The day the House of Representatives was supposed to vote on a bill to repeal the Affordable Care Act dawned in disarray.
As of 9 a.m., the vote had not been scheduled. The House Rules Committee had not finished its markup of the bill after 13 hours of debate, and was scrambling Thursday to override the House policy of forbidding same-day votes on bills. A planned meeting of the House Republican Conference was canceled at the last minute, but lawmakers who hadn’t received that memo were seen wandering into the room. Negotiations on major policy changes that would impact millions of people are ongoing, making the likelihood of a Congressional Budget Office analysis of the final bill before the vote close to zero.
Wednesday night was equally chaotic, as pressure from the White House and GOP leaders failed to win over either the moderate or hardline conservative wings of the Republican Party.
The desire to quickly patch up the deep divisions that emerged within the House GOP conference over the legislation was driven by Republicans’ desire to hold their vote to repeal the Affordable Care Act on the seventh anniversary of its passage. To do so, leadership Wednesday threw a Hail Mary pass—holding a round of late night negotiations where major changes to the legislation were floated.
The conservatives, many in the hardline House Freedom Caucus, that had been most resistant to the legislation appeared to inch closer to making a deal with the White House that would have substantially changed the bill but granted them their biggest demand. However, after a late-night meeting with the rest of the caucus, Freedom Caucus Chair Rep. Mark Meadows (R-NC) said he was optimistic about the direction the negotiations were going, but there was no deal yet.
Other members of the Freedom Caucus seemed less pleased.
Repealing EHB, w/out making other substantial changes, would make the bill worse, not better. It would hurt the sickest people on exchanges.
— Justin Amash (@justinamash) March 23, 2017
One change they are seeking—a repeal of Obamacare’s Essential Benefits provision—was entertained by the White House and Senate leaders on Wednesday. It would have a massive effect on the insurance industry, allowing insurers to sell extremely skimpy plans that don’t cover benefits such as maternity care, prescription drugs, or even hospitalization. Yet some conservatives are demanding that even more of the Affordable Care Act’s regulations, like coverage of pre-existing conditions, also be stripped.
The changes to the ACA’s market reforms had been previously been thought off the table, due to the Senate’s procedural rules, until leadership said Wednesday that there was new information that made lawmakers think the changes could be eligible for the Senate’s so-called reconciliation process, which gets around a Democratic filibuster.
President Trump will meet with the House Freedom Caucus members at the White House late Thursday morning in yet another attempt to bring them on board. Trump’s previous pitches to House Republicans—including dark warnings that they would be “ripe for a primary” challenge in 2018 if they don’t not fall in line and back the bill—have not been successful, but he continued to campaign publicly for the bill Thursday morning.
— President Trump (@POTUS) March 23, 2017
Moving the legislation in a conservative direction, however, puts the votes of the other side of the House GOP conference spectrum at risk.
House leadership also huddled with more than a dozen moderate Republican lawmakers late in the evening in Speaker Paul Ryan’s office to discuss the latest round of deal-making. In a sign that the discussions did not go well, the participants exited through the front door, where reporters were staking out the meeting. Late Wednesday, Rep. Charlie Dent (R-PA), the chairman of the centrist Tuesday Group, released a statement declaring he would vote against the bill.
“This legislation misses the mark,” his statement said.