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GOP Delays Health Bill Vote as Holdouts Weigh White House Offer

House leaders delayed a scheduled vote on their embattled health-care bill as conservatives mulled a deal proposed by the Trump administration aimed at winning Republican holdouts’ support.

The House had been planning to hold a vote Thursday, but a senior GOP aide says that will be delayed. White House spokeswoman Sarah Sanders said the White House expects the bill will pass Friday morning.

A key House conservative said that progress is being made but they are continuing to evaluate the White House’s proposal.

“We are going to get to the finish line,” House Freedom Caucus Chairman Mark Meadows said Thursday afternoon. The text of the deal “is not in enough of a form to make a good, informed decision.”

Stocks fell after Republicans delayed the vote, with the Standard & Poor’s 500 Index reversing gains from earlier in the day to drop 0.1 percent at 3:40 p.m. in New York. Hospital stocks were up, as the Bloomberg Intelligence North America Hospitals Valuation Peer Group rose 1.8 percent.

The delay came hours after Meadows said his group hadn’t reached agreement following a White House meeting with President Donald Trump.

The Trump administration made what it called a final offer to the group that includes repealing the so-called essential benefits requirements in Obamacare for the individual market only, not for employer-based plans, according to the White House official who spoke on condition of anonymity.

The Freedom Caucus, which has been calling for a broader repeal of Obamacare than envisioned in the current bill, held a meeting Thursday to discuss the offer.

“It’s really in the hands of members there to accept or reject the White House’s offer,” Representative Patrick McHenry, a member of the GOP vote-counting team, told reporters.

A group of House moderates are scheduled to meet with Trump later Thursday.

“The president has been on the phone with scores of Republicans,” White House Press Secretary Sean Spicer told reporters Thursday. “This bill has truly been a collaborative effort from the beginning.”

Negotiations over the GOP Obamacare repeal measure dragged late into Wednesday night, and Republicans postponed until Thursday a key procedural step before the bill gets to the floor.

The GOP bill would reverse massive gains in health coverage under the Affordable Care Act, which brought the uninsured rate to a record low. The proposal would pull hundreds of billions of dollars out of the health system by winding down Obamacare’s expansion of Medicaid and limiting its subsidies, threatening revenues for hospitals, doctors and insurance companies.

Holdouts in the House Freedom Caucus also pushed for changes in Obamacare’s requirements that insurers cover people with pre-existing conditions, but the White House gave them a hard no, according to a White House official.

‘Pre-existing Conditions’

Meadows of North Carolina disputed that. “Addressing pre-existing conditions has always been a requirement for any replacement plan that HFC would support,” he said late Wednesday.

Meadows said earlier Thursday that there was no deal yet with the White House, and that it was too early to tell if one would be reached. House Republicans leaders delayed a conference meeting scheduled for Thursday morning.

“We know the areas that have to be addressed and are still working to find consensus,” Meadows said Thursday morning in an email. “We do not have a deal, but remain optimistic that all parties are working in good faith for the benefit of the people we serve. It would be premature to suggest that there are enough votes to get it passed in the House.”

The House Rules Committee, which will make final changes to the bill before it gets a floor vote, postponed a session that lasted for more than 12 hours on Wednesday as the talks with the conservatives dragged on. The committee plans to reconvene Thursday, finalize changes to the bill and set the rules for how it will be debated in the full House.

Trump and House Speaker Paul Ryan have been working to win over conservative rebels who stand in the way of their Obamacare replacement measure.

Losing Moderates?

Yet as Trump and Ryan pick up conservative members with some of the potential changes, they risk losing moderates. Republican Representative Charlie Dent of Pennsylvania, leader of the moderate Tuesday Group in the House, reiterated Thursday morning that he would oppose the bill.

“I just feel this bill misses the mark,” Dent told MSNBC in an interview. Dent issued a statement Wednesday saying he believes the bill “will lead to the loss of coverage and make insurance unaffordable for too many Americans, particularly for low-to-moderate income and older individuals.”

Republican Representative Jaime Herrera Beutler of Washington also came out Thursday against the bill. The list of GOP defections also includes Staten Island’s Dan Donovan, as well as southern New Jersey’s Frank LoBiondo, Iowa’s David Young and Florida’s Ileana Ros-Lehtinen, none of whom are members of the Freedom Caucus.

Meadows and other conservative Freedom Caucus members have been demanding changes to the essential benefits portion of the Affordable Care Act, which requires insurers to cover 10 categories of services. Those services include hospitalization, ambulance services, maternity care, pediatric services, mental health and substance abuse treatment, prescription drugs, rehabilitative care and laboratory services.

The goal of limiting the required essential health benefits would be to bring down health insurance premiums. Freedom Caucus founder Representative Jim Jordan, the Ohio Republican, told Fox News Thursday that members haven’t been shown any amendments or agreements in writing yet. “We want to see the language first” and make sure “it does what needs to be done.”

Senate Rules

It’s unclear whether changes to these requirements could survive procedural challenges in the Senate.

“What the proponents aren’t telling conservative House Republicans is that the plan to repeal essential health benefits will almost certainly not be permissible under Senate reconciliation rules,” Matt House, a spokesman for Senate Democratic leader Chuck Schumer, said in a statement late Wednesday. “It will require 60 votes to repeal these protections, and the votes just aren’t there in the Senate.”

On Wednesday, Alyssa Farah, a spokeswoman for the Freedom Caucus, wrote on Twitter that more than 25 members of the group remain opposed — enough to defeat the bill — and that GOP leaders should “start over.”

Freedom Caucus members said White House officials made the pitch that conservatives should pass the bill so that the Senate can amend it and address their concerns, but several lawmakers said they weren’t buying it.

“Pence made a play for more support for the bill based on the Senate being able to change it,” Representative Randy Weber said in an interview, adding that he’s still a no. “That’s a hard row to hoe.”

“Because we’d like for it to be as strong as possible going over to the Senate,” he added.

Weber said many Republicans were elected to Congress because of Obamacare, and said they can’t wait years for costs to come down. “In 10 years none of us will be here,” he said. “Probably at this rate, in two years none of us will be here.”

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