Trump fights for support ahead of U.S. healthcare vote

U.S. President Donald Trump and Republican congressional leaders appeared on Wednesday to be losing the battle to get enough support in the House of Representatives to pass their Obamacare rollback bill, watched by wary investors in financial markets.

The current House Republican plan is scheduled for a floor vote on Thursday, but faces resistance from some conservative Republicans who view it as too similar to Obamacare, and from moderates concerned it will hurt some voters.

Mark Meadows, who heads the conservative House Freedom Caucus, said after a White House meeting with Vice President Mike Pence that his group had more than enough members to stop the bill from passing, although he remained hopeful for potential changes to the legislation.

Trump and House Speaker Paul Ryan, the measure's leading proponent, can afford to lose only about 20 Republican votes or risk failure, since Democrats are united against it. 

A Freedom Caucus aide said more than 25 of its members were opposed.

"Based on the resolve (of conservatives) and the lack of changes in the bill, I would be very doubtful it would pass," Meadows said.

White House spokesman Sean Spicer said the administration was optimistic, citing a couple of lawmakers who had been opposed but now supported the bill.

"The count keeps getting stronger for us," Spicer said at a White House briefing, while declining to provide a current count of where votes stood. 

"There is no Plan B. 

There is Plan A and Plan A. 

We're going to get this done," he said

Asked on Fox News if he would postpone the vote if he did not have enough votes to pass the bill on Thursday, Ryan said he was not going to get into "hypotheticals" and added: "We’re not losing votes, we’re adding votes, and we feel like we’re getting really, really close.”

Repealing and replacing Democratic former President Barack Obama's 2010 Affordable Care Act is a first major test of Trump’s legislative ability and whether he can keep his big promises to business.

Trump’s promises during his election campaign and his first two months in office have lifted U.S. stock markets to new highs. 

But stocks fell back sharply on Tuesday as investors worried that a rough ride for the healthcare legislation could affect his ability to deliver on other big pieces of his agenda, from cutting taxes and regulation to boosting infrastructure.

Major stock indexes wobbled on Wednesday, with the Dow Jones Industrial Average ending slightly down and the S&P 500 slightly higher. 

Investors are eagerly awaiting Thursday’s healthcare vote, which could be pivotal for Trump's broader plans.

"The Trump agenda is like a one-lane road with this big truck called 'healthcare' in the lead," said Brookings Institution senior fellow William Galston. 

"If that truck breaks down, everything else will back up."

While paying little attention to the details of the House Republican effort, Trump has put considerable effort into shoring up the bill, actively courting conservative lawmakers with objections to the bill. 

In a trip to Capitol Hill on Tuesday he warned Republicans that failure could have sharp repercussions in next year's congressional midterm elections.

Trump kept up his efforts to sell the plan, called the American Health Care Act, on Wednesday, meeting with a group of House members at the White House.

He declined to say what he would do if the proposed legislation fails in the House. 

Asked if he would keep pushing the bill, he told reporters: "We'll see what happens."


At rallies this week in Nashville, Tennessee, and Louisville, Kentucky, meant to drum up support for the bill, Trump spent little time discussing specifics and made clear he saw it as a step on the road in a broader agenda that includes his planned tax cuts.

Obamacare overhauled the U.S. health insurance system and aimed to reduce the numbers of Americans with no health insurance. 

Twenty million people gained insurance under the law, but Republicans have long targeted it as government overreach because of its mandates on individuals and employers, and they have criticized rising costs of insurance premiums.

The nonpartisan Congressional Budget Office estimated 14 million people would lose medical coverage under the Republican plan by next year. 

It also said that 24 million fewer people would be insured by 2026.

The plan would rescind the taxes created by Obamacare, repeal a penalty against people who do not buy coverage, slash funding for the Medicaid program for the poor and disabled, and modify tax subsidies that help individuals buy plans.

In a series of radio interviews on Wednesday, Ryan pressed his case that Republicans had to keep their campaign promise to jettison Obamacare and that the party should unite to deliver the bill. 

The House bill had to be crafted so it can pass the Senate, where Republicans hold a slimmer majority, and there will be opportunities to pursue changes later, Ryan said.

Conservatives stressed objections to a bill they say does not do enough to drive down costs. 

Scott DesJarlais, a member of the House Freedom Caucus, said he could not support the bill without changes, including doing away with the current bill's mandate for certain essential health benefits that should be covered by plans.

"I don't think there's any question how important healthcare is, but again getting it wrong is probably more damaging," he said.

Even if the legislation passes the House, its fate is uncertain in the Senate, where a number of Republicans have spoken out against the House version.

Ryan set out an optimistic timeline for the bill, which would depend on a rapid end to Republican resistance.

He said he expected the Senate to work on the bill next week and another House vote on the final measure to be held in the week of April 3, with it headed to the White House for Trump to sign it into law by Easter, April 16.


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