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Freedom Caucus chair: Paul Ryan does not have the votes to pass the health bill

Trump, Paul Ryan Attend Traditional Congressional Luncheon For Irish PM Photo by Win McNamee/Getty Images

This is the fun part of the legislative process for President Donald Trump. Two days out from the House’s expected vote on the Republican health bill, Trump paid a visit to House Republicans to close the deal on the American Health Care Act.

Still, the bill’s harshest conservative critics say Trump’s methods didn’t work — and some key conservative voices House Speaker Paul Ryan had been hoping to win over still look like they’re “no” votes.

House Freedom Caucus Chair Rep. Mark Meadows (R-NC), who has been a leading voice against the bill, maintains Ryan will not have the votes on the House floor Thursday. The Freedom Caucus plans to meet again Tuesday afternoon (earlier this week, they said they would not oppose the bill officially). Troublingly for Ryan, the conservative group Heritage Action, which is usually a key indicator for how hardcore conservatives might vote, hardened its opposition to the revised bill on Tuesday.

Trump tried to negotiate with House conservatives on the basis of politics. According to multiple representatives present at Trump’s meeting with Republicans, the president was vague on policy terms and tried to pressure members by reminding them of the primaries in 2018 — noting that a failure with AHCA would lose Republican seats in the House and Senate in the coming elections.

He even put Meadows on the spot, calling him out by name.

“He said, ‘Mark, if we remember correctly, you were supporting me even before I was a candidate — you are a great guy, we have worked together, I am counting on you to get this over the line,’” Rep. Chris Collins (R-NY) recalled of Trump’s remarks.

But asked about Ryan’s proposed amendments to the bill — which would make harsher cuts to Medicaid and give states more flexibility — to get more conservative Republicans on board, Meadows responded bluntly: “What changes?” Rep. Ted Budd (R-NC) also came out of the meeting with Trump saying he would still be a “no” vote on Thursday.

The problem is simply that the bill’s policy still does not go far enough for the Republican Party’s far-right contingent. It has the skeletal structure of Obamacare — and to them, that is unacceptable. As much as Ryan and his team try to brand Trump as the legislative closer, it will be down to the majority whip to get the party in line.

Ryan’s changes aren’t enough for Washington’s most conservative voices

Meadows has the backing of many conservative advocacy groups in Washington.

And they’re not going to make it easy for Ryan either. Heritage Action CEO Michael Needham said the group would be “key” in lobbying against this bill’s passage Tuesday.

On Monday afternoon, Heritage Action’s vice president, Dan Holler, said in an email that Ryan’s package of changes to the bill “will be insufficient unless it deals with Obamacare's regulatory architecture.”

On Tuesday, Meadows said it was “all about premiums,” noting that if the new Congressional Budget Office score showed a dramatic 20 percent cut to premium prices, he would change his mind — but he knows that likely won’t be the case.

Ryan and Trump’s efforts to negotiate with their party’s most conservative voices have not been completely futile; the proposed changes to the plan seem to be moving the bill closer to the 216 votes it needs to pass to the Senate. And after Trump’s appearance, Rep. Darrell Issa (R-CA) said he would likely vote in favor of the bill as well, after leaning against it last week.

But with two days left until the vote, it’s clear that the House Majority whip will have to work through to the House vote to ensure the bill’s passage.

Asked if he thinks House leadership will delay the vote until everyone’s on board, Meadows said, “I doubt it.”

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