GOP Leaders Weigh Saturday Health Bill Vote Amid New Support

  • Proposed amendment sways some, but moderates still opposed
  • White House is optimistic, but trying to downplay expectations

U.S. House Representative Mark Meadows discusses tax reform and rates President Trump’s actions thus far. He speaks with Bloomberg's Kevin Cirilli on 'Bloomberg Markets.' (Source: Bloomberg)

House Republican leaders are considering holding a quick vote on their embattled health-care bill after a group of conservative holdouts endorsed a revised version.

Facing White House pressure to pass the bill, the Republican vote-counting team is trying to gauge support for a vote Saturday, according to a Republican aide familiar with the process. But it’s unclear whether the changes will win over any moderate holdouts, or even cause some defections among those who supported the earlier version.

The health bill and a pair of amendments were posted late Wednesday on a House website listing bills that may be considered by the full chamber this week, the strongest signal yet that GOP leaders think they may have the votes to send the measure to the Senate.

White House budget director Mick Mulvaney told CNBC on Thursday that a House vote on the measure could happen next week or earlier. “I’m still holding out for Saturday,” he said.

Saturday would mark President Donald Trump’s 100th day in office, although that milestone is more important to the White House than to House leadership, the aide said. Last month’s failed push to repeal Obamacare on the seventh anniversary of that bill becoming law was scrapped when it became clear that Republicans lacked the votes for their own plan.

The bill got a new lease on life Wednesday when the conservative House Freedom Caucus, which helped derail the measure last month, formally endorsed the latest draft.

“While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower health-care costs,” the group said in a statement. “We look forward to working with our Senate colleagues to improve the bill.”

Other undecided Republicans "are so close to yes that I’m very optimistic whether the vote is tomorrow or Saturday or next week, the votes will be there to actually pass this," Freedom Caucus Chairman Mark Meadows said Thursday on Bloomberg TV.

Representative Charlie Dent of Pennsylvania, a leading Republican centrist, said he believes most moderates remain opposed. He called the new version an effort at “blame-shifting” for the failure of the repeal effort.

House Republicans have been under intense pressure to deliver on years of promises to repeal Obamacare, but GOP leaders weren’t making predictions of an imminent vote despite the pressure from the White House.

The new enthusiasm stems from an amendment that would give states the authority to apply for waivers from some of Obamacare’s requirements under certain conditions.

"It’s pretty much everything I was looking for in terms of concessions,” said Representative Scott DesJarlais of Tennessee, a member of the Freedom Caucus who had opposed an earlier version.

House Speaker Paul Ryan told reporters Wednesday the amendment provides “a great way to lower premiums, give states more flexibility while protecting people with pre-existing conditions.” When asked whether the House will vote next week on the health-care bill, he said, “We’ll see. We’ll vote on it when we get the votes.”

Still ‘Cautious’

“Cautious,” said Representative Phil Roe of Tennessee, a medical doctor, of the approach that House Republican leaders are taking. Representative Steve Chabot of Ohio said everyone is proceeding quietly so that nothing happens “to blow everything up.”

There are complications, including the revelation that the new amendment would treat health coverage for lawmakers and their staffs differently by barring waivers for their insurance plans.

Changes to the bill may also make it more difficult to pass the Senate. “It will be harder for the Senate to get 51 Republicans,” Republican Senator Roy Blunt of Missouri, a former House majority leader and longtime whip, said Wednesday.

The White House, which has been involved in discussions about the changes, is still eager to resurrect the health-care bill.

“We’re not going to overpromise anything; when the votes are there, the speaker will bring it to the floor but no sooner than that,” White House chief of staff Reince Priebus told reporters late Tuesday. He said he didn’t know if that might be this week or next.

Repeal of the Affordable Care Act was a major Trump campaign promise and a longtime goal of House Republicans. 

Growing Support

“We probably had about half of the members of the Freedom Caucus in the first go-around,” White House legislative affair director Marc Short told reporters Tuesday. Short said he thinks the health-care bill could be passed before the GOP tax measure is introduced in the next four to six weeks.

Meadows said Thursday the revised plan is backed by more than 80 percent of the Freedom Caucus, a group of about three dozen staunch conservatives. Opposition from many in that group -- who wanted a more robust repeal -- along with skepticism from many Republican moderates, was pivotal to Ryan’s decision last month to abruptly scrap a vote on the bill for lack of votes.

On Tuesday, members of the Freedom Caucus who previously didn’t support the bill, including Representative Dave Brat of Virginia, and DesJarlais said they now support the measure.

State Waivers

The amendment would allow insurers to charge higher premiums to people with pre-existing conditions in states that get a waiver. To obtain the waiver, states would have to provide sick people priced out of commercial insurance with access to a so-called high-risk pool run by the federal government, or establish their own, and satisfy other conditions.

Even Mo Brooks of Alabama, a conservative who opposed the previous version, said he’s considering the amendment.

“I believe there will be some movement,” he said. “I don’t know how much.”

Dent, however, said the bill doesn’t provide a “soft enough” landing for states that expanded Medicaid, and still doesn’t provide sufficient support to help low- and middle-income people, in his view.

Pressure from the White House and support from conservatives could put intense pressure on moderates to vote for the bill. But those moderates in swing districts, unlike the members of the Freedom Caucus, could end up losing their seats if the repeal bill continues to remain unpopular.

“I will vote my conscience,” said Representative Leonard Lance of New Jersey, who said he also remains opposed.

— With assistance by Shannon Pettypiece, Margaret Talev, Erik Wasson, Arit John, Sahil Kapur, and Steven T. Dennis

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