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Road to House GOP Health Plan Passage Still Uncertain

Budget Committee considers measure, but changes await

Pence has been a constant presence at the Capitol during the health care debate. (Tom Williams/CQ Roll Call)
Pence has been a constant presence at the Capitol during the health care debate. (Tom Williams/CQ Roll Call)


Two of the strongest proponents for the House Republican plan to remake the health care system, Vice President Mike Pence and Speaker Paul D. Ryan, R-Wis., said Wednesday they were open to changes to secure floor passage.

Those concessions came as the plan faced a test Thursday in the House Budget Committee, amid discontent among GOP moderates and conservatives.

“We’re getting feedback from various members on how we can improve the bill. Now that we have the [Congressional Budget Office score], we know exactly what we’re dealing with,” Ryan said at a Wednesday press conference.

“We can incorporate feedback to improve this bill to refine this bill and those kinds of conversations are occurring in the White House, the House and the Senate and our members. It’s premature to get into the conclusion of those things,” Ryan added.

Pence was back on Capitol Hill Wednesday meeting with key voting blocs, including the conservative Republican Study Committee and moderate Tuesday Group, as well as the whole GOP Conference. His message was that the White House remains behind the bill but is open to improvements, several members said.

Ways and Means Chairman Kevin Brady, R-Texas said after the Pence meeting with the conference that no decisions had been made about changing the bill, and that he is still confident leadership will bring it to the floor for a vote next week.

Rep. Frank LoBiondo said there was a “nice exchange of information” with Pence about moderates’ concerns. “He listened very carefully, he was very attentive,” said LoBiondo. The New Jersey Republican declined to state a position on the bill, saying he still is studying it.

Potential changes include provisions freezing the Medicaid expansion under the 2010 health law; moderates worry about constituents losing coverage. Conservatives want to accelerate the pace of the freeze.

“Anything that can get 218 votes and make the bill better, we’re all about it,” Rep. Markwayne Mullin, R-Okla., said after the RSC meeting.

While 218 votes are typically needed to pass a bill on the floor, 216 are  needed on this bill due to five vacancies.

The Budget Committee can’t make substantive changes to the measure. That would have to come later, through the Rules Committee or via amendment on the floor.

Meanwhile, the House GOP whip team took the temperature of their colleagues during Wednesday evening votes. Earlier in the day, House Freedom Caucus Chairman Mark Meadows predicted the whip count would reveal about 40 hard “no” votes on the current bill, with another 30 to 40 undecided.

“We’re confident tonight that there are not the votes to modify this current bill to make it acceptable to conservatives and moderates alike,” Meadows told reporters Wednesday night.

Meadows said he had not encouraged Freedom Caucus members who sit on the Budget Committee to vote against the bill. Virginia Republican Rep. David Brat, a Freedom Caucus board member, said Wednesday he would vote no in committee.

Republican Sen. Rand Paul, who joined Meadows and Brat at the same rally organized by conservative groups, encouraged the crowd to put pressure on Freedom Caucus members to “bring down the Paul Ryan plan.”

Paul, who met with Meadows and the Freedom Caucus and brought them copies of the Art of the Deal, added that GOP leaders should take a pause on the current bill.

“I don’t think there will be meaningful negotiation unless it becomes apparent that the House bill cannot pass.” he said.

Amid continued conservative opposition and talk of changes, House leaders remained optimistic about the bill’s prospects.

“I feel good about where we are,” Chief Deputy Whip Patrick McHenry told reporters after the RSC meeting.

RSC Chairman Mark Walker said the goal is to get some changes that would lead to a unanimous vote of support among the caucus’s membership, noting, “We’re as hopeful as we’ve ever been.”

The RSC has been pushing to begin the Medicaid expansion freeze in 2018, rather than 2020 as proposed in the bill, and adding a work requirement to the tax credits proposed for helping low-income individuals purchase insurance.

“Some of that’s going to be able to be moved a little bit back and forth,” the North Carolina Republican said. “I believe that there is still enough middle ground, enough breathing space that it keeps everyone on board.”

McHenry said he sees “very little opportunity” to move up the Medicaid expansion freeze and that the tax credits are unlikely to be altered “in any substantive way” — a sign that leadership and the rank and file are not on the same page regarding changes to the bill.

“We know we’re going to lose some and gain some as we move forward,” Mullin said.

The bill’s supporters believe that when it comes time to vote, Republicans will have a tough time voting no.

“Most Republicans ran on repealing and replacing Obamacare,” North Carolina Republican Richard Hudson said. “I don’t think our conference is going to squander this.”

Erin Mershon, Kerry Young and Paul Krawzak contributed to this report.

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