GOP Leaders Still Looking For Votes On Obamacare Bill

The White House backed Medicaid work requirements and block grants Friday, but the changes might not be enough to get a bulk of conservatives to vote for the legislation.

House Majority Whip Steve Scalise of La. listens as President Donald Trump speaks in the East Room of the White House in Washington, Tuesday, March 7, 2017, during a meeting with the Republican House whip team about the proposed health bill.
AP Photo/Andrew Harnik
Erin Durkin, Daniel Newhauser and Alex Rogers
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Erin Durkin and Daniel Newhauser and Alex Rogers
March 17, 2017, 5:01 p.m.

It’s still not clear wheth­er GOP lead­ers will have enough votes to pass their Obama­care re­peal-and-re­place bill next week, even after Pres­id­ent Trump on Fri­day en­dorsed changes that would shift the bill fur­ther to the right.

Re­pub­lic­an Study Com­mit­tee Chair­man Mark Walk­er said the White House signed off on two changes to the Amer­ic­an Health Care Act: al­low­ing states to im­pose work re­quire­ments for Medi­caid be­ne­fi­ciar­ies; and al­low­ing them to re­ceive their fed­er­al Medi­caid fund­ing via a block grant, in­stead of the capped per-per­son pay­ments already in­cluded in the bill.

Ma­jor­ity Whip Steve Scal­ise said the changes would “add sig­ni­fic­antly” to their whip count, but didn’t say wheth­er he had the votes yet to pass the le­gis­la­tion. He also said Trump is fully be­hind the bill.

But House Free­dom Caucus Chair­man Mark Mead­ows in­sisted there were still not enough votes for the bill to pass, and he took is­sue with the changes dis­cussed Fri­day.

“Op­tion­al work re­quire­ments. Let me ask you a ques­tion: Is the defin­i­tion of ‘oxy­mor­on’ man­dat­ory op­tion­al work re­quire­ments?” he said.

Mead­ows also said he doesn’t ex­pect any states to choose a Medi­caid block grant over the bill’s per-cap­ita caps.

“I don’t know of one state that will pick a block grant,” he said. “But it’s good that they can pick a block grant if they want it, but it would be in­ter­est­ing based on the bill that is writ­ten to see if there is more than a hand­ful of states that would ac­tu­ally pick block [grant].”

Without any Demo­crat­ic sup­port, GOP lead­ers can only af­ford to lose 21 votes in the House.

Rep. Paul Gos­ar said Fri­day’s changes didn’t change his mind. He and oth­er Free­dom Caucus mem­bers re­main skep­tic­al of lead­ers’ as­ser­tions that they can change ele­ments of the law through ad­min­is­trat­ive ac­tion or fur­ther le­gis­la­tion. They want the House to go much fur­ther in re­peal­ing Obama­care, even if it means chal­len­ging the Sen­ate’s par­lia­ment­ary rules.

Still, not all Free­dom Caucus mem­bers are against the bill. Rep. Gary Palmer, who was among the mem­bers who met with Trump on Fri­day, said he will vote for the bill after the pres­id­ent agreed to Medi­caid changes. Palmer, along with Reps. Dave Brat and Mark San­ford, had voted against the bill Thursday in the House Budget Com­mit­tee.

Palmer’s re­versal gave lead­er­ship some hope of peel­ing off more mem­bers of the Free­dom Caucus be­fore Thursday’s floor vote. House Re­pub­lic­an lead­ers, in ad­di­tion to Trump, Vice Pres­id­ent Mike Pence, and Health and Hu­man Ser­vices Sec­ret­ary Tom Price, will be work­ing the phones over the week­end, and lead­er­ship is es­pe­cially count­ing on Trump to twist Free­dom Caucus mem­bers’ arms.

Still, even with more con­ser­vat­ives on board, lead­er­ship must also avoid de­fec­tions from more mod­er­ate Re­pub­lic­ans in swing dis­tricts.

Rep. Mario Diaz-Bal­art, whose dis­trict has one of the highest con­cen­tra­tions of Obama­care en­rollees, said he still has ma­jor con­cerns with the bill. “If you’re over 55 and you’re poor … what hap­pens to those folks now?” he said.

Rep. Robert Ad­er­holt had sim­il­ar con­cerns, and said he told Trump he was wor­ried about low-in­come seni­ors fa­cing sig­ni­fic­antly high­er premi­ums. But he said that he felt bet­ter about the le­gis­la­tion after the White House meet­ing.

“These are people that are count­ing on him, that were look­ing to him for guid­ance. And he said, ‘I hear you. This is a very im­port­ant is­sue. We are deal­ing with it,’” Ad­er­holt said. “He said, ‘Those are the people that voted for me and I am not go­ing to let them down.’”

Even if the votes come to­geth­er in the House, the bill will likely face a whole new round of obstacles in the Sen­ate. Con­ser­vat­ives, in­clud­ing Sen. Rand Paul, have ex­pressed con­cerns sim­il­ar to the Free­dom Caucus’s, while more-mod­er­ate Re­pub­lic­ans, in­clud­ing Susan Collins and Dean Heller, say they can’t sup­port the bill be­cause of its deep cuts to Medi­caid.

Those three alone could sink the bill. And many oth­er sen­at­ors are con­cerned about vot­ing for a meas­ure that would, ac­cord­ing to the Con­gres­sion­al Budget Of­fice, lead to 24 mil­lion more un­in­sured Amer­ic­ans by 2026.

But for now, House Re­pub­lic­an are only fo­cused on something that can pass their cham­ber.

“I think the Sen­ate is wor­ried about hav­ing to vote on any­thing, which is pretty typ­ic­al,” Rep. Tom Cole told Na­tion­al Journ­al. “These de­mands that we write something that they can pass; they should write something that they can pass. That’s not really our job.”

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