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GOP Leaders Seek Votes To Pass Health Care Bill


Today could - could - be the most consequential day of President Trump's presidency so far. The House is set to vote on a bill to repeal and replace the Affordable Care Act. The president has been lobbying members of his own party to support it. But as we speak, the bill's fate remains unclear. Let's talk to NPR White House correspondent Tamara Keith, who joins us. Tam, good morning.


GREENE: So what is the state of play here? Is this thing likely to pass?

KEITH: Oh, that's a good question (laughter).

GREENE: Well, let me just start with the hard one.

KEITH: Yeah. I think a lot of people would like to know the answer to that one. At the moment, there is no time set for the vote to take place. There could still be amendments that are done at the last minute. But as of yesterday, the White House and House leadership remain determined to hold a vote today even though there is a very open question as to whether it can pass.

GREENE: So this could go on for hours? We have no idea here.

KEITH: Oh, this is going to be a long day. Let's just establish that.

GREENE: Well, we should establish that. Why force the vote if you're Republicans if there's so many moving pieces right now?

KEITH: Yeah. So that's what I asked Richard Hudson. He's a Republican from North Carolina. And he's a member of the whip team, which means he is one of the members of the House who is working to move his colleagues to a yes. He was in a meeting yesterday with the president and some uncommitted members of Congress. Here's how he explained it.

RICHARD HUDSON: Well, the speaker said there's a lot of people who want to take this vote who've promised their constituents they were going to vote to repeal and replace. And so he's not going to take away our opportunity to have this vote. And if there are members who want to bring this bill down and want to go home and explain it, then that's their choice, too.

GREENE: Oh, so they're actually worried if these lawmakers went home, even if there was like a week delay or something, that voters might say, oh, you see that, you're not keeping your promise here?

KEITH: Exactly. And the other thing is that they're partially thinking you bring this to the floor and suddenly there's a lot of clarity in actually having to take that vote.

GREENE: Forcing members to say yes or no.

KEITH: Yeah.

GREENE: Well, so the main focus in the last 24 hours or so has been these 30-roughly members of the House Freedom Caucus, those conservative Republicans who have been saying they can't support this bill in its current form. What do they want? Where do the negotiations stand with them?

KEITH: Well, so in terms of rounding up votes, the division of labor seems to be that Speaker Paul Ryan is focusing on moderates and that the president and the White House are working on the Freedom Caucus. A big group of them went up to the White House yesterday to meet with Vice President Mike Pence, senior adviser Steve Bannon and some others. And after it was over, I caught up with Louie Gohmert from Texas.

LOUIE GOHMERT: Anytime I can be around all those people, I figure I'm in high cotton. It was great to be there.

KEITH: Were you persuaded?

GOHMERT: No. No. No. I'm still a no because as I told them, I'm determined to help my president and so many of my colleagues keep their word. And the bill in its present form doesn't do that.

GREENE: OK. So high cotton, but not high enough cotton to change his mind. What does the congressman want? And is there a chance that he'll get it and come around here?

KEITH: Yeah. And he's getting closer to yes. Members of the Freedom Caucus appear to be getting closer to yes. One thing that they've been really focused on is the cost of premiums. And they believe that the best way to bring those down is to repeal what are known as essential health benefits.

These were a requirement put in place as part of the Affordable Care Act. And it requires all insurance plans to cover these 10, quote, "essential benefits." That includes things like trips to the emergency room, maternity care, care for the baby after the baby is born, prescription drugs, lab tests, pediatric services as well as preventive services and mental health and substance use disorder services, so a wide swath of things.

Freedom Caucus members see this as too much regulation. And they think that getting rid of it would move them to yes. And so the president and the vice president have been working the phones. And Freedom Caucus members late last night started changing their tune and seeming more optimistic that they could get what they were after, though at this point it's not yet in the bill. It hasn't been amended yet.

GREENE: And if they put things like this in the bill, wouldn't that risk potentially losing, say, some moderates? Isn't that the reality here?

KEITH: Yeah. I mean, the vote counting is a zero-sum game. And if they put that in, they certainly could lose some moderates especially over in the Senate. There are also questions about whether there could be parliamentary problems in the Senate because of this.

And just last night, Charlie Dent, a moderate Republican from Pennsylvania, a congressman, met with House Speaker Paul Ryan. And then he left that meeting and put out a statement saying he can't vote for the bill. He says that he believes in its current form it will lead to a loss of coverage and make insurance unaffordable for too many Americans.

GREENE: And, Tam, just a couple seconds left. I mean, the stakes are really high here for both the president and Republicans.

KEITH: Absolutely, very high. And the president believes that he - if he can't do this, he's going to have a lot of trouble with the rest of his agenda, including tax reform.

GREENE: OK. That was NPR White House correspondent Tamara Keith. Tam, thanks.

KEITH: You're welcome. Transcript provided by NPR, Copyright NPR.

Tamara Keith has been a White House correspondent for NPR since 2014 and co-hosts the NPR Politics Podcast, the top political news podcast in America. Keith has chronicled the Trump administration from day one, putting this unorthodox presidency in context for NPR listeners, from early morning tweets to executive orders and investigations. She covered the final two years of the Obama presidency, and during the 2016 presidential campaign she was assigned to cover Hillary Clinton. In 2018, Keith was elected to serve on the board of the White House Correspondents' Association.