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Despite Conservative Unrest, Ryan Steadfast on Health Effort

House speaker confident bill will pass despite GOP reservations

Speaker Paul Ryan said he was confident a repeal and replace health care bill would pass in the Republican-controlled House despite concerns from conservatives. (Photo By Bill Clark/CQ Roll Call)
Speaker Paul Ryan said he was confident a repeal and replace health care bill would pass in the Republican-controlled House despite concerns from conservatives. (Photo By Bill Clark/CQ Roll Call)


House Speaker Paul D. Ryan remained confident Wednesday that a repeal and replace health care bill in its current form would get enough votes to pass Congress despite some conservatives who flatly said the bill does not have the 218 votes needed to pass.

Republican Virginia Rep. David Brat told reporters after the GOP conference meeting Wednesday morning that he had several concerns about the bill and said there were “plenty” of members not on board.

“With the current bill, there’s not 218,” Brat said.

He and his House brethren were backed up on the other side of the Capitol by Sen. Ted Cruz, who said the legislation doesn’t have majority support in the Senate.

“The current draft in the House is a draft about which I have significant concerns,” the Texas Republican said. “As drafted, I do not believe this bill would pass the United States Senate.”

Cruz, who is scheduled to join his family for dinner with President Donald Trump and First Lady Melania Trump Wednesday evening at the White House, did say he was “optimistic that we can resolve those differences,” particularly with the backing of the administration.

“Yesterday President Trump tweeted that this bill was now open for negotiation, and I think that is exactly right,” Cruz said.

Cruz said that the dinner with the Trumps would primarily be a social gathering, with daughters Caroline and Catherine also planning to attend. But the Texan added that he anticipated discussing the way forward on rolling back the 2010 health care overhaul with the president during the evening in the White House residence.

While conservatives have largely made up their minds that the bill is unacceptable in its current form, other members have also raised concerns.

Pennsylvania Republican Charlie Dent, co-chair of the moderate Tuesday Group, said he’s still evaluating the bill. He has concerns about how the changes being proposed will affect states like his that expanded Medicaid.

Dent said he supports the idea of advanced, refundable tax credits — one of conservatives’ main objections to the bill — but wants to compare the amount of assistance the tax credits provide with that offered under the current law’s subsidies.

Dent was not as optimistic about the bill’s chances as GOP leaders, raising concerns about the dynamic in the House but noting he’s more concerned about what the Senate can accept.

“The challenge we’re going to run into is that there are going to be those on the hard right who will denounce any Obamacare replacement as ‘Obamacare lite,’ and so that’s what you’re hearing now,” he said. “And of course you’re not going to get any cooperation on the left from the Democrats.”

But Ryan said every Republican member of Congress promised on the campaign trail they would work to repeal and replace the 2010 health care law.

“I have no doubt we’ll pass this because we’re going to keep our promises,” Ryan said.

The Wisconsin Republican said Congress was working “hand in glove” with Trump, Vice President Mike Pence and Health and Human Services Secretary Tom Price.

“This is an all hands on deck,” Ryan said.

For Ryan to “guarantee” that the bill will have 218 votes on the House floor before a formal whip operation is conducted illustrates a bullishness that has defined the early weeks of Trump’s presidency.

The president on Tuesday exuded a similar confidence in tweeting, “I feel sure that my friend @RandPaul will come along with the new and great health care program because he knows Obamacare is a disaster!”

Paul has been one of the bill’s most vocal opponents, and rallied with House conservatives against the GOP bill on Tuesday at the Capitol.

In an earlier tweet that day, Trump called the GOP’s bill “wonderful” but noted that it was out for negotiation.

House Energy and Commerce Chairman Greg Walden cited support from Trump, Pence and Price as a reason for optimism about the bill’s chances.

“They ramp up as they are, I think the dynamic changes,” the Oregon Republican said Wednesday. “Remember there were only 61 one of us in my party who were here when George Bush was in the White House and we had Republican control in the House and the Senate. So for a lot of them. they maybe haven’t felt the inertia that comes from Air Force One landing in their district.”

House Chief Deputy Whip Patrick McHenry was also quick to provide a positive prognosis for the measure after the House GOP whip team met with Trump at the White House Tuesday.

“The president said to the deputy whip team very clearly this is the bill he wants on his desk and he wants to get this done quickly so we can move to tax reform and get to the broader economic agenda he’s laid out,” the North Carolina Republican told reporters back at the Capitol that evening. 

Trump told the whip team that he plans to be highly engaged in helping get the bill to his desk, McHenry said, noting that the effort will serve as a marker for how Trump intends to use his power going forward. 

“The president is paying attention to what people are saying and doing — where they’re saying it, where they’re doing it,” he said. “He is highly aware and has a highly attuned air to what is happening in the press and has a real understanding of the challenges legislatively that we’re going to see in the House, in the Senate to get the bill to his desk.”

McHenry dismissed conservatives’ opposition as an insurmountable obstacle.

“We’re Republicans,” McHenry said. “There’s always drama. It can’t be drama free.”

Niels Lesniewski contributed to this story.

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