Republicans fail to pass Trumpcare, and may return with a bill that is even worse
The best shot Republicans had of passing Trumpcare as-is faded away on Thursday. House Majority Leader Paul Ryan and Trump aggressively pushed to get enough House GOP members to back the plan and push it through the House, but failed. So let’s take a moment, breathe, and celebrate.
But just one moment. We have to keep mobilizing.
Party leaders do not usually hold votes they expect to fail. So if you hear that Ryan wants the House vote delayed beyond Friday, regardless of rationale, it is a good bet that there are not enough House votes to pass the bill.
So what could go down after that? Together We Will has carefully examined the likely outcomes, which come down to two scenarios.
The first option is least likely. Ryan could hold a floor vote even if he isn’t sure the bill has 216 votes. Trump and Ryan could start whipping their members to affirm the abysmal plan. You will know that’s happening if Pence heads to Capitol Hill or GOP members of Congress (MOC) come to the White House.
If Ryan goes ahead with the vote, he would basically be asserting his leadership role and daring GOP MOC in very conservative districts to vote against a bill that rolls back Obamacare and is backed by Trump. So the next week or two will be eye-opening on several fronts. I personally don’t think Ryan is bold enough to do that.
In the second, more likely scenario, the GOP could make changes to Trumpcare before it resurfaces for a later vote. And those changes would most likely be scarier than the current bill.
Republican MOC rejecting Trumpcare do so because they do not think the bill’s cuts go far ENOUGH. They want it moved further to the right, and to remove more essential benefits for Americans. They are holding out because they think Trumpcare is basically Obamacare light. The GOP MOC holdouts are members of the House Freedom Caucus, which has about 30 members. The bill can afford to lose no more than 22 GOP representatives.
The House Freedom Caucus
The Freedom Caucus officially came together in 2015 to push for ultra-conservative spending and policy ideals in the House. At first the caucus had just nine members, but the group has grown. The caucus does not release an official list of members, but the group is currently led by North Carolina Republican Rep. Mark Meadows. Other prominent members include Ohio Rep. Jim Jordan, Idaho Rep. Raul Labrador, Alabama Rep. Mo Brooks, South Carolina Rep. Mark Sanford and Michigan Rep. Justin Amash.
Since forming just two years ago, they have wielded great influence over Republican policies. In 2015, they pushed to defund Planned Parenthood in a must-pass bill to keep the federal government funded. The caucus also revolted against House Speaker John Boehner on various issues, eventually leading to Boehner’s retirement.
During the Obama presidency, many of the conservative bills that made it through the House never had a shot of being signed by the president. With Trump now in office, the caucus could have a lot more sway. And while the group has insisted its relationship with House Speaker Paul Ryan is more collaborative, the opposition of caucus members to the House Trumpcare bill has created a schism once again between themselves and GOP leadership.
Cuts to Essential Health Benefits
The caucus has often reminded GOP leaders that they have the votes to kill House leadership’s Trumpcare bill. Members seem to have enough sway with the White House that they have continued negotiating with Trump even after House leaders indicated no more changes would likely be made to the bill.
The Freedom Caucus may get a repeal of Essential Health Benefits included in the House leadership’s bill. That would repeal the Obamacare requirement that insurers cover 10 benefits such as maternity care and prescription drug coverage, and is discussed in more detail below. By repealing Essential Health Benefits, the bill would substantially frustrate moderates who want to be a “yes” but worry that taking away these popular benefits would anger their constituents.
Freedom Caucus members want to cut the Obamacare requirements that every qualifying health plan cover 10 essential health benefits. These 10 items include outpatient services, emergency room care, hospitalization, maternity, mental health and substance abuse services, prescription drugs, rehabilitative and habilitative services, lab tests, preventive care such as vaccines, and pediatric vision and dental care. The caucus also wants young adults ages 26 and under to no longer be eligible for health care under their parents’ plans.
This is why the healthcare bill that Ryan will most likely return with may be far worse than the version of Trumpcare we have been studying for the past two weeks. This means we must remain vigilant. So take your vitamin C, regroup, and let’s get ready for round two.
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