Republicans closer, but a “handful” of votes short of passing healthcare overhaul

Rep. Mark Meadows (R-N.C.) says work is still progressing toward a healthcare deal

Kevin Lamarque—Reuters
Chairman of the Freedom Caucus U.S. Rep. Mark Meadows (R-NC)

WASHINGTON, D.C. — Republicans in the U.S. House of Representatives said on Tuesday they were closer to agreeing on a reworked bill to overhaul the nation’s healthcare system but still lacked the votes to pass it, as President Donald Trump pressed lawmakers for a vote.The White House has been pressuring House Republicans to find a deal on legislation to repeal and replace the Affordable Care Act, commonly called Obamacare, after a first effort failed in March. Healthcare overhaul was a key campaign promise for Republican candidates across the country.”I think it’s time now” for a healthcare vote, Trump told lawmakers at the White House on Tuesday.But Republican leaders, including House Speaker Paul Ryan, are once again struggling to balance the concerns of moderates, who want to keep federal mandates on pre-existing conditions and conservatives within the party who want to let states decide. Representative Mark Meadows (R-N.C.), who heads the conservative House Freedom Caucus that fought for further changes in the first bill, said Republicans were still “a handful of votes away.”Representative Tom MacArthur of New Jersey, a Republican moderate who brokered a deal that revived the healthcare legislation, said there were still some moderates in the party sitting on the fence. “It’s close. It’s close. We’re getting there,” MacArthur said.MacAurthur’s new amendment to the latest version of the American Health Care Act (AHCA) brought Republicans closer to a deal, garnering support from Freedom Caucus. The amendment puts in waivers for states to opt out of federal Obamacare regulations on pre-existing medical conditions – provisions that force insurers to charge sick people and healthy people the same rates.That is seen as a concession to the Freedom Caucus, which has endorsed the new measure.”Over the past couple of months, House conservatives have worked tirelessly to improve the American Health Care Act (AHCA) to make it better for the American people. Due to improvements to the AHCA and the addition of Rep. Tom MacArthur’s proposed amendment, the House Freedom Caucus has taken an official position in support of the current proposal,” said the Freedom Caucus in a statement.In an interview earlier this week, Trump, however, insisted the new bill would maintain protections for those with pre-existing conditions. The measure is one of several key provisions that are in negotiations among Republicans, with some lawmakers expressing worries of a spike in the number of people without coverage, or sharp increases in insurance premiums.”They’re still talking about possible changes. If they don’t have the votes, then they’ll have to make changes,” Representative Peter King of New York, a Republican, told reporters indicating he would likely vote for the bill.But any tack to the center to shore up moderates’ support threatens to spur defections on the Republican right flank.”They change it one iota, I’m out,” Representative Dave Brat of Virginia, a Freedom Caucus member, told reporters.Adding to the pressure on Republicans is the unified opposition of Democrats, many of whom view the 2010 healthcare law as the defining domestic legacy of Obama’s presidency. Trump made its repeal the first major legislative item of his presidency, investing early political capital, only to see the bill he backed torpedoed by his own party.This time, the White House appears to be taking more of a low-key approach.”I think it’s been quieter. I think it’s been more bottom-up-driven from a member’s standpoint,” said Republican Representative Mark Sanford of South Carolina.If a plan passes the House, it is expected to face a tough fight in the Senate, where Republicans have a narrower majority and where some party senators have expressed misgivings about the House bill. Senate Republican leader Mitch McConnell said on Tuesday that his party did not want to give up on the legislation.