GOP leaders boost pressure as health bill crunch time nears

WASHINGTON — President Donald Trump and House leaders revved up pressure Wednesday on balky conservatives and other Republican lawmakers as crunch time approaches on the party’s health care overhaul bill, a drive GOP leaders concede they can’t afford to lose.

A day before the House planned votes on the measure, Trump and top Republicans continued hunting support for what would be a significant achievement for his young presidency. But underscoring the bill’s uncertain fate, a senior administration official said that 20 to 25 House Republicans remained opposed or undecided. That’s a grave figure since united Democratic opposition means the measure crashes if 22 GOP lawmakers vote “no.”

“Big day for health care. Working hard!” Trump tweeted Wednesday.

On Tuesday, Trump told House Republicans at a private meeting at the Capitol that “a loss is not acceptable, folks.” He warned they’d face widespread defeats in next year’s elections and possible loss of control of the chamber if the measure failed.

With a smile he told Rep. Mark Meadows, R-N.C., a leading conservative opponent of the measure, “I’m gonna come after you so hard.”

Trump’s remarks and the White House nose count of votes were each described by Republicans who provided inside information on condition of anonymity.

House Speaker Paul Ryan, R-Wis., also painted a gloomy political picture for Republicans if they flop after vowing to demolish former President Barack Obama’s health care law that the GOP has assailed since its enactment in 2010.

“If we don’t keep our promise, it will be very hard to manage this,” the speaker said Tuesday.

The Republican legislation would halt Obama’s tax penalties against people who don’t buy coverage and shrink the federal-state Medicaid program for low earners, which the statute has expanded. It would provide tax credits for medical bills, though generally skimpier than the aid Obama’s statute provides. It also would allow insurers to charge older Americans more and repeal tax boosts the law imposes on high-income people and health industry companies.

The House Rules committee, usually tightly controlled by GOP leadership, was meeting Wednesday to set the terms of debate.

The panel was expected to let the chamber vote on revisions that top Republicans concocted to win votes. These include adding federal aid for older people and protecting upstate New York counties — but not Democratic-run New York City — from repaying the state billions of dollars for Medicaid costs.

Eager to showcase their support for Obama’s law, House Democrats invited former Vice President Joe Biden to speak Wednesday on the Capitol’s steps. Democrats champion the statute for its expansion of health care coverage to 20 million more people and requiring insurers to cover the very ill, families’ grown children to age 26 and specified services like mental health care.

Most House GOP opposition comes from some of the chamber’s most conservative lawmakers, though a smattering of GOP moderates have also said they oppose the Republican bill.

Many conservatives are demanding that the bill void Obama’s restrictions on insurers, which they say drive up premiums. Moderates’ concerns include a worry that the measure would snatch insurance from many voters — a week after the nonpartisan Congressional Budget Office said the measure would toss 24 million off coverage in a decade.

House GOP leaders’ amendments to round up votes will literally be costly.

The budget office had projected the original bill would cut federal deficits by $337 billion over a decade. But those savings are plummeting as top Republicans dole out provisions to nail down backing. Language helping older and disabled people includes $85 billion set aside for the Senate to beef up tax credits for people aged 50 to 64, who budget analysts said would see big cost increases from the GOP bill.

While victory remained uncertain in the House, both sides were looking ahead to what could be an even tougher Senate fight.

Republicans control that chamber 52-48 and six GOP senators have already said they oppose the legislation, enough to sink it without changes. Senate Majority Leader Mitch McConnell, R-Ky., said in an interview with The Associated Press Tuesday he will “have the president weigh in” with senators.

Senate Minority Leader Chuck Schumer, D-N.Y., and other Democrats will try removing provisions from the GOP bill cherished by conservatives: letting states require some Medicaid recipients to work and barring federal health subsidies from use for abortions. The tactic was described by a Democrat speaking on condition of anonymity to discuss strategy, and it could weaken conservative support for the measure if successful.

The Senate will debate the bill under rules barring provisions not directly related to the federal budget. The Senate parliamentarian makes that call and it would take 60 votes to overrule that decision — a threshold Republicans would be unlikely to reach.