothing, about either Obamacare or the party’s prior views on health care that would explain why it would provoke the unified and visceral contempt that we have seen, other than that Obama is the one who passed it.
Trump has, wittingly or not, made that very clear. Unlike many other members of his party, he has never bothered to maintain the pretense that his opposition to the law has much of anything to do with conservative beliefs. The man who once praised Canada’s health care system (which is quite literally “Medicare for all”) has stated repeatedly that any Obamacare replacement would cover everyone and that the government would pay for it. Of course absolutely nothing he’s proposed, the current bill included, would have anything close to that effect. But it demonstrates the utter vacuity of what they are trying to do. They’re dropping a bomb on everyone (including themselves) for no reason, because that’s the inevitable consequence of basing policy on pure spite.
This attempt by Trump to stampede everyone into voting for Ryan’s pet project reminds me of a sleazy barker trying to get you to put your signature down on a time-share in the Bahamas.
the american right-wing is authoritarian. Authoritarians believe they are the only legitimate rulers. Just two days ago i saw a fb post “no democrat is legitimate”. The right-wing doesn’t control the media, the judiciary, or academia, so they hate all three. And hateful authoritarians want vengeance. That seems to me to explain the “if liberals hate it, that’s good enough for me.”
@Kylopod:
That’s certainly a part of it, but I think you hit the other part earlier in your post — namely, liberals value it. We really have gone all the way to the “dog in the manger” scenario — the GOP literally does not care about anything except vandalizing the things liberals value, regardless of the consequences to the country. GOP politicians probably split down the middle between those who only want to vandalize liberal accomplishments to win votes, and those who are part of the base that just wants to lash out.
@Tyrell: Congratulations. You’ve essentially reinvented a Swiss-style single-payer system ;-).
@DrDaveT:
I don’t see those two factors as distinct–I think they go hand in hand. There are plenty of things liberals value–sometimes more than health care–but only one of them happens to be the signature achievement of the last Democratic president.
“you’ll never have to lift the seat there’s no one here but men!”
https://www.youtube.com/watch?v=-m-xZ4gz4MM
Thank You Martin Mull
(Trigger Warning! Bare Naked Male Bum!)
@MBunge:
That’s an odd way to try and point out the GOP isn’t yet interested in improving Obamacare.