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Paul Ryan, Donald Trump Lose The Battle, Postpone Vote On ACA Repeal

Trumpcare Vote Delayed After Last-Minute Opposition

WASHINGTON ― With conservatives unable to find a deal and leadership unable to find the votes, House Republicans pulled their health care bill from the floor and delayed a vote that had been scheduled for Thursday.

“No vote tonight,” a GOP leadership aide said.

Conservatives have teetered between strongly opposing the GOP health care bill and looming support. The House Freedom Caucus has negotiated with the White House on potentially eliminating Essential Health Benefits and some unknown provisions in Title I of the Affordable Care Act. That expansive section of the 2010 health care law Republicans are trying to repeal includes provisions requiring coverage for people with pre-existing conditions and allowing young adults to remain on a parent’s plan until they’re 26 years old.

The last-minute renegotiation of the bill spooked moderates, whose trickle of opposition became a steady stream throughout Thursday. Rep. Charlie Dent (R-Pa.) ― the head of the Tuesday Group, which is made up of roughly 50 moderate House Republicans ― announced his own opposition.

The delay also comes one day after White House press secretary Sean Spicer agreed with chief deputy whip Patrick McHenry (R-N.C.)’s assessment that President Donald Trump is “the closer.”

The vote delay, while not the floor defeat that the Freedom Caucus and reluctant moderates had been promising, is still a huge loss for congressional leaders like House Speaker Paul Ryan (R-Wis.) and House Majority Leader Kevin McCarthy (R-Calif.), as well as for Trump.

Trump has come to own the American Health Care Act, even making a direct pitch during a closed-door meeting with House Republicans on Tuesday. The continued opposition to the bill may be the first signal that Trump’s political capital doesn’t run very deep in the House GOP conference, and that Republicans, particularly conservative ones, aren’t afraid to cross the president.

Trump’s vaunted dealmaking skills have failed him so far, however. He didn’t pick up any new support by offering to eliminate Essential Health Benefits from the bill, but instead lost a wave of moderates and made the measure more politically toxic than it had been.

Lawmakers emerging from an evening caucus with leaders and Trump administration figures said it was still unclear if there would be the votes on Friday, but they intended to push ahead anyway.

The compromise that emerged was said to be a take-it-or-leave-it final offer from the White House that would let conservatives eliminate certain essential benefits from insurance requirements, such as maternity care and mental illness treatment. To appease moderates concerned too many people will be tossed from the health insurance rolls, the deal includes keeping a 0.9 percent Medicare surcharge tax from the Affordable Care Act on high-income earners for six years. That would add about $15 billion to a fund to help states defray costs.

“We didn’t even discuss votes,” said Rep. Chris Collins (R-N.Y.), one of the biggest boosters for the repeal. “This was a plea one-on-one-on-one for the entire conference to come together as a team, to look in the mirror, understand we are the governing body.”

A procedural vote was expected at 10 a.m. Friday, followed by a vote on passage of the bill in the afternoon.

Some lawmakers were pushing to hold a vote on the bill itself as soon as possible, regardless of whether too many of their colleagues were publicly opposed. Ryan can afford to lose 21 or 22 members, depending on how many lawmakers are present, and still succeed. The Huffington Post’s count has him losing well more than that.

“Some of them that are at least indicating to y’all that they’re going to vote no are going to vote yes,” Rep. Bradley Byrne (R-Ala.) told reporters outside of Ryan’s offices, arguing that the longer past midnightThursday the vote goes, the less likely it will succeed.

“Time to make a decision, gentleman and ladies,” Byrne said. “And this is one of those moments where you’ve got to say who you are deep inside of you. Are you for President Trump and repealing and replacing Obamacare, or are you against President Trump, and you are against repealing and replacing Obamacare? It’s that simple.”

After House leaders delayed the vote, the Congressional Budget Office released a fresh analysis of the bill, which had already been revised once.

The budget scorekeeper’s assessment found the revised bill would save less money than the original but have similar poor outcomes. As with the original version, 24 million fewer people would have health insurance by 2026. Premiums would also rise 10 percent to 15 percent in 2018 and 2019 ― then wind up 10 percent lower by 2026, after high prices drove older customers from the market. The new version of the bill would cut just $150 billion from the deficit over 10 years, while the original legislation would have cut $337 billion.

The new CBO estimates did not include the new potential changes that are currently being discussed in an effort to win over conservatives, such as eliminating portions of the Affordable Care Act that require insurers to sell plans covering a set of basic benefits.

This article has been updated with the evening caucus of House Republicans with Trump administration figures.

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