Trump presses on with health bill but vote uncertain

The new Republican healthcare plan would reduce the federal deficit by $337 billion over t
AFP

Washington (AFP) – The White House signaled that US lawmakers will go ahead with a showdown vote Friday on the Republican plan to replace Obamacare, despite signs the bill may not have the votes to pass.

House Speaker Paul Ryan, the chief champion in Congress of the plan known as the American Health Care Act, personally briefed President Donald Trump on the status of the embattled legislation, amid reports he let Trump know they were short of the support needed.

White House spokesman Sean Spicer declined to confirm the reports, and said the vote in the House of Representatives was still set for 3:30 pm (1930 GMT).

“The president understands this is it,” Spicer told reporters.

“At this point it’s not a question of negotiating anymore. It’s understanding the greater good that is at hand.”

Trump is putting his reputation as a dealmaker on the line with the high-risk vote, with Republican rebels threatening to torpedo their own party’s health care reform.

He heaped pressure on die-hard conservatives with the White House framing the effort as a do-or-die chance to dismantle Barack Obama’s signature heath care law.

Passage would hand Trump a monumental victory after a bruising battle with recalcitrant Republicans, mainly conservatives who say the new plan is too similar to Obamacare and would cost the government too much.

Defeat could send the seven-year Republican effort to pull Obama’s Affordable Care Act out by its roots and replace it with something better careening into a tailspin.

It would deal a major setback to the president, who campaigned relentlessly on a pledge to “repeal and replace” Obamacare.

“After seven horrible years of Obamacare (skyrocketing premiums & deductibles, bad healthcare), this is finally your chance for a great plan!” Trump tweeted in an 11th-hour message to Republicans in Congress.

US media estimated that the number of Republicans likely to vote against that measure would number in the high twenties or low thirties — well above the maximum 21 defections that Republican leadership can spare if all Democrats vote as expected against the measure.

“We’ll continue to work with the speaker and the leadership there to see where the votes are,” Spicer insisted. 

Spicer, pressed on why Trump might demand a floor vote if the support for his plan was not clearly there, refused to discuss legislative strategy.

But he said the president and aides “have left everything on the field” in their effort to win enough support.

Trump’s effort took a further blow Friday when the powerful head of the House Appropriations Committee, Rodney Frelinghuysen, came out against the bill, a shock because key committee chairs are traditionally seen as loyal to leadership.

“Unfortunately, the legislation before the House today is currently unacceptable as it would place significant new costs and barriers to care on my constituents in New Jersey,” Frelinghuysen said in a statement.

Ryan, the reform’s chief champion in the House, had planned a Thursday vote but in a stunning development was forced to pull the bill off the floor when it became clear it lacked sufficient backing.

But Trump issued an ultimatum to his party: Vote Friday, and if it fails, Obamacare — which he and Republicans have blasted as disastrous — will remain in force and he will move on to other items on his policy agenda.

– Hardened positions-

The House Freedom Caucus — some 30 lawmakers who are heirs-apparent to the ultra-conservative Tea Party movement — have spearheaded opposition to a bill they dub “Obamacare Lite,” complaining it will only reduce, not eliminate, health coverage subsidies by replacing them with refundable tax credits.

Conservatives, eager to rein in rising premiums, want to repeal “essential health benefits” that all insurance policies must pay for under Obamacare — including maternity care and emergency room visits.

Republican leaders conceded to that demand and repealed those benefit requirements. But for some, the changes only hardened their position against the legislation.

“Changes made to bill last night strengthen my no vote,” House Republican Frank LoBiondo said in a statement.

As debate began Friday, Democrats seized their chance to loudly rail against the bill.

House Democrat Robin Kelly warned that Republican lawmakers will “own its aftermath,” as she cited a recent congressional analysis that projected 24 million more Americans will be left without health insurance over the next decade if the plan becomes law.

Even if the bill squeaks by in the House, it faces an equally tough road in the US Senate, where Republicans hold a slim 52-48 majority.

Some Republican senators have urged their House colleagues to scrap the health plan and start again.

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