After seven years of fervent promises to repeal and replace "Obamacare," President Donald Trump and GOP congressional leaders buckled at a moment of truth Thursday, putting off a planned showdown vote in a stinging setback for the young administration.
The White House insisted the House vote would still happen — Friday morning instead — but with opposition flowing from both strongly conservative and moderate-leaning GOP lawmakers, that was far from assured.
The delay was announced after Trump, who ran for president as a master deal-maker, failed to close the deal with a group of fellow Republicans in the first major legislative test of his presidency.
Still, leaders of the conservative Freedom Caucus said they were continuing to work with the White House late Thursday on their demands to limit the requirements on insurance companies now in place under former President Barack Obama's Affordable Care Act.
"I can tell you at this point we are trying to get another 30 to 40 votes that are now in the 'no' category to 'yes.' Once we do that I think we can move forward," said Freedom Caucus Chairman Mark Meadows of North Carolina.
The figures quoted by Meadows were startling since Republicans can lose only 22 votes in the face of united Democratic opposition. A tally by The Associated Press counts at least 31 solid "no" votes.
Moderate-leaning lawmakers were bailing, too, as the demands from conservatives pushed them even further from being able to support the GOP bill. The legislation would eliminate some of the requirements, taxes and penalties from Obama's health care law, but also would mean millions would lose their health insurance, older voters would pay higher premiums and Medicaid coverage would shrink for many low-income voters across the country.
GOP leaders planned to meet into the night to figure out how to try to resuscitate the bill. At the White House, Trump insisted just before the delay was announced that "we have a great bill and I think we have a very good chance."
As word trickled out that the vote was delayed, one reporter asked the president for a reaction, and Trump just shrugged. White House press secretary Sean Spicer had insisted earlier that Thursday's vote would happen and the bill would be approved.
There was "no plan B," the White House said.
The drama unfolded seven years to the day after Obama signed his landmark law, an anniversary GOP leaders meant to celebrate with a vote to undo the divisive legislation. "Obamacare" gave birth to the tea party movement and helped Republicans win and keep control of Congress and then take the White House.
Instead, the anniversary turned into bitter irony for the GOP, as C-SPAN filled up the time as the House recessed and lawmakers negotiated by playing footage of Obama signing the Affordable Care Act.
"In the final analysis, this bill falls short," GOP Rep. Jaime Herrera Beutler of Washington state said in a statement Thursday as she became the latest rank-and-file Republican, normally loyal to leadership, to declare her opposition. "The difficulties this bill would create for millions of children were left unaddressed," she said, citing the unraveling of Medicaid.
The Republican legislation would halt Obama's tax penalties against people who don't buy coverage and cut the federal-state Medicaid program for low earners, which the Obama statute had expanded. It would provide tax credits to help people pay medical bills, though generally skimpier than Obama's statute provides. It also would allow insurers to charge older Americans more and repeal tax boosts the law imposed on high-income people and health industry companies.
The measure would also block federal payments to Planned Parenthood for a year, another stumbling block for GOP moderates.
In a danger sign for Republicans, a Quinnipiac University poll found that people disapprove of the GOP legislation by 56 percent to 17 percent, with 26 percent undecided. Trump's handling of health care was viewed unfavorably by 6 in 10.
House Minority Leader Nancy Pelosi, D-Calif., who as speaker was Obama's crucial lieutenant in passing the Democratic bill in the first place, couldn't resist a dig at the GOP disarray.
"You may be a great negotiator," she said of Trump. "Rookie's error for bringing this up on a day when clearly you're not ready."
Obama declared in a statement that "America is stronger" because of the current law and said Democrats must make sure "any changes will make our health care system better, not worse for hardworking Americans." Trump tweeted to supporters, "Go with our plan! Call your Rep & let them know."
Congressional leaders have increasingly put the onus on the president to close the deal, seemingly seeking to ensure that he takes ownership of the legislation — and with it, ownership of defeat if that is the outcome.
Yet, unlike Obama and Pelosi when they passed Obamacare, the Republicans had failed to build an outside constituency or coalition to support their bill. Instead, medical professionals, doctors and hospitals — major employers in some districts — the AARP and other influential consumer groups were nearly unanimously opposed. So were outside conservative groups who argued the bill didn't go far enough. The Chamber of Commerce was in favor.
Moderates were given pause by projections of 24 million Americans losing coverage in a decade and higher out-of-pocket costs for many low-income and older people, as predicted by the nonpartisan Congressional Budget Office. In an updated analysis Thursday, the CBO said that late changes to the bill meant to win over reluctant lawmakers would cut beneficial deficit reduction in half, while failing to cover more people.
And, House members were mindful that the bill, even if passed by the House, faces a tough climb in the Senate, where Majority Leader Mitch McConnell has made clear it will need to change to win the support needed to pass.
