Trump, GOP struggle to find healthcare votes

House Republican leaders on Tuesday struggled to pick up votes for their ­ObamaCare repeal-and-replace bill, even after President Trump visited Capitol Hill to sell the plan.

With only a day before a scheduled vote on the House floor, the White House and Speaker Paul RyanPaul Davis RyanPolitical figures pay tribute to Charles Krauthammer House approves five-year farm bill House postpones vote on compromise immigration bill MORE (R-Wis.) are facing an uphill fight to get the majority — 216 votes — needed to clear the lower chamber.

In a closed-door meeting with House Republicans, Trump warned that failure to pass the legislation might trigger a backlash for the GOP in the 2018 midterm elections. Republicans, the president said, could lose their seats next year, give Democrats the majority and derail Trump’s ambitious 2017 agenda if they fail to fulfill their campaign promise of repealing ­ObamaCare, said sources in the room.

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But Trump’s dire warning didn’t appear to immediately change many minds. House Freedom Caucus Chairman Mark Meadows (R-N.C.), whom Trump singled out during the meeting, emerged from a private meeting with Vice President Pence Tuesday afternoon, insisting that he was still opposed and that he had at least 22 votes from conservative hard-liners to defeat the bill. Following the meeting, Reps. Jim Jordan (R-Ohio) and Walter Jones (R-N.C.) also said they remain opposed.

According to The Hill’s Whip List at press time, 22 House Republicans were firm “no” votes, with six more leaning no or likely no. Many other Republicans have not said how they will vote. Should all members vote and all Democrats — as expected — vote no, 22 defections would kill the legislation. The bill is scheduled to hit the floor at some point on Thursday.

A pair of Freedom Caucus members, Reps. Rod Blum (R-Iowa) and Andy Harris (R-Md.), added their names to the list of “no” votes on Tuesday, while Rep. Lou BarlettaLouis (Lou) James BarlettaPoll: Casey holds double-digit lead over Barletta in Pa. Senate race How lawmakers have landed an endorsement from Trump Pennsylvania lawmakers invite Eagles to Capitol after Trump snub MORE (R-Pa.), one of the earliest Trump supporters on Capitol Hill, also said he would reject the measure.

Barletta told reporters he’ll remain a no unless the bill adds tougher screenings to ensure that those receiving tax credits are in the country legally. But he said GOP leaders have been unrelenting in lobbying him.

“They’ve been talking to me all day, and we’ll be talking again tonight,” Barletta said.

Shortly after the Trump gathering, Meadows held a midday huddle with fellow Freedom Caucus members. The group of conservative rabble-rousers didn’t vote to take a formal position for or against the legislation, but they emerged from the meeting saying they remained firmly opposed. They maintain the bill doesn’t go far enough to repeal ­ObamaCare provisions.

“The bill needs to change,” Meadows told The Hill. “The insurance regulations and mandates, the essential health benefits need to be repealed.”

Leadership has “maintained the general framework of ­ObamaCare. They haven’t fixed the real problems with ­ObamaCare, and then they expect us to vote for it?” asked Rep. Justin AmashJustin AmashGOP rep refutes Trump's account of Sanford attacks: 'People were disgusted' Trump claims Sanford remarks booed by lawmakers were well-received GOP congressman blasts Trump’s attack on Sanford as ‘classless’ MORE (R-Mich.), a Freedom Caucus co-founder. 

“It’s unreasonable and unrealistic.”

There were a few bright spots for leadership, however.

After GOP leaders rolled out a package of tweaks to the bill Monday night, four reluctant Republicans — Reps. Martha McSally (Ariz.), Tom McClintock (Calif.), Tom MacArthur (N.J.) and Robert AderholtRobert Brown AderholtHouse GOP leaders push immigration vote to next week Trump immigration comments spark chaos in GOP The Hill's Morning Report — Sponsored by PhRMA — Tensions mount for House Republicans MORE (Ala.) — issued a joint press release saying they supported the changes and underlying bill.

And there appeared to be small cracks forming in the House Freedom Caucus wall of opposition. Rep. David SchweikertDavid SchweikertMembers of Congress demand new federal gender pay audit Republican candidate favored in Arizona special House election Ryan leaves legacy of tax cuts and deficits MORE (R-Ariz.), another caucus co-founder, told reporters he definitely would support the bill on the floor, just like he did in the Ways and Means Committee last week.

Yet Rep. Leonard Lance (R-N.J.), who voted for the bill in the Energy and Commerce Committee, is now a no. Democrats are targeting Lance, who represents a district their presidential nominee, Hillary ClintonHillary Diane Rodham ClintonSessions says FBI agent Peter Strzok no longer has his security clearance Melania Trump puzzles with 'I really don't care' jacket Grassley wants to subpoena Comey, Lynch after critical IG report MORE, won in the fall.

Meanwhile, conservative Reps. Trent FranksHarold (Trent) Trent FranksFreedom Caucus bruised but unbowed in GOP primary fights Eric Schneiderman and #MeToo pose challenges for both parties The Hill's 12:30 Report MORE (R-Ariz.) and Scott DesJarlais (R-Tenn.) told The Hill they were looking to find a way to support it. Both said they needed the bill to repeal ­ObamaCare’s minimum coverage requirements.

The White House will be engaged in a full-court press over the next day as it tries to push the American Health Care Act over the finish line. 

While Pence, a former member of House leadership, worked on Meadows in the Capitol, Rick Dearborn, one of Trump’s deputy chiefs of staff, was holed up in DesJarlais’s office asking the congressman what he needed to support the bill. There was no agreement after 45 minutes, DesJarlais said.

Back at the White House, Trump hosted a dozen members of the centrist Tuesday Group, including co-chairs MacArthur, Charlie Dent (R-Pa.) and Elise Stefanik (R-N.Y.). Majority Whip Steve Scalise (R-La.) also joined the meeting. Attendees characterized it as a good meeting, but it didn’t appear that Trump flipped any votes.

“We are very happy with where we are and how productive our conversations with members are,” said a GOP leadership aide. “Our whip team is moving members in the right direction and doing the work to have a good vote this week.”

At the Capitol earlier in the day, Trump laid out in plain terms what’s at stake for Republicans if they fall short on repeal. 

“He told us if we don’t pass this bill on Thursday, it will put everything in jeopardy that he wants to do, his agenda,” Rep. John Duncan (R-Tenn.) said.

He also singled out Meadows during the private meeting, saying in jest: “Oh Mark, I’m coming after you.”

Speaking to reporters as he left the meeting, Trump predicted victory.

“I think we’ll have a winner vote. We’re going to have a real winner,” the president said, even as he conceded further “adjustments” might need to be made to secure 216 votes.

Trump late last week leaned on GOP members, and legislative modifications were made to appeal to members of the conservative Republican Study Committee (RSC). The effort paid off as Rep. Mark Walker (N.C.), chairman of the RSC, publicly backed the bill, as did other RSC members. But it’s clear Trump and GOP leaders have to get more votes before Thursday.

Rep. Richard Hudson (R-N.C.), a member of the GOP whip team and a Trump ally, said the president was anything but vengeful in Tuesday’s meeting. 

“He was endearing, charming, funny, self-deprecating,” Hudson told The Hill, adding that the president also made a serious point about the electoral consequences of keeping the status quo on healthcare.

“A lot of folks are holding out because they think there will be a better offer. I think he’s got to make the case and the point that this is the final offer — take it or leave it,” Hudson continued. “Either you accept the greatest entitlement reform in the history of the country or you leave it.”

Mike Lillis and Jonathan Easley contributed.