When President Trump summoned Representative Ted Yoho and about a dozen other lawmakers to the White House on Wednesday to hear a direct, presidential pitch for the House Republican healthcare bill, the Florida conservative told Trump what he wanted: a “100 percent repeal” of the Affordable Care Act.
Like most of his fellow members of the hardline House Freedom Caucus, Yoho believes the party leadership’s American Health Care Act doesn’t go far enough in dismantling the law former President Barack Obama signed seven years ago this week. The group is now playing a game of high-stakes chicken with the White House and Speaker Paul Ryan, vowing they have the votes to defeat the Trump-endorsed plan and hand the new president an embarrassing loss in his first major legislative push.
The bill guts Obamacare’s insurance mandates and repeals most of its tax increases, but it leaves key parts of its architecture in place. As the GOP plan barrels toward a House vote on Thursday, conservatives are urging Speaker Paul Ryan to agree to changes that would strip out Obamacare’s requirement that insurance plans cover certain “essential health benefits,” which include maternity and newborn care, mental health treatment, and preventive services.
“As long as that’s there, we do not have a repeal of the Affordable Care Act,” Yoho told me at the Capitol on Wednesday. He told Trump that if GOP leaders repealed the essential health benefits provision as part of their bill, it would be “really close” to getting his vote.
The president smiled, Yoho recalled. “We’ll see what we can do,” Trump told the congressman.
When he returned to the Capitol, Yoho was still a no.
So were the bulk of the roughly two dozen members of the Freedom Caucus who left a separate White House meeting with Vice President Mike Pence empty-handed and defiant. They were unmoved both by Trump’s warning of political fallout on Tuesday and by the vice president’s more policy-focused plea on Wednesday.
Pence, along with several senior Trump aides at the meeting, rejected the conservatives’ push either to “start over” on repealing Obamacare or a least to add language stripping out the law’s essential health benefits. “They steeled our resolve by their unwillingness to lower premiums on hard-pressed American families,” Representative Mo Brooks of Alabama told reporters afterward. “If they want to bring it up for a vote, we’ll vote it down.”
Just how many votes there were for the leadership’s bill was a source of debate throughout the Capitol on Wednesday. Brooks and other conservatives declared there were plenty more than the 21 or 22 Republican defections they needed to defeat the measure and, they hoped, force the leadership back to the bargaining table. “Right now, you’re seeing a gain in the no votes and a subtraction from the yes votes as more and more Republican congressmen communicate with their constituents back home,” Brooks said.
Allies of the speaker claimed the opposite. They said that over the course of a flurry of meetings on both ends of Pennsylvania Avenue, they were getting closer and closer to a majority of the House. Depending on absences on Thursday, Ryan will need either 215 or 216 Republicans to back the bill, given the unified Democratic opposition. “We’re pretty close,” said Representative Richard Hudson of North Carolina, a member of the leadership’s whip team. “We’re seeing a lot of folks who are getting comfortable enough to say yes or getting close.”
In an appearance on Fox News, Ryan said GOP leaders were “adding votes, not losing them,” and he claimed that Trump had personally persuaded 10 members to support the bill. Yet the speaker notably stopped short of predicting the plan would pass on Thursday, as he had done in previous weeks.
Ryan has resisted the conservative demands to repeal the essential health benefits as part of the House bill because he and other leaders fear that the provision could sink the bill in the Senate, where strict budget reconciliation rules limit how much Republicans can change in Obamacare without the measure being subject to the 60-vote filibuster threshold. As it stands, the current bill is unlikely even to get the 51 votes it would need to pass the Senate without major changes. Republicans can only use the reconciliation process once in a single fiscal year.
“Our whole thing is we don’t want to load up our bill in such a way that it doesn’t even get considered in the Senate and it’s killed in the Senate, and then we lost our one chance with this one tool we have,” the speaker told the radio host Hugh Hewitt on Wednesday morning.
Ryan and administration has tried to assuage conservatives by promising that Senate Republicans would try to add more repeal provisions once the House passes its version. “That’s unsatisfying,” Brooks said.
With just over 24 hours before Thursday’s vote, neither House conservatives nor the White House had blinked yet. “We’re not looking at a Plan B,” Trump’s press secretary, Sean Spicer, said. “We have Plan A, and it’s going to pass.” At the Capitol, lawmakers said last-minute changes were possible, and even Yoho voiced hope that Trump and the conservatives would strike a deal—eventually.
But leadership allies and GOP aides said that Ryan planned to call up the bill on Thursday regardless of whether it would pass.
“If we don’t have the votes,” Hudson told me, “it’s going down tomorrow.”