Exactly one month after Trump was humiliated by his own party, when in the last moment the House failed to get the number of votes to pass a Republican healthcare bill due to holdouts from the conservative Freedom Caucus, the president's second attempt to repeal Obamacare before his first 100 days in office run out, appears on the edge of failure. However, whereas the latest effort succeeded in appealing to the conservatives who caused the first vote to be pulled in the last moment, this time is the moderates who are about to pull the plug on Trump's - and Paul Ryan's - second attempt to overhaul Obamacare.
As a reminder, in order to appeal to conservatives, the revised bill was negotiated by centrist Rep. Tom MacArthur (R-N.J.) and conservative Rep. Mark Meadows (R-N.C.) and was meant to allow states to opt out of some of ObamaCare’s requirements, which however could result in people losing their current health coverage or facing much higher premiums. While the changes aimed at winning over conservatives, proved successful, in the process the new bill might have lost just as many centrists. According to the latest roll call by The Hill, at least 21 Republicans have said they would vote no on the revised GOP healthcare bill. Only 23 votes are required to kill the bill.
"The mood is still guardedly optimistic," said Representative Chris Collins, a moderate and Trump ally who supports the bill. "There are, I’m going to say, still some 'lean no's' that we’ve just got to get over the hurdle ..."
The "no" votes include Reps. Patrick Meehan (Pa.), Ryan Costello (Pa.), Barbara Comstock (R-Va.), Jaime Herrera Beutler (Wash.) and John Katko (N.Y.), all centrists who had reservations about the previous ObamaCare repeal bill that was pulled from a floor vote last month because of a lack of GOP support. The Hill adds that on top of that, a trio of usually reliable Republicans — Foreign Affairs Committee Chairman Ed Royce (Calif.), Adam Kinzinger (Ill.) and Mario Diaz-Balart (Fla.) — said that they were undecided on the new bill after saying they were yes votes on the earlier legislation.
“I’m absolutely undecided,” Diaz-Balart, a member of the GOP whip team, told The Hill. “I was a yes before, but there are a lot of red flags” with the revised bill.
It also remains unclear how dozens of other Republicans would vote this time, but the number of Republicans publicly opposed or leaning against the bill is enough to raise doubts about whether the House would pass it in its current form. In fact, just two more no votes would be sufficient to end the latest push.
Centrists opposed to the new bill are largely echoing Rep. Charlie Dent (R-Pa.), who said the negotiations between Meadows and MacArthur only exacerbated his earlier problems with the bill. Dent, in an interview on MSNBC’s “Morning Joe” on Thursday, said he worried that people with pre-existing health conditions might be left without insurance because of the changes, something supporters of the bill have fiercely denied.
Many members of the centrist Tuesday Group members complained that the MacArthur-Meadows amendment pushed the bill too far to the right, and they privately griped that MacArthur had shifted blame for the stalled healthcare effort from conservatives to centrists.
The White House has kept the pressure on GOP leaders to hold a vote by President Trump’s 100th day in office, Saturday. But they say they won’t bring their revised bill to the floor until they secure the 216 needed GOP votes. And right now, they acknowledge, they don’t have them.
Speaking earlier on Thursday, Paul Ryan said that “I think we’re making very good progress. … We’re going to go when we have the votes, but that’s the decision we’ll make when we have it." For now, however, there is no indication of progress, in fact quite the opposite.
There are other considerations among voting republicans, many of whom are up for reelection next year and are "running scared." According to the Hill, one moderate Republican was overheard in a House cafeteria this week telling an aide: “If I vote for this healthcare bill, it will be the end of my career.”
Finally, there are significant doubts about whether the legislation would go anywhere in the Senate.
Several Senate Republicans have raised questions about the bill, making it unclear whether it could win 50 votes in the upper chamber.
And Senate Democrats have said that parts of the bill, including the new language, would run afoul of special budget rules the GOP is using to avoid a filibuster. That means those sections might have to be ripped out of the bill to prevent it from being dead on arrival in the Senate.
Should Friday come and go with no healthcare vote, there won't be dramatic consequences, but it will mean even more embarrassment for Trump, who will have been defied by his own party twice in the span of 100 days.
There is a silver lining, if only for markets: with Democrats warning they "will not support a stop gap bill" to fund the government after Saturday if there is a healthcare bill this week - thus potentially resulting in a government shutdown - at least the government will stay open for one more week. How a long-term deal can be achieved in one week, however, with animosity between the left and right growing by the day, remains very much unclear.