GOP tries to round up conservatives to support healthcare plan

WASHINGTON—The Republican plan to repeal and replace the Affordable Care Act enters its final stages as party leaders drum up support for a full vote next Thursday.

Health and Human Services Secretary Tom Price huddled with lawmakers on Capitol Hill this morning to answer their questions and plan next steps for healthcare legislation. Across town, President Donald Trump spoke with House Whip Rep. Steve Scalise, R-La., and Republican Study Committee members at the White House.

Trump asserted after the meeting he is 100 percent behind the American Health Care Act (AHCA) and skeptical conservatives are changing their minds on the plan. Republican leadership also appears confident there is enough support to move forward; they announced there will be a full vote on the AHCA next Thursday, the seven-year anniversary of President Barack Obama signing the Affordable Care Act.

According to the president, there will be changes to the AHCA before the vote next week to address the concerns of Republican holdouts.

“I also want everyone to know that all of these noes or potential noes are all yeses,” Trump said. “Every single person sitting in this room is now a yes.”

That included Republican Study Committee Chairman Rep. Mark Walker, R-N.C., who has been a vocal critic of the legislation.

Walker’s committee comprises more than 150 Republican members, and his support is crucial if the bill has any chance of reaching the Senate.

He said after Friday’s meeting he’s confident in new changes to the bill, including allowing for states to use block grants for Medicaid, establishing work requirements for able-bodied Medicaid recipients, and ensuring the refundable tax credits will not be used to pay for abortions.

“We will continue to advocate changes to the bill and hope the legislation improves in the Senate,” Walker said. “At the end of the day, we are all committed to repealing Obamacare.”

Because of five House vacancies, the bill only needs 216 votes to pass it on to the Senate. That means no more than 21 Republicans can join Democrats to block the healthcare package.

But while possible changes to the bill have earned Walker’s support, other conservatives aren’t ready to commit just yet.

During the House Budget Committee markup of the legislation, three Republicans voted against moving the bill forward. All three are part of the House Freedom Caucus.

On Friday morning, Rep. Raúl Labrador, R-Idaho, a Freedom Caucus member, told me he’s still a no vote.

Another Freedom Caucus member, Rep. Justin Amash, R-Mich., rejected the idea that Trump’s comments have won over conservative support.

“Absolutely not true that conservatives have flipped to yes on the healthcare bill,” Amash tweeted. “It doesn't repeal Obamacare. It remains a disaster.”

During a Friday morning press conference, Price stated multiple times the plan to overhaul the U.S. healthcare system is not a one-step procedure. He said passing the AHCA is step one, regulatory reforms implemented by the Department of Health and Human Services are step two, and passing more healthcare legislation in the future, not limited by the budget-centric reconciliation process, is the last piece of the puzzle.

But Labrador maintained the only option for changing healthcare is through the filibuster-proof reconciliation process. He said it would be unlawful for Price to make significant changes to policy through regulations, and if future legislation backed by Democrats was on the table, Republicans would be working on that instead of the AHCA: “It is a fantasy to believe anything else.”

As a group, the 40-member House Freedom Caucus continues to criticize the AHCA. The group’s chairman, Rep. Mark Meadows, R-N.C., said he didn’t hear any significant changes proposed in the meeting with Price. He added, however, that a “possible optional work requirement for Medicaid” came up in the discussion. But Meadows left the meeting without much optimism about the direction of the plan.

Earlier this week, holdouts suggested adding a “manager’s amendment,” a package of smaller amendments agreed to in advance, to the AHCA during the House Rules Committee’s review to address conservative concerns before the final vote.

Meadows said Friday the Freedom Caucus would unveil its proposed manager’s amendment next week.