March 24 (UPI) — The U.S. House of Representatives shelved a vote scheduled for Friday afternoon to determine the fate of the American Health Care Act, apparently because GOP leaders couldn’t find the votes needed to send it on to the Senate.
The House vote was first set for Thursday, scrapped, rescheduled for Friday and scrapped again following a tumultuous 24 hours that saw President Donald Trump and his party mount a final push to get the replacement package for the Affordable Care Act through the lower chamber.
In the end, though, hesitant conservatives could not talk themselves into voting for the AHCA.
“This bill is dead,” one GOP lawmaker said.
Earlier, House Speaker Paul Ryan visited Trump at the White House to assess the situation. Several Republicans have said the president is finished negotiating on the matter and might now just leave the ACA on the books as the healthcare law of the land.
Trump, Ryan and other GOP leaders must now decide what to do about former President Barack Obama‘s signature law, which the party has pledged to repeal since the day it was enacted seven years ago.
White House spokesman Sean Spicer said during his daily press briefing earlier that the AHCA vote would go on as planned.
“We’re gonna continue to work with the speaker and the leadership there to see where the votes are and we’re getting closer and closer,” he said.
The vote was set for late afternoon Friday after four hours of floor debate. Under House rules, amendments cannot be added to the bill once it reaches the floor, meaning the language in the final draft couldn’t be changed unless the vote was canceled.
It remains possible that another vote will be scheduled and another push for the required votes will happen, but that’s up to GOP leadership and Trump.
Friday, Republicans walked away from the bill when the non-partisan Congressional Budget Office released an updated report saying amendments drafted to earn GOP support would cost billions more without increasing coverage. Hardline conservatives balked at the cost, while moderates said the bill wouldn’t improve access to care or reduce insurance premiums.
The CBO said the AHCA’s amendments would decrease the federal deficit by $150 billion in a decade. The original bill was projected to cut the deficit by $337 billion. The CBO said the amendments would also not increase coverage, meaning there would still be 24 million fewer people with healthcare by 2026 if signed into law.
The CBO also said the amended AHCA’s impact on health insurance premiums would be about the same as the original version. The CBO estimated average premiums for individual plans would increase up to 20 percent over the next two years, but by 2026, premiums would be 10 percent lower than they would be under the Affordable Care Act, or Obamacare.
In short, the CBO said the AHCA’s amendments did little other than cost the federal government more money.
In order to be approved and sent to the Senate, the AHCA needs 215 of the 237 Republican votes in the House. In other words, House Republicans can only afford to lose 21 votes. Freedom Caucus voters could easily help surpass that threshold, and have been at odds with Republican leadership since the AHCA, or H.R. 1628, was first announced.
Republicans were unable to secure enough votes Thursday to pass the bill and delayed the vote until Friday. The decision to go forward Friday came at Trump’s insistence, after the president and Ryan essentially told GOP lawmakers to take the new plan as is, or leave it, White House Budget Director Mick Mulvaney said.
If the vote fails, Trump purportedly said he will leave the Affordable Care Act in place and move on to other matters. Mulvaney and Rep. Chris Collins, R-N.Y., a close ally of Trump’s on Capitol Hill, both said the president is done negotiating on healthcare.
Some conservatives have panned the package because they say it doesn’t go far enough in repealing the ACA, or Obamacare. Trump has courted holdouts among Republicans heavily this week, warning them they might eventually lose control of Congress if they don’t approve the bill.
Trump this week visited Capitol Hill in an attempt to persuade the House Republicans to pass the AHCA.
“After seven horrible years of Obamacare (skyrocketing premiums & deductibles, bad healthcare), this is finally your chance for a great plan!” Trump tweeted on Friday. “The irony is that the Freedom Caucus, which is very pro-life and against Planned Parenthood, allows P.P. to continue if they stop this plan!”
The GOP plan shares some similarities with the ACA, like requiring insurers to cover people with pre-existing conditions and providing coverage subsidies. Young adults would also be allowed to remain on their parents’ insurance until the age of 26.
Those provisions are widely viewed as the most popular reforms put in place by Obama.
Unlike the former president’s signature law, though, the AHCA would spend less on subsidies and reduce Medicaid spending — using those savings to eliminate taxes imposed by the ACA on wealthier Americans and medical companies.
In an effort to win over restive conservatives, GOP leadership made the changes to grant individual states more flexibility on Medicaid, and eliminate ACA taxes for uninsured persons this year instead of the original 2018 target date.
To please moderates, the revisions also said Medicaid allotments for older and disabled beneficiaries would increase faster than inflation, and allowed the Senate to craft more generous tax credits for people between the ages of 50 and 64.
The CBO said those changes would only lead to less savings and cause little other effect.
“CBO estimates that enacting H.R. 1628, with the proposed amendments, would save $186 billion less over that period,” the CBO said in a statement. “The legislation’s impact on health insurance premiums would be approximately the same as estimated for the previous version.”