Conservatives in the House openly rebelled Tuesday against legislation backed by their leadership to repeal and replace ObamaCare, sowing doubts about whether the legislation can pass.
The rollout for the long-awaited healthcare plan, released Monday evening, was rocky. It was panned on the right as a retreat from full repeal, pilloried on the left as a tax giveaway to the rich, and criticized from the center as potentially stripping insurance from millions of people.
GOP leaders were undaunted, defending the legislation as a work in progress that will ultimately pass.
“This is the beginning of the legislative process. We’ll have 218 when this thing comes to the floor. I can guarantee you that,” Speaker Paul RyanPaul Davis RyanHow Kevin McCarthy sold his soul to Donald Trump On The Trail: Retirements offer window into House Democratic mood Stopping the next insurrection MORE (R-Wis.) said, referring to the typical number of votes needed for a simple majority in the House.
“I’m prepared to lead our conference to do what we said we would do in the election. We ran on a repeal-and-replace plan. That’s what this is: the repeal-and-replace plan.”
But the path to a majority vote, for Ryan, starts with winning support from members of the hard-right Freedom Caucus who appear set against it.
“You have to get rid of ObamaCare completely,” said conservative Rep. Jim Jordan (R-Ohio) at a press conference with other Freedom Caucus members, along with Sens. Rand PaulRandal (Rand) Howard PaulConservative pundit says YouTube blocked interview with Rand Paul These Senate seats are up for election in 2022 I'm furious about Democrats taking the blame — it's time to fight back MORE (R-Ky.) and Mike LeeMichael (Mike) Shumway LeePut partisan politics aside — The Child Tax Credit must be renewed immediately These Senate seats are up for election in 2022 Senate panel advances bill blocking tech giants from favoring own products MORE (R-Utah), who also object to the bill.
Paul called the plan “dead on arrival.”
After a meeting later Tuesday evening, Freedom Caucus members said leadership doesn't have enough support.
The conservatives vowed to reintroduce the same ObamaCare legislation that passed Congress in 2015 but was vetoed by then-President Obama. That bill would repeal all of ObamaCare’s taxes and mandates and eliminate its Medicaid expansion.
The leadership-backed legislation also took heavy fire from outside conservative groups, including the Club for Growth, Heritage Action and Americans for Prosperity, which is backed by the billionaire GOP mega-donors Charles and David Koch. They saddled the plan with names like “RyanCare” and “ObamaCare lite” and attacked centrist Republicans who fear the measure already goes too far.
FreedomWorks said it would be holding a “day of action” on Wednesday, with 1,000 activists visiting congressional offices to call for full repeal and not the leadership-backed bill.
Criticism of the legislation was also prevalent in conservative media, with the plan taking flak from radio hosts Laura Ingraham and Mark Levin and websites like the Drudge Report and Breitbart News.
But the prospects for the legislation got a boost from the White House, with President Trump telling members of the House GOP whip team that he was “proud to support it.”
“It’s very important, so let’s get it done,” the president said.
Vice President Pence visited the Capitol to begin pushing for the bill, meeting with the House conservatives in an effort to bring them on board.
Freedom Caucus Chairman Mark Meadows (R-N.C.) said after the meeting that he was “encouraged” that Pence said the legislation is “still open for negotiation.”
Meadows added, “Obviously, we have some serious concerns.”
While top Republicans expressed an openness to changes, committee votes on the legislation are already set to begin, less than 48 hours after the plan was unveiled to the public.
The Energy and Commerce Committee and the Ways and Means Committee plan to mark up the legislation on Wednesday, before a Congressional Budget Office analysis of the legislation’s cost and its impact on coverage will be available.
Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellSchumer requests Senate briefing on Ukraine amid Russia tensions Bipartisan Senate group discusses changes to election law There is a bipartisan path forward on election and voter protections MORE (R-Ky.) embraced the legislation and pledged to get it to the Senate floor before Congress leaves for a two-week recess in April.
GOP leaders are betting that when the moment of truth arrives, Republicans will not be willing to vote against a bill that dismantles huge portions of ObamaCare.
“Everyone right now, I think, is trying to leverage their position and help shape and influence the bill in the direction they want to see it go before it’s ultimately voted on,” said Sen. John ThuneJohn Randolph ThuneThere is a bipartisan path forward on election and voter protections Juan Williams: It's Trump vs. McConnell for the GOP's future Biden's year two won't be about bipartisanship MORE (R-S.D.), a member of Republican leadership.
“But when push comes to shove and the vote occurs over here, it’s going to be either a vote for the status quo or a vote to repeal this and to move to a better way, and that’s what our members are going to be faced with, and I think that’s the way it’s going to be framed. It’s going to be a yes or no vote.”
Outside of Congress and the White House, the plan got mixed reviews.
The American Hospital Association, for example, came out against it, pointing to issues such as Medicaid cuts that make “significant reductions in a program that provides services to our most vulnerable populations.”
But the legislation did get an early vote of confidence from the U.S. Chamber of Commerce, which said the recommendations would “repeal a substantial number of the most harmful provisions” in the Affordable Care Act.
The bill was also applauded by AdvaMed, a trade association for medical device manufacturers, and the National Retail Federation, which represents merchants.
The conservative objections to the bill, meanwhile, are centered on a refundable tax credit that would help people afford insurance. Conservatives call that tax credit a “new entitlement.”
They also point to the retention of ObamaCare’s “Cadillac Tax” after 2025 and say the Medicaid expansion must be repealed in full.
House Ways and Means Committee Chairman Kevin BradyKevin Patrick BradyOn The Trail: Retirements offer window into House Democratic mood Members of Congress not running for reelection in 2022 Trump war with GOP seeps into midterms MORE (R-Texas), who has been on a public relations blitz for the legislation, pushed back against the conservatives. It’s time, he said, for Republicans to stand up and deliver.
“As Republicans, we have a choice,” Brady said. “We can act now, or we can keep fiddling around and squander this opportunity to repeal ObamaCare and begin a new chapter for the American people.”
Scott Wong and Jessie Hellmann contributed.