House GOP, Trump pressure holdouts on ACA replacement bill

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Donald Trump and House Speaker Paul Ryan are working to win over conservative rebels who stand in the way of passing an Obamacare repeal measure, but the opponents say they are still largely opposed.

"There are still concerns with the bill," Mark Meadows, the chairman of the House Freedom Caucus, told reporters Wednesday after a meeting at the White House. "There are not enough votes to pass this."

Asked whether he expected a delay in the vote, he said, "That’s a good question for the speaker." But a House leadership aide said the vote would be held Thursday regardless of what the vote count looks like.

Alyssa Farah, a spokesman for the Freedom Caucus, wrote on Twitter that more than 25 members of the group remain opposed—enough to defeat the bill—and that GOP leaders should "start over."

Trump met with nearly a dozen Republican lawmakers Wednesday morning who still have concerns about the legislation. Separately, about 26 Republicans met with senior White House officials, including Vice President Mike Pence.

White House Press Secretary Sean Spicer noted that at least two lawmakers who had expressed reservations as recently as Tuesday are now backing the bill. “I think the trajectory is going very well for us,” he told reporters. “This is the only way that we will repeal and replace Obamacare.”

But the Freedom Caucus argues that the current bill is not a complete enough repeal of the healthcare law. The floor vote scheduled for Thursday could be the first sign of whether the caucus will be able to enforce its conservative principles in the age of Trump.

“How can you talk about repealing the ACA, Obamacare, without repealing the essential benefits and the guaranteed issue?" Representative Scott Perry of Pennsylvania said, referring to the required benefit packages under the Affordable Care Act and the law’s pre-existing condition rules.

Freedom Caucus members said White House officials made the pitch that conservatives should pass the bill so that the Senate can amend it and address their concerns, but several lawmakers said they weren’t buying it.

"Mike Pence made a play for more support for the bill based on the Senate being able to change it," Representative Randy Weber said in an interview, adding that he’s still opposed to the House bill. "That’s a hard row to hoe, because we’d like for it to be as strong as possible going over to the Senate.”

Weber said many Republicans were elected to Congress because of Obamacare, and said they can’t wait years for costs to come down. "In 10 years, none of us will be here," he said. "Probably at this rate, in two years, none of us will be here."

If the Freedom Caucus is unable to win major changes or block the measure, it could mark a double victory for Ryan by diminishing the influence of a group that led the ouster of his predecessor, John Boehner. So far, about a dozen members of the Freedom Caucus have come around to embrace the bill. The group claims to have roughly 40 members, but doesn’t publish an official roster.

Whether any of the Freedom Caucus’s remaining holdouts will drop their opposition to the healthcare measure before Thursday’s vote will determine the outcome. Those holdouts are being cheered on by several Senate conservatives, including Rand Paul of Kentucky and Mike Lee of Utah.

“There’s a sense on the Hill that the Freedom Caucus always caves,” said Sarah Binder, a congressional expert at the Brookings Institution. “So caving this time would surely further diminish their leverage for future fights.” For the caucus to fold again, said Binder, would provide another lesson that Republican leaders will draw that they can mold bills by picking off a few caucus members without having to engage the entire group.

Representative David Brat, a Republican caucus member from Virginia, said the Freedom Caucus’s goals haven’t changed; they still “want to move this bill toward free market solutions, not the federal government running one sixth of the economy,” he said.

Representative Tom Cole, a Republican from Oklahoma, said that the Freedom Caucus still has an important role to play in the conference, and credited them for the additions of two key changes to Medicaid, an optional work requirement and the option to states for block grants. But while the Republican party has proven that it’s a “very good opposition party,” it now has to prove it can govern, he said. “If you accept credit for the improvements you’ve made, you have to take responsibility for the defeats you inflict, and it would be a great disappointment to me if we lost,” he said.

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