WASHINGTON — Republicans remained divided on a replacement for Obamacare late last month, as a House vote on the replacement American Health Care Act was aborted due to lack of support for the bill.
House leaders pulled back the legislation despite a vow from President Trump to leave Obama’s signature law in place if Congress did not act.
“We’re going to be living with Obamacare for the foreseeable future,” said House Speaker Paul Ryan (R., Wis.). “We came really close … but we came up short.”
He said he spoke to Trump and the president agreed with the decision to pull the bill.
Trump blamed Democrats and said they would pursue a deal within a year once “Obamacare explodes,” from high premiums.
“The best thing that could happen is exactly what happened — watch,” he said. “It’s enough already.” The AHCA was withdrawn twice, with the first vote slated for the seventh anniversary of the signing of Obamacare, or the Affordable Care Act.
White House budget director Mick Mulvaney had delivered Trump’s ultimatum, saying the president was done negotiating. The directive to the House was to “finish the job,” said Rep. Dennis Ross (R., Fla.).
“We have a great bill, and I think we have a good chance, but it’s only politics,” Trump had said.
But the plea for passage by the White House, including last-minute appearances on Capitol Hill by vice president Mike Pence, secretary of health and human services Tom Price, and chief of staff Reince Priebus, was for naught.
The legislation faced opposition from both conservative members of the Freedom Caucus, and moderates who wanted the bill to make insurance more affordable for people too young to be eligible for Medicare. In a late move to appease the centrists, GOP leaders offered to add a provision designed to raise funds for that purpose.
The measure would postpone for six years the repeal of a 0.9% tax on wages above $200,000 annually for individuals and above $250,000 for married couples. The amounts aren’t indexed for inflation, so the impact would be greater over time. The earlier version of the AHCA would have thrown out the tax retroactively as of January 1.
To assuage conservatives, who had criticized the bill for insufficiently rolling back Obamacare regulations, GOP leaders added an amendment repealing a mandate that most insurers have benefits in health plans including maternity care, pediatric care and preventive services. The amendment would let the states set minimum benefit standards.
Many Republicans said the mandate drives up the cost of insurance, while Democrats said it assures coverage of essential medical needs.
According to an anonymous source quoted by The New York Times, Trump told members of the Freedom Caucus, “Guys, we’ve got one shot here. This is it — we’re voting now.”
Caucus chairman Mark Meadows (R., N.C.) said, “We’re committed to stay here until we get it done.” He said that whether the vote was on the ACA signing’s anniversary, the next day or five days later, “the president will get a victory.”
But he said 30 to 40 Republicans planned to vote against the AHCA. More than 22 GOP votes against the bill would have doomed it.
Trump earlier had singled out Meadows for an attack prior to next year’s election, but it was unclear how serious he was.
And in trying to satisfy the Freedom Caucus, Trump had to take into consideration the demands of the House members of the moderate Tuesday Group, who objected to Medicaid cuts and fewer insurance benefits.
Rep. Leonard Lance (R., N.J.) said the bill would not provide complete and affordable access to coverage. “There’s a little bit of a balancing act,” White House press secretary Sean Spicer said.
Trump personally lobbied 120 lawmakers, either in person or on the phone, Spicer told reporters. The president “left everything on the field,” he said.
Rep. Bradley Byrne (R., Ala.), a supporter of the legislation, said the stage had been set for the first big vote of the Trump presidency. According to The Washington Post, Byrne said, “I think it’s a statement, not just about him and the administration, but about the Republican Party and where we’re headed.”