While one can debate if last week's failed attempt by Trump to pass the GOP healthcare vote before the expiration of his 100 days in office counts as attempt #2 by the administration to repeal Obamacare, the Republicans are now back to square one, because based on the latest whip count by The Hill, the GOP again appears to lack sufficient votes to pass its Healthcare bill in the House, despite earlier reports from GOP leaders and the White House that it might be approved by the lower chamber this week.
The Hill's most recent whip list reveals 22 Republicans - mostly moderates - who oppose the bill, the maximum number of GOP defections that can be afforded, meaning the GOP is just one vote away from another failure.
The latest Republican to announce his opposition is Rep. Billy Long (Mo.), a staunch conservative who often says he was “Tea Party before Tea Party was cool.” He told The Hill he wouldn't support the bill because of the impact it could have on people with preexisting conditions.
“I have always stated that one of the few good things about ObamaCare is that people with pre-existing conditions would be covered,” Long said in a statement to The Hill. “The MacArthur amendment strips away any guarantee that pre-existing conditions would be covered and affordable.”
Reps. Brian Fitzpatrick of Pennsylvania, Daniel Webster of Florida and Chris Smith of New Jersey will also vote against the current bill, making their decisions public in succession Monday afternoon.
Adding to the confusion, Trump himself, who earlier in the day was optimistic the House could pass a bill Wednesday, "muddied the waters" by suggesting the measure may still be changed. "I want it to be good for sick people. It's not in its final form right now," he said during an Oval Office interview Monday with Bloomberg News. "It will be every bit as good on pre-existing conditions as Obamacare." Heading into a Republican whip meeting Monday afternoon, some of the members going in still didn't know how they would personally vote for the health care bill: Reps. Kevin Yoder, David Valadao, Erik Paulson, Elise Stefanik, and Adam Kinzinger all were undecided.
As a reminder, the fight over how pre-existing conditions are covered is at the center of the fight. Trump said Sunday the White House is pushing forward, and that the GOP plan "guarantees" coverage for Americans with pre-existing conditions. "Pre-existing conditions are in the bill. And I mandate it. I said, 'Has to be,'" Trump said on CBS's "Face the Nation" Sunday.
An amendment authored by Rep. Tom MacArthur (R-N.J.) would allow states to apply for waivers to two ObamaCare provisions: essential health benefits, which mandates what services insurers must cover, and “community rating,” which essentially bans insurers from charging people with preexisting conditions more for coverage. While the AHCA keeps an ObamaCare provision banning insurers from denying coverage to people with preexisting conditions, allowing states to waiver out of community rating means insurers could charge sick people more.
Trump said that "we actually have a clause that guarantees" coverage for those with pre-existing conditions and added that the health care legislation is "changing." Unlike the mandate under Obamacare, however, under the GOP bill insurers could charge them higher rates than others in the plan if they allow their coverage to lapse.
The Hill’s whip list includes some Republicans who were ready to vote for the bill before changes made the language backed by MacArthur and Rep. Mark Meadows (R-N.C.), the Freedom Caucus chairman.
They include Reps. Adam Kinzinger (Ill.) and Fred Upton (Mich.). Rep. Mike Coffman (R-Colo.) went from being a yes on the bill to a no. And four members of the GOP Whip team, Reps. David Valadao (Calif.), Erik Paulsen (Minn.), Elise Stefanik (N.Y.) and Kevin Yoder (Kansas) are undecided on the bill. Rep. Kathleen Rice (D-N.Y.) told CNN that she's talked to centrist Republicans who say they won't back the bill because they don't like it, and because they don't think it will be approved by the Senate even if it does pass the House.
“They're being asked to walk the plank on a bill they know won't survive,” she said.
It didn't end there, as the Hill elaborates:
In another bad sign for the GOP’s whip count, Appropriations Committee Chairman Rep. Rodney Frelinghuysen (R-N.J.) on Monday refused to say if it had his support.
Frelinghuysen came out against the bill shortly before it was pulled from the floor last month and told reporters Monday he was “still looking” at the changes.
“I'm focusing on the appropriations bill for 2017, so that's my focus,” he said.
“My position is that I'm focused on the appropriations process, trying to get the bill across the finish line. I haven't been focused on anything else.”
The Republican leadership's focus remains trying to help those moderates get comfortable with the new MacArthur amendment. Over the weekend, House leaders, as well as Pence and Health and Human Services Secretary Tom Price, spoke with members hoping to flip enough votes to move the bill forward. Leadership aides emphasize that there isn't much room to change the proposal at this point, but many deputy whips are trying to get members to keep the process in perspective.
"You remind them there is a United States Senate, and it will change things. What we send over there isn't going over there on stone tablets," said Rep. Tom Cole, R-Oklahoma.
"Going back to the drawing board would be death to repeal and replace," one aide said.
Of course, if just one more Republican flips, the latest attemp to repeal would be dead anyway. That, increasingly appears to be the most likely scenario because after last week's discussion, many moderates are frustrated with the process. Some say they see their party making the same kind of mistakes Republicans criticized Democrats for making back in 2010.
"We didn't learn anything from their mistakes," said Rep. Mark Amodei, a moderate Republican from Nevada told CNN. "We learned nothing from their mistakes."
As to promises the bill will be changed once it's in the Senate? "Seriously, you want me to go back and tell the people in my fourth of Nevada 'the Senate will make it better?'" Amodei said. "What the hell?"