President Donald Trump is demanding a vote Friday in the House on the Republican plan to repeal and replace Obamacare, White House budget director Mick Mulvaney told GOP lawmakers. If the bill fails, Trump is prepared to move on and leave Obamacare in place, Mulvaney warned.
The surprise announcement by the top White House official — made with the full support of Speaker Paul Ryan (R-Wis.) and other House GOP leaders — came during a closed-door meeting of Republicans Thursday evening in the basement of the Capitol.
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Mulvaney, a member of the House until a few weeks ago who now heads the Office of Management and Budget, said Trump was done negotiating and wanted an up-or-down vote now.
The move by Trump and Ryan is an enormous gamble, setting up a real cliffhanger when the legislation hits the floor on Friday.
All day Thursday, the White House and GOP leaders lacked the votes to pass the American Health Care Act. A loss on the House floor would be a glaring embarrassment for the new president and House speaker — one that could undermine other parts of the GOP legislative agenda, including tax reform.
A victory, on the other hand, would provide not just a shot of badly-needed momentum for both men, but undermine the House Freedom Caucus, the group of conservative hard-liners who've fought the GOP health care plan because it doesn't go far enough.
The group's opposition was seen as a public rebuke to both the White House and House GOP leadership. If the the Freedom Caucus loses to Trump and Ryan, its power will be curtailed. If it wins, the group will once again be able to dictate terms to party leaders.
Yet this is the showdown that many mainstream GOP rank-and-file members have sought. They want a fight out in the open with the Freedom Caucus — either the group votes against Trump, or it gives in.
Negotiations between Trump and the Freedom Caucus hit an impasse earlier Thursday its members were told recent concessions from the White House and GOP leadership represented a final offer. The group rejected that, wanting more.
The setbacks triggered another series of meetings later Thursday — between Trump and the moderate Tuesday Group, and separately between the Freedom Caucus and Ryan. That was followed by a full GOP Conference meeting where Trump played his trump card.
Trump and Ryan had found themselves playing see-saw with moderates and hard-liners: Lean too much toward one faction and they lose votes from the other. So far, they've been unable to find a sweet spot.
Ryan can afford to lose only 22 votes on the floor. The Freedom Caucus has three dozen members, many of whom have vowed to block the bill unless they get what they want. More than a dozen centrist Republicans have also come out against the bill, further endangering its prospects.
But the Trump-Ryan gambit may pay off. Freedom Caucus Chairman Mark Meadows (R-N.C.) said the move by Trump and Ryan "certainly does" put enormous pressure on the Freedom Caucus to get behind the bill. And already a handful sounded like their positions were softer than they had been before.
Rep. Trent Franks (R-Ariz.), who said he remains undecided, added that efforts by the Freedom Caucus had "improved the bill." Rep. Mark Sanford (R-S.C.) said members will feel more pressure to vote "yes" with the bill on the floor, even if they may have felt comfortable opposing it before. Sanford said he was undecided.
Rep. Scott DesJarlais (R-Tenn.) was a "no" but is now undecided.
"I've got to decide whether this is best for my district and best for the president and best for my country. And I'm not convinced it will bend the cost curve down… but it may be as good as it gets on this one," DesJarlais said.
"We get elected to make votes, and this is a big vote," added Rep. Joe Barton (R-Texas), a Freedom Caucus member who supports the bill and called it "the right thing to do."
"I think it passes," he added.
GOP Rep. Tom Reed (R-N.Y.) said Mulvaney "put it completely in focus. The moment is now. Do we advance the cause so we can move forward and move on and accomplish what we said we would and repeal and replace Obamacare … and also tax reform? It's a major test, and we're gonna pass that test tomorrow."
"If we vote it down, we will neuter Donald Trump's presidency … We are not going to undermine the president's ability to get things done," Rep. Dana Rohrabacher told reporters after the meeting.
A senior administration official in the room for the Freedom Caucus meeting at the White House said most members left the meeting as "no's" but suggested some flipped to "yes." While Trump did not go around the room and ask people how they would vote, it became immediately clear GOP leaders did not appear to win over enough members to put the measure over the top.
"We're down right now," the official said.
Freedom Caucus chairman Mark Meadows (R-N.C.) told reporters in the Capitol Thursday afternoon that "we have not gotten enough of our members to get to yes at this point. … However, I would say progress is being made." He called Trump's engagement in the negotiations perhaps "unparalleled in the history of our country."
There were daunting obstacles to a deal heading into the White House meeting Thursday morning. A number of Freedom Caucus members had suggested Trump's latest concession — repealing Obamacare's mandate that insurance plans provide a minimum level of "essential" benefits — wasn't enough. The group wants a complete repeal of all Affordable Care Act regulations — including popular provisions Trump promised he would maintain.
The conservatives' target list encompasses a prohibition against discriminating against people with pre-existing conditions and a requirement that adults up to age 26 can remain on their parents' health insurance.
"Repealing [essential health benefits], w/out making other substantial changes, would make the bill worse, not better," tweeted Freedom Caucus member Justin Amash (R-Mich.). "It would hurt the sickest people on exchanges."
The Freedom Caucus has been a constant thorn in the side of House GOP leadership, sinking bills its members believe were too accommodating to Democrats. The group was expected to fall in line behind Trump after he won, but it has refused to do so on the health care bill.
Now, Freedom Caucus members are threatening to trip up not John Boehner or Ryan, but a Republican commander-in-chief who remains highly popular in their districts.
Many House Republicans are furious with the Freedom Caucus, saying the group keeps moving the goal posts and that it really wants to sink the health care bill altogether.
"The president is good at negotiating, but he has to have someone who wants to get to yes," Rep. Mike Kelly (R-Pa.), an ardent Trump supporter, told POLITICO. "I was never able to sell a car or a truck to someone who didn't want a car or a truck. It just doesn't work. And that's where we are right now. I don't think they're really interested in getting to an 'end.'"
Kelly then added: "Maybe the 'end' is: making sure it doesn't pass."
Jake Sherman and John Bresnahan contributed to this report.