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Here's what happens if the House fails to pass the Trump-backed Obamacare replacement today

Here's what happens if the House fails to pass the Trump-backed Obamacare replacement today Here's what happens if the House fails to pass the Trump-backed Obamacare replacement today

The House is expected to vote on the Republican Party’s health care bill on Thursday — and tensions are high as divisions within the GOP could potentially derail the long-awaited Obamacare replacement.

President Trump, who has previously expressed unequivocal hope for the so-called American Health Care Act, signaled on Wednesday that there might be reason to believe its future could be wobbly.

President Trump has been an active force in replacement negotiations. 

“We’ll see what happens,” the President said when asked by a reporter if he’ll keep pushing for the plan should it not pass the House on Thursday.

With conservatives blasting the plan as overly moderate, questions are being raised over what will happen should the bill be sidelined.

Rep. Mark Meadows (R-N.C.) speaks about health care during a news conference on Capitol Hill on Tuesday.

Based off marathon meetings held on Capitol Hill Wednesday, Trump appears to have two options if the bill fails: side with the hardline conservative base and push for a complete repeal of all Obamacare-related provisions, or argue to keep the popular provisions and please the more moderate wing of the party. Finding a middle ground could prove hard, as both factions have been vocal in their opposition when the President tilts one way or the other.

Republicans can only afford to lose about 20 votes in the House on Thursday and even if the plan passes there, it is facing staunch opposition in the Senate, where the GOP can only lose about two votes.

Meanwhile, time keeps ticking and Trump made it a key promise of his campaign to repeal Obamacare “immediately” upon taking office.

The Hardliners

Republicans emerged from all-night meetings on Wednesday and announced that they had not yet managed to cut a deal that pleased all sides.

“I can tell you that we’re making great progress,” Mark Meadows, the chairman of the hard-right House Freedom Caucus, told reporters after a Wednesday night meeting, with hours to go before the expected House vote. “We’re not there yet. But we’re hopeful.”

Meadows represents a significant chunk of Republicans who have no interest in keeping any of the popular parts of the Affordable Care Act, including mandatory insurance plan coverage for so called “essential health benefits” such as mental health help, emergency room visits and maternity and newborn care.

The influential caucus claims that the current House GOP replacement plan has proven to be just another “entitlement” program, as it proposes to implement a system of consumer tax credits, rather than gutting Obamacare completely and replace it with a system staked out only by unrestricted free market rule.

Earlier Wednesday, a Freedom Caucus aide said more than 25 of its members were opposed to the current bill. That would be enough to block it from passing, as all House Democrats are united in opposition.

But Trump, who has been an active force in negotiations, is expected to meet with the caucus on Thursday morning and some staunch conservatives, including Rep. Steve King of Iowa, said Wednesday they are now on board with the House plan, citing Trump’s promise to roll back the “essential benefits” from Obamacare before the plan reaches the Senate.

If Trump could convince the conservative block to vote for the House bill in exchange for a pledge to rip Obamacare to shreds, the GOP leadership might be in luck on Thursday. If the bill fails, Trump could side with the conservative block and possibly get the House to pass a more radically reforming bill with the Freedom Caucus' blessing.

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The Moderates

While Trump appeared to have courted some conservatives on Wednesday, the other side of the party reacted negatively as word spread that the President was making promises to gut even the most popular parts of the Affordable Care Act.

“I believe this bill, in its current form, will lead to the loss of coverage and make insurance unaffordable for too many Americans, particularly for low- to moderate-income and older individuals,” Rep. Charlie Dent, a leader of the moderate “Tuesday Group,” said in a statement, echoing arguments commonly raised by Democrats.

The bipartisan Budget Congressional Committee found earlier this week that some 14 million Americans would lose their health care coverage should the current plan pass.

The more moderate wing of the GOP, which includes House Speaker Paul Ryan, are looking to roll out a soft repeal that would keep intact the most popular provisions of Obamacare, including mandatory insurance coverage for preexisting conditions and a measure allowing young Americans to stay on their parents’ plan until they turn 26.

Health care activists participate in a rally in front of the Capitol on Wednesday.

If the previously positive moderates begin to question the current bill because of Trump’s apparent promises to the more conservative faction, the bill could also be in jeopardy on Thursday.

What both moderates and conservatives are set on, however, is to slash funding for the low-income Medicaid programs, which were expanded under the Obama administration. That has prompted outrage from Democrats and activists.

Opponents to the overhaul gathered on the Capitol rotunda on Wednesday to voice their concerns. Many were in wheelchairs or suffered from serious medical conditions.

“Rather go to jail than die without Medicaid,” the protesters chanted.

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Here's what happens if the House fails to pass the Trump-backed Obamacare replacement today
Dave Arnold

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