Conservative Lawmakers Push for Changes to ACA Replacement Before Floor Vote

Rep. Mark Meadows, who leads the conservative House Freedom Caucus, told reporters he had enough votes to block the bill, the American Health Care Act, in a vote in the House.

Reps. Mark Sanford of South Carolina, Dave Brat of Virginia and Gary Palmer of Alabama voted against the legislation.

Some members already have voted the bill out of committee, and one who voted against it in committee now has changed his mind and favors it, Ryan said.

Take Rep. Mark Meadows, R-N.C., the caucus chairman, who is now leaning against the legislation.

A tally from CNN showed that 11 House Republicans have said outright that they will vote against the current bill, while nine others have indicated they will likely oppose it. Ryan can't lose more than 21 Republicans and still get the bill through the House.

President Trump signed on to a pair of changes to the House Republican health plan and declared "100 percent" backing for it Friday, moving to consolidate support among GOP lawmakers in hopes of moving it through the House next week. If every Democrat opposes Trumpcare, 22 GOP "no" votes would be enough to defeat the bill. In effect, Republicans are saying the House has to pass the bill to find out what exactly is in it.

The bill faces its next major test as it heads for a markup, a process of adding amendments and making changes, with the House Budget Committee on Thursday.

While Meadows was cagey about an exact whip count ― as well as whether some members of the group might waver if Trump applied all the pressure at his disposal ― other Freedom Caucus members were confident that conservatives controlled their own destiny.

Meadows noted that some changes will be released Monday night in the form of a "manager's amendment", but said his understanding is that the changes would not be enough to bring the Freedom Caucus on board. Rand Paul of Kentucky, Ted Cruz of Texas and Mike Lee of Utah - who have also voiced opposition to the bill - at their caucus meeting Monday, where they discussed their stance on health-care reform.

Ryan's bill to replace Obamacare has struck a hard impasse.

Speaking with Fox News host Tucker Carlson on Wednesday, Trump said the AHCA was "preliminary" and the GOP was "going to have a negotiation" on the bill. A yes vote would leave them holding the bag for a health-care bill so bad not even Portman, Sen. "The goal here is get to a bill that we can pass and that actually is great policy, and the president is playing a very constructive role on this". It then must pass a Senate where conservatives and moderates are also at odds, and which has even less margin for error as Republicans hold only a 52-48 majority.

The rest of Thursday's Budget Committee hearing after the vote consisted of short debates about motions to potentially change the bill.

Republicans, meanwhile, pushed provisions that would allow states to run their Medicaid programs as they see fit, while requiring able-bodied enrollees to work in exchange for benefits.

"I'm not confident that leadership will take it up, given the fact that they've been so insistent on keeping the bill largely intact".

  • Carolyn Briggs