House Speaker Paul Ryan is making concessions on his Obamacare replacement plan to win Republican votes, but it still may not be enough.
On Monday night, Ryan proposed manager’s amendments to the American Health Care Act, three days before the bill is scheduled for a vote on the House floor. The amendments would, if adopted by the Rules Committee, make harsher cuts to Medicaid, create a new reserve fund for older Americans’ tax credits, and further accelerate the repeal of Obamacare’s taxes on the rich. Put simply, the goal is to attract enough conservative lawmakers to pass the bill on the House floor.
Ryan’s team says the amendments put them a lot closer to the 216 votes the House needs to pass the bill on to the Senate. But some of the bill’s biggest conservative critics are still saying it’s a no-go.
House leadership has acknowledged the health bill will not pass without more support from the chamber’s most conservative members. But it seems even with these tweaks, AHCA is still being regarded as “Obamacare 2.0” — and that simply won’t win their votes.
Freedom Caucus leaders say Ryan still doesn’t have the votes
Rep. Mark Meadows (R-NC), who chairs the chamber’s ultra-conservative Freedom Caucus, and Rep. Justin Amash (R-MI), told reporters on Thursday that the bill still won’t muster enough conservative votes.
Meadows & Amash have both told me w/ full confidence that the GOP Obamacare replacement bill won't have enough votes despite Ryan's changes— Haley Byrd (@byrdinator) March 21, 2017
"There are some small tweaks that are good tweaks, but there's not substantial changes in the manager's amendment that would make anybody be more compelled to vote for this," Meadows told the Hill. "I don't think that the bill will pass without substantial changes." He added that he felt negotiations were over.
The amendments are a clear rightward shift for the bill, meeting some conservative demands on Medicaid and Obamacare’s taxes. But Meadows and Amash are echoing the sentiments of the most conservative factions of the Republican Party, which say it’s not enough. On Monday afternoon, Dan Holler, vice president of the conservative advocacy group Heritage Action for America, which has been openly critical of Ryan’s bill, said in an email that “the manager's amendment will be insufficient unless it deals with Obamacare's regulatory architecture.”
Amash tweeted along the same lines, saying that while Ryan has made some tweaks, “[t]hey haven't changed the bill's general framework. They don't have the votes to pass it. They have seriously miscalculated.”
Clearly Ryan’s changes don’t go far enough for some in his caucus.
.@RepLouBarletta tells me he is a NO on AHCA..was a "lean No" last week. Asked if he's hopeful he can support it by Thurs, "I'm still a No"— Al Weaver (@alweaver22) March 20, 2017
Ryan’s negotiations seem to be a step in the right direction
There has been some success in the negotiations so far. Rep. Gary Palmer (R-AL) said he would now vote in favor of the bill, after voting against it in committee last week. (He had recommended adding work requirements for able-bodied adult Medicaid enrollees, which Ryan’s amendment includes.)
And all the Republican representatives from New York, except for one, have also signed on, because of a specific provision proposed by Rep. Chris Collins (R-NY) that would help prevent Gov. Andrew Cuomo (D-NY) from passing off new Medicaid costs onto the state’s counties.
Important: All NY Republicans now expected to vote for AHCA except Katko, per Collins. Katko told Collins he promised voters full replace.— Steven Dennis (@StevenTDennis) March 21, 2017
Ryan and Majority Whip Rep. Steve Scalise (R-LA) still have three days to convince the bill’s skeptics to vote for the legislation.
Vox is keeping track of the House whip count here.