Republicans put off ACA repeal vote again

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(Bloomberg) — House GOP leaders aren’t ready to hold a vote this week on their stalled health-carebill, despite intense pressure from the White House to deliver on a long-promised repeal of Obamacare.

“We’ve been making great progress, and when we have the votes we’ll vote on it,” Majority Leader Kevin McCarthy of California told reporters late Thursday.

Republicans vote-counters had been weighing whether to hold a vote this week, after conservative holdouts endorsed the bill following recent revisions. But a number of moderate Republicans remained opposed to the measure, and leaders were also distracted by the need to assemble votes for a stopgap measure to fund the government. The current spending bill runs out Friday.

When it comes to the health bill, conservative and moderate holdouts are still “struggling to get to yes,” Representative Tom MacArthur of New Jersey, the chief author of an amendment that is reviving hopes for the GOP’s health-care bill, said earlier Thursday.

“I think it’s close,” said MacArthur on whether enough votes to pass the bill will be found. “But I think there is a real chance of a vote.”

Several moderate Republicans are visibly frustrated about the renewed push to pass the bill after leaders made changes aimed at winning over conservatives.

“We’ve been through this before,” Republican Representative Charlie Dent of Pennsylvania said Thursday. “The business model around here is to load the bill up, make it as conservative as possible, send it to the Senate and have the Senate clean it up and send it back, and the very people who are placated on the first launch won’t be there on the final. And that dog ain’t hunting anymore.”

House Rules Chairman Pete Sessions, a Texas Republican, added that he hasn’t seen “any impact” from the amendment on the bill’s prospects.

Some lawmakers, along with the White House, have been pushing for a quick vote even as industry groups are starting to weigh in with criticism of the revised measure.

House Speaker Paul Ryan told reporters Thursday that there has been “real progress” in winning over skeptics. “We have not yet made any decisions on a vote,” he said.

White House press secretary Sean Spicer told reporters that President Donald Trump “wants a vote when they have 216 votes, and I feel very good about the progress that’s being made to get to that number.”

The text of the bill and a pair of amendments were posted late Wednesday on a website listing bills that may be considered this week on the House floor, but the House Rules Committee hasn’t yet scheduled a meeting that would be needed to prepare for a floor vote.

100th day
Saturday marks Trump’s 100th day in office. “I’m still holding out for Saturday,” Trump’s budget director, Mick Mulvaney, said Thursday morning on CNBC.

Other undecided Republicans “are so close to yes that I’m very optimistic whether the vote is tomorrow or Saturday or next week, the votes will be there to actually pass this,” House Freedom Caucus Chairman Mark Meadows said Thursday on Bloomberg TV. He said later Thursday that they don’t yet have enough votes to pass the bill.

The most recent changes to the bill have won the formal backing of the conservative Freedom Caucus, but some moderates remain opposed. A Bloomberg News count shows at least 16 Republicans opposed to the revised measure. The GOP can only afford to lose 22 votes from its side and still guarantee passage.

Meadows said Friday that he was confident that the legislation would receive a vote in “the coming days” as more members of Congress understand the revisions.

“I don’t know that there will be necessarily a lot of fundamental changes,” he said on MSNBC. “This will get done -- it’s a matter of weeks, not a matter of months.”

The Congressional Budget Office has told Democrats that it won’t have an updated estimate of the cost of the revised measure or how it would affect insurance coverage this week or next week, according to Drew Hammill, deputy chief of staff for House Minority Leader Nancy Pelosi.

The American Medical Association, American Hospital Association and AARP, the lobbying group for senior citizens, said they oppose the revised Obamacare measure.

“The proposed change would still result in millions of Americans losing their health-care coverage and could make coverage unaffordable for people with pre-existing conditions,” the AMA said in a statement.

The hospital group said allowing states to get waivers from a requirement that insurers cover so-called essential health benefits “could leave patients without access to critical health services and increase out-of-pocket spending.”

State ‘flexibility’
MacArthur, who defines himself as a centrist, disputed criticism that his amendment would be a setback on coverage for people with pre-existing conditions.

“What my amendment does, first and foremost, is it protects people with pre-existing conditions, while at the same time giving states some flexibility so that they can bring costs down,” he said.

MacArthur brushed off criticisms from fellow moderates that his amendment is designed to draw conservative support at the expense of centrists’ concerns. Dent, the senior leader of a bloc of House centrists, said Wednesday the amendment is “an exercise in blame-shifting” onto moderates, should the bill fail.

“I don’t think in those terms, at all,” said MacArthur. “We either win together, or we all lose.”

Ryan also said that Republicans need to deliver on their seven years of promises to repeal the Affordable Care Act.

“I think people’s seats are at risk if we don’t do what we said we’d do,” he said when asked about political risk to moderates voting for the bill. “If you commit the sin of hypocrisy in politics” that’s a bigger risk to losing an election, Ryan said.

Bloomberg News