House Speaker Paul Ryan met Friday with President Donald Trump to tell him Republicans don’t have the votes to pass the GOP health care bill.
A key portion of the Trump-Ryan conversation was over the ownership of the health care bill and whether the President will take either full or partial responsibility over a decision to pull the bill, two people familiar with health care talks say.
Ryan showed Trump the numbers, and asked what the President wants the speaker to do.
The decision is largely in the hands of the White House, the sources say, and the speaker wants to make it “the President’s call.”
Efforts on Capitol Hill to sway members are ongoing, but things aren’t heading in the right direction.
“Not good. Not good at all,” the source said.
A risk to Republicans: if members are fully aware that the bill is going down, there’s a real risk that that undecideds, undeclared and even some yes votes would flee.
“The risk is it wouldn’t just be a loss, but a big loss,” a source said.
Republicans are still careening toward a House vote Friday afternoon on repealing and replacing Obamacare in a moment that has huge implications for Trump’s presidency and the GOP’s hopes of enacting an agenda that will change the face of American life.
White House press secretary Sean Spicer said Friday afternoon that Trump has “left everything on the field when it comes to this bill.”
But Republicans have few firm commitments from conservatives and watched a continued exodus of moderates. This was exactly what House leadership was worried would happen when they changed the bill, the source said.
Friday afternoon, moderate Republicans and members of the conservative Freedom Caucus have indicated they won’t back the bill.
Blame game
Trump has confidence in Ryan, Spicer said.
“I think the speaker has done everything he can,” Spicer said. “He’s worked really closely with the President. I think at the end of the day, you know I said this yesterday, you can’t force people to vote.”
But the President is said to be “agitated” by the process, an aide said, which he thinks is all “political.”
There have been whispers against Ryan, suggesting that if the bill fails it will inflict a series blow to the relationship between the speaker and the President which will be vital to moving forward the Republican agenda.
State of play
The vote, already delayed a day to give Republican leaders a chance to eke out a majority for the bill, is currently scheduled to proceed following Trump’s huge gamble in warning he would walk away from health care reform if the GOP did not follow his desires.
Spicer told reporters “you guys are so negative” as they asked about the poor prospects for the vote.
Though he said he’s done negotiating, Trump lobbied for a yes vote on Twitter on Friday morning.
“Disastrous #Obamacare has led to higher costs & fewer options. It will only continue to get worse! We must #RepealANDReplace. #PassTheBill.”
Trump started calling lawmakers early in the morning, Spicer said. “The President and his team have committed everything they can to making it happen.”
Ryan needs to get a simple majority in the House — around 216 votes depending on how many members show up to vote. He can probably afford to lose no more than 21 Republican votes.
A final vote is still expected around 4 p.m.
Freedom Caucus holding out?
Vice President Mike Pence is meeting this with members of the House Freedom Caucus at the Capitol Hill Club, a source familiar with the meeting says.
Freedom Caucus members have stood by their ideological objections to a bill they say does not go far enough in repealing Obamacare.
There are signs of frustration in the White House at the Freedom Caucus, which has won a series of concession but is still holding out against the bill.
“We’ve emboldened them,” one White House aide said.
Freedom Caucus Chairman Mark Meadows, R-North Carolina, was mum about his plans. “I’m not making any comment,” he said.
A Republican official involved in counting votes says the party thinks it needs about 25 of the roughly 36 members of the conservative House Freedom Caucus members to back the GOP health care bill if it’s going to pass Friday.
But while Mark Meadows claims lawmakers are allowed to vote their conscience, White House and GOP leadership don’t think the Freedom Caucus members take that seriously.
The Freedom Caucus traditionally votes in a block and it will be hard to break from that.
Will moderates flee?
Rep. Leonard Lance, R-New Jersey, said that without a doubt, the decision to concede the repeal of essential health benefits to the Freedom Caucus definitely moved some of his colleagues to “no.”
“I suspect some became a no because of that,” Lance said. “That certainly didn’t help.”
The northeast Republicans are the ones to watch, he said.
“New York, New Jersey, Pennsylvania — that’s where you should count heads.”
What’s in the bill
The GOP health care bill would eliminate many of the taxes and eradicate the individual mandate imposed by Obamacare, officially known as the Affordable Care Act. Instead of the Obamacare subsidies that are tied to income and premiums, the GOP plan provides Americans with refundable tax credits based mainly on age to purchase health insurance.
The bill also significantly curtails federal support for Medicaid and allows states to require able-bodied adults to work. After 2020, states that expanded Medicaid would no longer receive enhanced federal funding to cover low-income adults like they did under Obamacare, and states that haven’t expanded would be immediately barred from doing so.
However, the GOP bill doesn’t touch 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. But it would end the requirement that insurers offer comprehensive policies that cover maternity, drugs, mental health and substance abuse.
