GOP Leaders Still Looking For Votes On Obamacare Bill

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.”