WASHINGTON

Damn the torpedoes: GOP sets Friday vote on health care despite opposition

Erin Kelly, Eliza Collins and Deirdre Shesgreen
USA TODAY

WASHINGTON — President Trump called for a vote on the Republican plan to repeal and replace Obamacare — even if it doesn’t pass — and Speaker Paul Ryan, R-Wis., complied, scheduling a Friday vote on a bill that may not have enough Republican support to pass.

In a closed-door meeting with all House Republicans Thursday night, Office of Management and Budget Director Mick Mulvaney said that the president was done negotiating and ready for the party to come together behind an amended bill to repeal and replace Obamacare.

Rep. Chris Collins, R-N.Y., told reporters at the Capitol that Mulvaney’s message was: “The president needs this, the president has said he wants a vote tomorrow. If for any reason (it fails) we’re just going to move forward with additional parts of his agenda. This is our moment in time but the president is insisting on a vote one way or the other.”

Collins said the message from the administration — Stephen Bannon, Reince Priebus and Kellyanne Conway also attended the meeting — was that negotiations were over and it was time to act.

The announcement follows a day of back-and-forth between the White House, House leadership and rank-and-file Republicans unhappy with the current bill. Republican leaders were forced to postpone the planned vote after it became clear they could not get enough support from their own party to pass the legislation.

Collins said the final offer was a new amendment that will repeal "essential health benefits," 10 services Obamacare plans are required to cover, including prescription drugs, hospitalization and maternity care. The new version of the bill will also retain a 0.9% tax on high income earners for six years which would generate $15 billion additional dollars for states to fund health programs.

Slashing the essential health benefits is an olive branch to conservatives who don't believe insurers should be required to offer that coverage to all customers.

It was not immediately clear if the deal would win enough support of the conservatives who were balking or the moderates who were unhappy about changes that moved the bill to the right.

Rep. Dana Rohrabacher, R-Calif., said if Republicans vote this down, it will “neuter” Trump’s presidency.

Rep. Mark Meadows, R-N.C., who leads the conservative Freedom Caucus which has said it has enough members to sink the bill, told reporters that negotiations still weren't over.

"Anytime you don't have 216 votes negotiations aren't totally over," Meadows said. When asked about Trump's message that he would leave Obamacare in place if the bill did not pass Meadows responded: "I think we have all campaigned on getting rid of Obamacare."

"There's a good chance it fails if there is a vote tomorrow," said Rep. Thomas Massie, R-Ky., adding that they shouldn't vote for a bill they haven't had time to read.

House Speaker Paul Ryan walks to his office on Capitol Hill on March 23, 2017, as he and the Republican leadership scramble for votes on their health care overhaul in the face of opposition from reluctant conservatives in the House Freedom Caucus.

After the meeting, the House voted 233-185, along party lines, to approve a procedural measure that clears the way for a Friday vote on the health care bill.

The tumult on Capitol Hill underscored just how difficult it is for Republicans to unite their divided party and deliver on a big campaign promise despite controlling Congress and the White House.

President Trump invited both conservative and moderate factions of House Republicans to the White House on Thursday to try to win them over, but Ryan called off the Thursday night vote when it was clear that he might not have enough GOP support to approve the American Health Care Act.

Even if the bill passes, it is unlikely to be approved by Senate Republicans without major changes. Senate Majority Leader Mitch McConnell, R-Ky., said Thursday that there will be "a robust amendment process" in that chamber, where both conservative and moderate Republicans have expressed skepticism about the House bill.

Read more:

President Trump gets crash course on the art of the deal — in Washington

Why Republicans can't put everything they want in their health care bill

The House health care battle: What's at stake?

"The last few weeks of drama could have been avoided if Speaker Paul Ryan and House leadership had provided a more open process and sought feedback early on from House conservatives, including the members of the Freedom Caucus," said Adam Brandon, the president of FreedomWorks, a conservative group that has been lobbying for changes in the GOP bill.

The Congressional Budget Office said Thursday that changes made to the bill this week would add billions to its cost without reducing the number of people who would no longer have medical coverage. Like the original version of the GOP bill, an estimated 24 million fewer people would have medical coverage in 2026 compared to the number that would be covered under Obamacare. The latest version of the Republican bill would reduce the deficit by about $150 billion over 10 years instead of the estimated $337 billion under the initial version.

House Freedom Caucus Chairman Mark Meadows speaks to reporters on Capitol Hill on March 23, 2017.

Rep. Joe Barton, R-Texas, a member of the House Freedom Caucus, said he thinks "we'll get a bill. I just don't know when."

"I hope we're all adults and we don't go pout," Barton said. "We are the majority party. I hope ... we work to find a solution and get a bill soon to go to the Senate."

He said he thinks all sides are working in good faith. "Democracy is messy," he said.

House Minority Leader Nancy Pelosi, D-Calif., told reporters Thursday that Trump and House GOP leaders were so eager to pass their bill on the seventh anniversary of the signing of the Affordable Care Act on Thursday that they failed to make sure they had reached agreement within their own party on what the legislation should do.

"Rookie error, Donald Trump, for bringing this up on a day that it is clearly not ready," Pelosi said, chastising the president. "You do not bring up your bill just to be spiteful on the anniversary of the Affordable Care Act. You build consensus ... not the shortest, quickest monstrosity you can bring to the House floor."

She said the vote "is going to be tattooed on their (Republicans') heads" and they will have to take responsibility for the outcome.

House leaders had said originally that removing that Obamacare requirement could not be accomplished on this bill because it has to remain strictly focused on budget issues to get through the Senate under special procedures that require only 51 votes and do not allow for a Democratic filibuster. On Wednesday evening, Sen. Mike Lee, R-Utah, said the Senate parliamentarian had told him the insurance provisions would not necessarily violate those budget procedures.

White House press secretary Sean Spicer conducts his daily briefing on March 23, 2017.

Trump’s message to Republicans is that — while many of them have voted to repeal Obamacare dozens of times over the past seven years — the vote on the GOP bill is the only one that counts.

“You’ve taken all these votes when it didn’t matter, because you didn’t have a Republican president,” White House Press Secretary Sean Spicer said earlier in the day. “This is a live ball now.”

Thursday's scheduled vote on the GOP bill began to look shaky on Wednesday, when the Freedom Caucus announced they had enough "no" votes to kill the bill.

That touched off a flurry of negotiations into the night and continuing Thursday over changes that could still be made to win their support.

At the same time, Republican moderates began announcing their dissent. Reps. Charlie Dent, R-Pa., Frank LoBiondo, R-N.J., Chris Smith, R-N.J., and Mark Amodei, R-Nev., said that they will vote "no" on the bill, joining a growing list of GOP lawmakers who said they are concerned the plan will raise costs for their constituents, particularly seniors.

With Democrats unified in opposition to the bill, the legislation will not pass if more than 22 Republicans vote against it.

Former president Barack Obama issued a statement Thursday defending his signature law and its achievements. "If Republicans are serious about lowering costs while expanding coverage to those who need it, and if they’re prepared to work with Democrats and objective evaluators in finding solutions that accomplish those goals — that’s something we all should welcome," he wrote. "But we should start from the baseline that any changes will make our health care system better, not worse for hardworking Americans. That should always be our priority. "

Contributing: Gregory Korte