Despite a frantic lobbying effort, President Donald Trump and House GOP leaders are still short of the votes they need to pass their Obamacare replacement bill, just two days before the legislation is set to be taken up on the floor.

Conservative hard-liners from the House Freedom Caucus are threatening to derail the legislation, saying revisions announced on Monday night don’t go far enough. A handful of moderate Republicans are also balking at the Trump-backed measure. They’re worried about damaging themselves politically by voting for a proposal that will never make it through the Senate.


The upshot is that Trump, House Speaker Paul Ryan and other GOP leaders are dealing with a legislative balloon — whenever they push on one side, it pops out somewhere else. Every concession or revision they make has the potential to cause more problems for the other end of the conference.

White House officials and Republican leaders remain optimistic that they will get the 215 votes they need, but it will be very tight.

Hours after being singled out by Trump over his opposition to the Republican health care plan, Freedom Caucus Chairman Mark Meadows said his group of conservatives still has the votes to block the bill. Freedom Caucus insiders say the group has 27 members who are firmly against it or leaning "no."

House GOP leaders can afford to lose only 22 members on the bill.

Trump, eager to stave off an embarrassing defeat that could hobble his legislative agenda for the rest of the year, has dramatically stepped up his efforts to shift votes.

After personally calling out Meadows during a GOP Conference meeting Tuesday, Trump held a series of face-to-face meetings with lawmakers later in the day. At a bill-signing ceremony in the West Wing Tuesday afternoon, Trump pulled aside a number of Freedom Caucus members, including Rep. Jim Bridenstine (R-Okla.), to try to cajole them to support the package.

Later in the afternoon, Majority Whip Steve Scalise (R-La.) escorted a group of more than 15 moderate members to the Oval Office to meet with Trump. And the president will continue to buttonhole GOP members at a high-profile fundraiser for the National Republican Congressional Committee Tuesday night.

“I think these group meetings are great,” said House Majority Leader Kevin McCarthy (R-Calif.). “[Members] can explain, they get the one-on-one; members get to talk about what the concerns are. The president’s really become very versed in it. I was really impressed by it … He’s been very flexible with his time.”

Yet GOP leaders and White House officials privately admit they’re still short of the votes they need.

“We’re not there yet,” said a top House Republican. “I think we’ll get there, especially with Trump working it, but we’re not there right now.”

Freedom Caucus sources said the group is planning to hold a news conference early Wednesday to trumpet its opposition to the bill, despite Trump's pleas for support. The group's leaders hope to have all 27 members who oppose or are leaning against the measure show up, as well as ultraconservatives in the Senate who oppose it.

"I serve at the will of 750,000 people in western North Carolina, and my primary job, more than anything else, is to serve them," Meadows told reporters Tuesday. "I believe I am representing them in opposing this bill because it won’t lower premiums. And until it does I’m going to be a no — even if it sends me home."

Meadows also met privately with Vice President Mike Pence after the GOP Conference meeting, but did not change his position. The lawmaker said Pence did not lean too hard on him.

“Was it brass knuckles or bare fists? No,” Meadows said afterward.

Scalise and other members of leadership met with Meadows again during the day but got nowhere.

Despite Trump’s victory in November, and their claims of fealty and support for the new president, Freedom Caucus members remain the key bloc of votes in the House GOP Conference. These recalcitrant conservatives have dogged Ryan and former Speaker John Boehner (R-Ohio) for years, and if Trump can't move them, the thinking is nobody can.

Influential Washington-based conservative outside groups — including the Club for Growth and Heritage Action — have come out against the final version of the bill and are pressuring lawmakers to vote against it.

Ryan and GOP leaders plan to take the bill to the floor Thursday regardless of what they expect the outcome to be, despite the problems that could occur if they lose, GOP lawmakers and aides told POLITICO. They're hoping that Trump's message to the GOP Conference Tuesday will sink in over the next 48 hours and persuade enough members to back the measure.

“We still have two days before the vote," said Rep. Patrick McHenry (R-N.C.), the chief deputy majority whip. "This did the right thing and helped move members. And it was the right thing for the president to come in and take ownership of this."

McHenry insisted that Trump wasn't threatening Meadows, despite the fact that the president had singled out the North Carolina Republican several times during the closed GOP Conference meeting.

"The president said publicly and privately he likes Mark Meadows, that Meadows is going to work with him, and Meadows has said likewise," McHenry added. "I think [Meadows] will get to yes.”

Rep. Rod Blum (R-Iowa), one of the few Freedom Caucus members who has a close relationship with GOP leadership, said Trump's remarks at the Conference meeting — and the building pressure — just "steels my resolve."

“The way it stands right now, no,” he would not vote for the bill, Blum told POLITICO. “Not because of the Freedom Caucus, but because I’m a free-marketer and I’m a businessman. ... And the present bill doesn’t give us a free market. I want health insurance premiums to come down. … This bill doesn’t give us a free market.”

Blum's position appears to be a significant problem for GOP leaders, since he's seen as more willing to engage on potential compromises than other Freedom Caucus members.

Even one of Trump's closest allies in the Freedom Caucus, Rep. Scott DesJarlais, remains opposed to the GOP health care legislation. Trump tried to work the Tennessee Republican during a trip on Air Force One last week. Yet DesJarlais told him he was afraid a vote in favor would haunt him the way tax increases haunted President George H.W. Bush, according to a source familiar with their conversation.

“When we get it right, I’ll be there,“ DesJarlais said after leaving the GOP Conference meeting. “If he’s going to put his name on this,” the Tennessee Republican said of Trump, “we need it to work.”

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Still, the entire Freedom Caucus is not opposing the bill, and the group hasn’t take a formal stance. GOP leaders have solidified the support of Reps. Morgan Griffith (R-Va.) and Dave Schweikert (R-Ariz.), for instance, though Schweikert acknowledged that he is an "outlier" among his conservative colleagues.

More moderate Republicans remain a problem as well. They worry about efforts to cut off Medicaid for those who signed up under Obamacare, or the impact the GOP plan could have on the working poor.

Rep. Leonard Lance (R-N.J.), after meeting with Trump on Tuesday afternoon, said he still intends to vote against the plan.

“[Trump] wanted to hear our concerns, and he certainly did hear our concerns,” Lance said. "I think we need to make sure health care policy is accessible to those who need health care policy, and I don’t think this legislation does that.”

Rep. Charlie Dent (R-Pa.), probably the most high-profile moderate, declared he has just as many reservations about the bill after meeting with Trump as he did going into the Oval Office powwow.

And Rep. Lou Barletta of Pennsylvania, one of Trump’s earliest and most ardent backers on Capitol Hill, announced on Twitter that he would vote against the American Health Care Act after Trump’s personal plea for passage.

"Due to my concern over lack of verification that tax credits won't go to people unlawfully in U.S.,” Barletta wrote, “I can't support AHCA in its current form.”

