President Donald Trump and his inner circle are furiously courting the leaders of two key conservative factions in the House of Representatives as dozens of Republicans still have serious concerns about the GOP plan to repeal and replace Obamacare.
Prospects for the bill’s passage worsened Monday evening as the leader of the conservative House Freedom Caucus proclaimed that there aren’t enough Republican votes for the GOP-crafted legislation to pass.
Freedom Caucus Chair Mark Meadows, R-N.C., said his group wouldn’t take a position on the bill, even as House Republican leadership unveiled a so-called manager’s amendment designed to persuade skeptical conservative and moderate Republicans to support it.
The House Rules Committee is expected to take up the amendment Wednesday.
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“I am confident that we have enough concerns that a vote of 216 votes in the House would not happen today,” he told reporters after the meeting. “Hopefully, if there’s the belief that there’s not 216 votes we’ll look at some amendments that actually bring conservatives and moderates together.”
Meadows added: “I think cooler heads will prevail and we will find a way to get to yes with reasonable amendments negotiated in good faith.”
Earlier Monday, Rep. Mark Walker, R-N.C., chair of the conservative Republican Study Committee, also expressed doubt about the bill’s ability to garner enough Republican support.
“I don’t know that we are overly confident that the votes are there to move this through the House at this point,” Walker told McClatchy. “There are a few things that are still concerns with some of our members.”
With the bill scheduled for the House floor Thursday, Republican leaders must get Meadows, Walker and their constituencies on board. A McClatchy review of lawmakers’ statements on Ryan’s plan shows the legislation teetering dangerously close to failure. Just 21 Republican “no” votes would sink the bill, and some two dozen have indicated they’re leaning no.
Meanwhile, Walker estimated that about 30 or 40 Republicans, both hard-line conservatives and moderates, retain serious concerns about House Speaker Paul Ryan’s proposal. Trump plans to meet with House Republicans on Tuesday morning to make another appeal for support.
Meadows said the opposition to the GOP health care bill is a defining moment for the Freedom Caucus, which has about 40 members.
“I don’t think there’s a more critical vote for the Freedom Caucus than this particular one,” he said.
Meadows and Walker were in touch with either Trump Cabinet members or senior staffers over the weekend. Walker spoke with Health and Human Services Secretary Tom Price, and Meadows traveled to Trump’s Mar-a-Lago resort in Florida to meet with administration staffers.
The Freedom Caucus, the smaller of the two groups, with about 30 members, has enough power to run the health care bill aground even if some of its members wind up supporting it. The Republican Study Committee is much larger, with nearly 170 members.
No Democrats are expected to support the plan.
One criticism from the hard right is that Ryan’s proposal doesn’t go far enough to permanently unwind health care regulations introduced by the Affordable Care Act. Other conservatives condemn a Republican-proposed tax credit to help individuals pay for coverage, saying it amounts to a substitute for Obamacare’s subsidy for low-income people.
The complaints – with Walker and Meadows leading the charge – have already prompted House Republicans to slow down long enough for more debate and changes.
The Republican Study Committee has pushed for amendments to the bill, including giving federal block grants to states to administer Medicaid programs with fewer regulations, adding work requirements for some Medicaid recipients who don’t have physical disabilities and limiting health savings account tax-credit dollars from going toward abortions.
“The caveat for us signing off on this is we have to see the language of these adjustments,” Walker said. “We’re in constant conversation with Ryan’s office. . . . This went on all weekend, back-and-forth discussions.”
Meanwhile, Meadows went to Mar-a-Lago, the latest sign that he has been accepted as a sort of spokesman for right-wing concerns over the House bill, which the president has said he supports. A Meadows spokesman didn’t give details about the meeting with senior Trump staffers.
U.S. Sen. Ted Cruz, R-Texas, was also there. He said Sunday on CBS’s “Face the Nation,” that he, Meadows and Sen. Mike Lee, R-Utah, were negotiating with Trump’s team over the health care bill, without naming specifics.
Already this month, Meadows has met with Trump and other lawmakers at the White House to talk about the repeal-and-replace effort. He found himself at the table just two chairs down from Trump, sitting beside U.S. Sen. Mike Enzi, R-Wyo., the chair of the powerful Senate Budget Committee.
If Trump and Ryan lose the Freedom Caucus, they risk a stalemate in Congress over health care and potential backlash from the party’s base if they’re unable to do what Republicans have promised their voters for years: Get rid of Obamacare, repeal the mandate that most people must have health insurance or pay a fine, and loosen restrictions on insurance companies.
“We’re hearing the same thing that we’ve been hearing (from voters) for the last eight years. . . . They want this thing repealed,” said Donald Bryson, state director for Americans for Prosperity in North Carolina.
The national group held a rally with hundreds of people at the U.S. Capitol earlier this month with a singular message to Republicans in Congress: “You promised.”
Bryson said Meadows and Walker were right to demand that Obamacare be fully gutted, without tax credits to buy insurance and without stipulations that insurance companies charge more for coverage if individuals let their plans lapse.
“Groups like Americans for Prosperity are going to be beating the drum on this,” Bryson said. “The longer (Congress) waits, the louder the drum is going to be.”
Conservative resistance was buoyed earlier this month by cries from right-wing groups that the Ryan bill was effectively “Obamacare Lite” or a Republican-authored entitlement program.
Heritage Action, the political arm of the conservative Heritage Foundation, supports rolling back regulations on the health care industry associated with Obamacare.
“If Republicans want to have good policy . . . but also have good politics, they have to make sure premiums go down,” said Dan Holler, vice president for communications and government relations at Heritage Action. “And you can’t do that if you have a whole suite of Obamacare regulations remaining in place.”
The climate is almost perfect for Meadows to be on the front line of debate and dissent, said Andy Yates, a co-founder and senior partner at Red Dome Group, a political consultancy firm in North Carolina. Yates helped Meadows on his 2014 congressional campaign.
Meadows comes from a safe Republican district in western North Carolina and his national profile has risen alongside the House Freedom Caucus, a group he helped start two years ago partly out of frustration that rank-and-file conservative members had little influence on major pieces of legislation.
Plus, Meadows – an early endorser of Cruz in the 2016 presidential race – ended up being a faithful campaigner for Trump in North Carolina after Trump won the Republican Party nomination. Meadows flew around the state on Trump’s plane, attending campaign events even as other North Carolina Republicans cited scheduling conflicts and made limited public appearances with the candidate.
“There’s a mutual respect there,” said Yates, who also served as a consultant for the Republican National Convention and Trump’s nauguration committee.
CORRECTION: An earlier version of this story gave the wrong state that U.S. Rep. Mark Meadow represents. He’s from North Carolina..