Donald Trump managed to win over two Republican opponents of the current Obamacare repeal plan on Wednesday, breathing new life into the embattled effort to make good on the party’s top legislative priority of the last seven years.
At the White House, Trump persuaded representatives Fred Upton of Michigan and Billy Long of Missouri, two normally loyal Republicans who had balked at the bill’s provision to remove protections for those with pre-existing conditions, with the promise of $8bn in extra funding to subsidize healthcare for those affected.
The House speaker, Paul Ryan, expressed confidence in the bill’s prospects in an interview with a local radio station in Milwaukee on Wednesday. “We’re making good progress – we’ve got some momentum,” the Wisconsin Republican said, pointing to Upton and Long’s announcement as a sign of that progress. “We feel really good about that.”
Ryan wouldn’t commit to a specific timetable for the vote but said that House Republicans were working to hold a vote before Friday, when the House is scheduled to begin a week-long recess.
The White House press secretary, Sean Spicer, said a vote was imminent but said there was no “deadline”. “We continue to move closer and closer to that time,” he said.
With many moderate Republicans still wary of the proposal, the White House engaged in a full scale effort to woo skeptics on Wednesday. Trump put his deal-making skills to the test, working the phones and appealing personally to lawmakers, while Vice-President Mike Pence and the White House budget director, Mick Mulvaney, were dispatched to the Capitol to convince wavering members.
The efforts, including the extra $8bn in funding, were not, however, necessarily a sell for many wavering moderates. Ryan Costello of Pennsylvania told reporters that he still had fundamental concerns about “the underlying policy”. Several other lawmakers echoed his sentiment, telling reporters they remained a “no” as they shuffled on to the floor for afternoon votes. Moderate Leonard Lance of New Jersey insisted: “I’m a no. It’s a two-letter word. N in the front. O in the back. I’m not a hard no, a soft no, or a middle no. I’m a no.”
In a break from past divisions in the House Republican caucus, conservatives were solidly behind the effort. Mark Meadows, chair of the hard-right Freedom Caucus, told reporters that his faction was still solidly behind the proposal, which had been crafted to attract their support, and said that the modification to add the additional $8bn in spending hadn’t led to any defections.
Negotiations continued on Wednesday as the Republican leadership and White House officials targeted wary Republicans in one-on-one meetings throughout the day. It was unclear, though, how close Republicans were to the 216-vote mark needed to pass the bill.
As Lou Barletta of Pennsylvania, a Trump loyalist, told reporters: “I don’t think we’re going to put any timelines on this. When they know they’ll have the votes, that’s when they’ll call the vote.”
And yet the push to bring Republicans onboard was somewhat successful with representative Steve King of Iowa, who said he was moved from a “no” to a “lean yes” on the bill after receiving a personal call from the president.
“As the calendar ticks another page or two, we either get something done or we live with Obamacare, that’s a part of it,” King said, describing his change of heart on the legislation.
But in a sign of just how politically fraught negotiations over healthcare reform have become, the co-chair of a moderate Republican group was dogged by questions not about the bill but about his standing with moderates. A report on Wednesday suggested that Tuesday Group members furious with Tom MacArthur for forging an agreement with the Freedom Caucus were plotting to oust him as co-chair.
Asked on Wednesday if he would remain a part of the moderate coalition, MacArthur said: “Of course, these are my closest colleagues. These are people in districts like my mine and among my closest friends here in Congress.”
Since the first attempt at healthcare reform failed to win enough support from House Republicans in March, lawmakers revised the measure to remove protections for people with pre-existing conditions, a change that brought on board conservatives who were initially opposed. But moderates are reluctant to line up behind a bill that would undermine protections for sicker Americans, one of the Affordable Care Act’s most popular provisions.
The revised Republican plan would permit states to apply for waivers that allow them to opt out of a handful of crucial mandates in the Affordable Care Act. And under the proposal, states, if they meet certain conditions, could allow insurers to charge sicker enrollees more.
Republican leadership has maintained that the bill provides “several layers” of protection for people with pre-existing conditions.
Ryan has said sicker Americans would be “better off” under the Republican plan. And in the lunchtime interview, Ryan denied that the proposal would hurt sicker Americans, calling those concerns “more about perception that the actual reality of the bill itself”.
Spicer acknowledged that there were still uncertainties over cost relating to individuals with pre-existing conditions. “Right now, pre-existing conditions are covered in the bill,” he said. “They always have been; we’ve talked about that before. States have the right to receive a waiver. If someone has continuous coverage, that’s never going to be an issue, regardless. In no circumstance would anyone with continuous coverage ever have a problem.”
Democrats dismissed the plan as an inadequate gesture. In a statement, the Senate Democratic leader, Chuck Schumer, described it as akin to “administering cough medicine to someone with stage four cancer”.
“This Republican amendment leaves Americans with pre-existing conditions as vulnerable as they were before under this bill,” he said. “High-risk pools are the real death panels: they mean waiting forever in line for unaffordable health insurance.”