U.S. House Speaker Paul Ryan briefed President Donald Trump at the White House on Friday on the status of the health replacement bill, only hours before the measure was scheduled to come to a vote in the House of Representatives. This comes amid conjecture the Republicans may not have the necessary votes to pass the bill.

A day after threatening to leave the nation’s health care law intact if congress fails to overhaul it, the president launched an eleventh hour campaign to secure support for the bill, the American Health Care Act.

A panel that sets rules for House floor debate sent the replacement measure to the full House of Representatives Friday for debate before a vote later in the day.

Friday morning, Trump targeted fellow Republicans who remained opposed to the measure that would replace what is commonly known as Obamacare, a key promise during his presidential campaign.

On Twitter, the president singled out members of the conservative House Freedom Caucus. In his posts, Trump said the vote was their final chance to replace Obamacare, and apparently suggested their failure to support the replacement plan would allow the reproductive health care group Planned Parenthood to continue to operate. 


Trump has threatened Republicans with leaving Obamacare in place if they do not support the new replacement bill. Repealing and replacing Obamacare was one of Trump’s key promises during his presidential campaign.

It was not clear late Thursday night, after a day of negotiations up and down Pennsylvania Avenue, whether the Republican legislators had enough support to pass the long-promised health care bill.

Deal maker

Trump put his skills as a deal maker on the line, but he failed to win over the House Freedom Caucus, and even alienated some moderates afraid for their political futures. His and House Speaker Paul Ryan’s failure to secure enough votes backed the once unified Republican Party into a politically tricky corner that could be hard to escape, even if the bill eventually does pass.


“This is one of those moments where you have got to say who you are really deep inside of you – are you for President Trump and repealing and replacing Obamacare or are you against President Trump and are you against repealing and replacing Obamacare – it’s that simple,” Rep. Bradley Byrne, a Republican from Alabama, said as he emerged from a late afternoon emergency strategy meeting in Speaker Ryan’s office after the House Freedom Caucus rejected the latest deal.


“This is a tense moment for everybody, because we’re driving down to the finish line – but I think there’s a determination to get this done and get it done in the right way,” Byrne told VOA.

“For seven and a half years, we have been promising the American people that we will repeal and replace this broken law because it’s collapsing and it’s failing families, and tomorrow we’re proceeding,” Speaker Ryan said, without answering any questions from reporters.

 This week’s turmoil could decimate the political capital of the Republican leadership, ruining plans for tax reform and major infrastructure spending, and throwing a shadow over a looming budget battle that could shut down the government.


“An effective speaker, an effective leader of House Republicans would have taken one look at this bill, understood it had no chance of passage and would have stopped the bill writing in its tracks and never let it see the light of day,” John Hudak, a senior fellow in governance studies at the Brookings Institution, told VOA. “Paul Ryan failed to do that and he failed to do that at the expense of his own party, his own caucus and his own president.”


Ryan scheduled the vote for the seventh anniversary of the signing of the Affordable Care Act, just weeks after introducing the legislation and before he could build consensus within his own party.


“I think you see here a Congress who is going to come away from this vote very worried that their president – the president of their party – is incapable of helping them task big ticket legislation,” Hudak said.

The House Freedom Caucus – a politically conservative group of House members – kept the bill from the votes required for passage, arguing that Trump and Ryan’s proposal violates limited government principles by keeping too many key provisions of President Obama’s health care plan.


“We’re certainly trying to get to yes, but indeed, we’ve made very reasonable requests and we’re hopeful that those reasonable requests will be listened to and ultimately agreed to,” Freedom Caucus Chair Mark Meadows told reporters after a last-minute White House meeting to negotiate with Trump.


Trump repeatedly has warned caucus members they could lose big in 2018 mid-term elections if they fail to act in support of his bill.


“The president is correct – if Republicans fail to pass this bill, it will be a problem for them. The problem is passing the bill creates a problem for them as well,” said Hudak.


But the president’s concessions to the caucus alienated more moderate Republicans who fear the changes could doom the bill’s chances in the Senate, ruining their own opportunities for re-election. Suddenly, Trump and Ryan found themselves facing a battle on two fronts within their own party.

Democrats’ strategy

House Democrats smelled blood in the water – and a future political opportunity – as they stood to the side, watching the events unfold.


Minority Leader Nancy Pelosi told reporters Thursday that Trump made a “rookie” mistake by staking his reputation as a negotiator on a piece of legislation that was rushed to a vote without party consensus.


“If this bill were to fail today – rookie day – I stand ready to negotiate with them on how we can go forward in incorporating their ideas, saving face for them in some areas and doing right for the American people,” Pelosi told reporters.


“The Democrats – for once – are playing this in a masterfully political way. They recognize that the only thing worse than Republicans failing to pass this bill, is for Republicans to pass this bill,” said Hudak of the Brookings Institution. “For Democrats, it’s a win-win.”

After a closed door meeting Friday among members of the House Democratic Caucus, House Minority Whip Steney Hoyer told reporters if the replacement bill becomes law, millions of Americans will be adversely affected.

“Twenty-four million Americans will lose their insurance because of this bill. Every American will pay more, and get less from their insurance policies,” he said. “And seniors, as you’ve heard, will have to pay thousands and thousands more.”


Pelosi told reporters the situation ultimately will end up working in the Democrats’ favor, no matter what the outcome. 


“This is a bad day for them,” she said, summing up a week of uncertainty.


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