The Republican-controlled
House of Representatives votes on the controversial measure despite
challenges over whether Trump and ally House Speaker Paul Ryan have
enough backing to get the measure over the finish line.
With
Democrats opposed to Trump's effort to rip out his predecessor's
crowning domestic policy achievement, and his own party's right flank in
revolt, Trump brought in wavering lawmakers Wednesday to try to tip the
scales in his favor.
"Big day for healthcare. Working hard!" Trump tweeted.
Insiders
say Trump's meetings have been focused less on specifics than on the
politics of "Trumpcare" failing -- an outcome that would be a
humiliating defeat for the billionaire leader at the start of his term.
But some lawmakers have emerged defiant, including Mark Meadows, chairman of the grassroots conservative Freedom Caucus.
"We need changes to the underlying bill before we vote on it in the House," Meadows told reporters.
"There's not enough votes to pass it tomorrow."
Speaking
on Fox News later Wednesday Meadows said that "to say that we've got a
deal -- that wouldn't be accurate," but did say that he and Trump had
come to "an agreement in principle."
"There's still work to be done but I can tell you that the president is engaged."
For
years, Republicans have promised to overturn Obama's reform, describing
it as government overreach. But some lawmakers have balked at their own
party's plan, saying it is still too costly for the government.
Others
worry that their constituents will no longer be able to afford health
insurance. A nonpartisan congressional budget estimate says 14 million
Americans would lose their coverage from next year under the Republican
plan.
"We'll see what happens," Trump said Wednesday during a meeting on health care and women.
Close vote expected
The House vote on the American Health Care Act (AHCA) looks tight.
The
Democratic minority is prepared to vote against it as a bloc, so
Republican leaders need to limit defections to about 22 out of their
party's 237 representatives -- depending on how many members end up
casting a vote.
Those
who are the most unhappy with "Trumpcare" are members of the Freedom
Caucus -- heirs apparent to the ultra-conservative Tea Party movement.
They
call the new bill -- championed by Ryan -- "Obamacare Light," as it
will only reduce, not eliminate, health coverage subsidies by replacing
them with refundable tax credits.
Party
leaders made tweaks to the bill late Monday, which they hope will allay
concerns enough for the bill to squeak by in Thursday's vote.
The White House was all in.
"There is no plan B," White House spokesman Sean Spicer said Wednesday.
Credibility at issue
As
the vote neared, the arm-twisting on Capitol Hill and at the White
House continued. Ryan could decide to postpone the vote if it becomes
clear the measure will fail.
Several
conservatives want to see the bill lift burdensome regulations on
insurance companies -- including requirements for preventive care --
that they blame for the rise in insurance premiums.
As
Meadows stood firm, Ryan countered: "We're not losing votes, we're
adding votes, and we feel like we're getting really, really close," the
speaker said.
On Tuesday, House
Republican and Trump loyalist Chris Collins said some of the 20 to 30
lawmakers still in the "no" camp could vote "yes" at the last minute to
spare the party a major setback.
New York Republicans like Collins have won a concession on taxes for their constituents, and have since shifted to "yes."
Trump has put his own credibility and deal-making skills on the line for the measure.
On
Tuesday he took his case directly to Capitol Hill, where he warned that
congressional Republicans risk a major defeat at the 2018 mid-term
polls if they do not deliver for him.
Trump
also singled out specific lawmakers who oppose him -- including
one-time supporter Meadows -- suggesting he could make their lives
difficult if they defy him.
Conservative House Republican Thomas Massie was unmoved.
"We're afraid he's a one-term president if this passes," Massie warned on CNN. "We're trying to save him."
After
defeats in the federal courts for both of his executive orders on
immigration, the president needs to show he can get results on the Hill.
So far, he has only succeeded in rolling back some Obama-era regulations and signed into law a bill on NASA funding.
Should the House pass the bill Thursday, the Senate is expected to take up the measure next week.
Trump will need all of his negotiating talent once again, as opposition there is likely to be equally stiff.
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