Health bill short of votes, GOP leaders look to Trump

WASHINGTON -- Short of votes for their health-care bill, Republican congressional leaders turned to President Donald Trump on Thursday to wrangle support for the divisive legislation they hope to push through Congress before Easter.

But Trump sounded more like he was at the start of a negotiation than ready to close the deal. And combined with opposition from Republicans of all stripes, the president's flexible stance suggested final passage of the bill could be delayed, potentially exposing the legislation to the same kind of extended public backlash that undermined former President Barack Obama's Affordable Care Act from the start.

"It's very preliminary," the president said of the House GOP bill in a Fox News Channel interview Wednesday when questioned about reports the legislation would help Democratic voters more than those who elected him. "A lot of things aren't consistent. But these are going to be negotiated. ... We will take care of our people, or I'm not signing it, OK, just so you understand."

The House Budget Committee voted narrowly Thursday to advance the troubled Republican health bill, with defections by three GOP conservatives underscoring the obstacles party leaders face in maneuvering to avoid a stinging setback to their showpiece legislation after seven years of promises to repeal and replace "Obamacare."

The House GOP bill repeals elements of that law, including the "individual mandate" that penalizes people who don't have insurance. It sets up a new system of tax credits that is less generous, particularly to older Americans. It eliminates some of Obamacare's requirements for services health plans need to cover, and it sunsets an expansion of Medicaid over several years, an element causing great consternation with moderate-leaning Republicans but one conservatives want to move up faster.

The bill also cuts a slew of taxes, mostly to the benefit of the rich. Conservatives said it doesn't go far enough in repealing the Obama-era law in full, and an analysis by the nonpartisan Congressional Budget Office found 24 million people would lose their health insurance over a decade, although the bill also would reduce the deficit.

Republicans in the Budget Committee pushed nonbinding proposals to phase out the Medicaid expansion more rapidly, help low-income people more with tax credits and require able-bodied Medicaid recipients to meet work requirements.

House conservatives said they are negotiating some changes directly with the White House, cutting out House GOP leaders, while rebellious GOP senators were stoking the opposition.

GOP Sen. Rand Paul of Kentucky met with House Freedom Caucus members Wednesday night, handing out copies of Trump's book "The Art of the Deal," along with a handout highlighting takeaways that could be applied to the health-care debate.

One lesson from the book, according to Paul's summary, is to "protect your downside," leading him to instruct House conservatives: "Don't go along with Obamacare Lite -- a bill that will fail in the Senate. Don't put your name on OBAMACARE LITE. As the markets collapse, you will be blamed."