Make-or-break

GOP faces make-or-break moment on Obamacare repeal

This week may be the last, best chance to get it done in the House.

By RACHAEL BADE , JOHN BRESNAHAN and KYLE CHENEY

House Republican leaders and White House officials are increasingly confident about passing their long-stalled Obamacare replacement bill: More lawmakers than ever are committed to voting “yes," they say, and GOP insiders insist they’re within striking distance of a majority.

But the window of opportunity for Speaker Paul Ryan and his leadership team is closing fast. The House is scheduled to leave town for a one-week recess on Thursday, and some senior Republicans worry that failing to get it done by then would fritter away critical momentum. Skittish Republicans would return home to face a barrage of pressure from Democrats and progressive outside groups.

Some senior Republicans and White House officials are advising Ryan (R-Wis.) and his top lieutenants to cancel the recess if needed, and to keep the House in session until they have the votes.

"I think they could have voted on Friday," President Donald Trump said in a Sunday interview on CBS' "Face the Nation" to discuss his first 100 days in office. "I said, 'Just relax. Don't worry about this phony 100 day thing. Just relax. Take it easy. Take your time. Get the good vote and make it perfect.'"

"I think health care reform, repealing and replacing Obamacare is just around the corner,” Vice President Mike Pence added on NBC’s “Meet the Press.” “I think we’re close.”

While Trump and the White House have been overly optimistic before about repealing Obamacare, senior House Republicans agree with them this time.

“We’re very close," Republican Conference Chairwoman Cathy McMorris Rodgers of Washington said on Fox News’ “Sunday Morning Futures.”

At a Republican Party event in Texas on Saturday, House Majority Leader Kevin McCarthy of California hinted strongly that a vote is imminent.

"Stay tuned — watch next week — and you will see the repeal and replace of Obamacare," McCarthy told the crowd, according to social media reports.

House GOP leaders say publicly that they have until around the end of May to pass a health care reform bill. The reason has to do with arcane but critical parliamentary rules and the sequencing of big-ticket GOP agenda items.

The short version is this: Republicans need a new budget in order to pass a tax cut or tax reform package. But once they pass a new spending blueprint, they lose their authority provided by the current budget to approve health care reform using the majority-vote tool called reconciliation. That means it would take 60 votes in the Senate, rather than 51, to pass a bill — an impossible hurdle given Democratic opposition.

In other words, it looks like now or never.

“This is it,” said an administration official closely following the repeal effort. “We get it done now, or we don’t get it done ever.”

Ryan, McCarthy, Majority Whip Steve Scalise of Lousiana and Chief Deputy Majority Whip Patrick McHenry of North Carolina spent the weekend working the phones trying to whip wavering moderates, sources said. They’ve put members in touch with Health and Human Services Secretary Tom Price, who has briefed the lawmakers on administrative actions he intends to take to stabilize health care markets and explained how the legislation would work.

Ryan’s health care adviser, Matt Hoffmann, has also been educating Republican members.

A revised version of the House GOP bill negotiated by centrist Rep. Tom MacArthur of New Jersey and House Freedom Caucus Chairman Mark Meadows of North Carolina secured the backing of all but a few Freedom Caucus members — a huge boost for Ryan and his leadership team. The group’s endorsement, along with new support from outside conservative groups that blasted an earlier version of the bill, has given GOP leaders momentum they’re unlikely to have again.

“The repeal and replace issue has dogged us this first 100 days, and there are a lot of us frustrated by the fact we haven't settled it already,” said Rep. Steve Womack of Arkansas, a deputy whip. “My hope is that we can move this across the finish line before the next recess."

Complicating the legislative maneuvering is a looming Friday deadline to fund the government through September. The must-pass legislation could eat up time leaders need to round up votes for health care.

GOP leadership and appropriations staff worked through the week to strike a deal with Democrats. And on Sunday night, they reached an agreement that would increase defense spending by $25 billion and provide $1.5 billion in new border security spending, though it would not allocate money to build a border wall.

While leaders scrounge for votes on their new spending deal, Ryan and his team still have to nail down about 20 undecided Republicans on health care. More than 15 lawmakers — mostly moderates — have said publicly they will not vote for the current bill. So GOP leaders, who can only lose 22 votes, are scrambling to persuade those who haven’t made up their minds.

On Friday, Rep. Fred Upton of Michigan, the former chairman of the Energy and Commerce Committee and a staunch ally of leadership, said he’s “not comfortable” with the health care compromise. Upton's position is especially notable because he has helped craft dozens of GOP Obamacare repeal bills in the past.

Likewise, Rep. Don Young of Alaska emerged from a one-on-one meeting with Ryan on Friday saying he still hadn’t made up his mind. Ryan called GOP holdouts to his office that day to discuss their outstanding concerns.

House Republicans are under enormous pressure from all sides. Democrats are determined to make health care a driving issue of next year's midterm elections regardless of whether Obamacare is ultimately overturned, but Republicans from competitive districts who back the repeal measure will have an extra-large target on their backs. If the GOP falls short, however, Republicans could face primary challengers from the right.

Ryan's reputation as speaker and his standing with Trump are also on the line. After the embarrassing collapse of the first Republican stab at passing a bill in late March, the speaker needs to show Trump he can deliver.

Trump will not be endlessly patient, and if Hill Republicans fail, the president is sure to shift the blame to someone other than himself.

The president's finger-pointing was on full display at a rally in Harrisburg, Pennsylvania, on Saturday night. After promising that “we’re going to give Americans the freedom to purchase the health care plans they want, not the health care forced on them by the government,” Trump singled out two House Republicans in the crowd.

“I’ll be so angry at Congressman [Mike] Kelly and Congressman [Tom] Marino and all of our congressmen in this room if we don’t get that damn thing passed quickly,” Trump said of two of his earliest and most loyal supporters.

After a pause and loud cheers, Trump added, “They’ll get it done. We know them. They’ll get it done.”

On Sunday morning, Trump tweeted that a “New healthcare plan is on its way” that will "have much lower premiums & deductibles while at the same time taking care of pre-existing conditions.”

If GOP leaders don’t hold the vote soon, they’re bound to face internal pressures as well. Meadows told reporters Friday that while he hopes the current version passes, he’s readying a Plan B “backup” repeal bill if the legislation fails.

“I don’t think [the bill] has to be voted on next week, [but] I certainly would be extremely disappointed if it weren’t,” Meadows said, later adding: “We’re going to vote on something.”