Republican Infighting Derails Vote On Health Care Bill

The House of Representatives delayed a scheduled Thursday vote on the GOP health care bill aimed at rolling back and replacing the Affordable Care Act. The White House is working to cut a deal with a bloc of conservatives in order to pass it.

KELLY MCEVERS, HOST:

The House of Representatives will not vote tonight on a bill that would make good on the party's promise to repeal and replace the Affordable Care Act. The White House and congressional leaders insist they will get this bill passed eventually, but Republican infighting threatens to derail it. Some conservatives say it doesn't go far enough to repeal Obamacare while other Republicans are increasingly skeptical that it's the right thing to do.

NPR congressional correspondent Susan Davis joins us now from the Capitol Hill. Hey there, Sue.

SUSAN DAVIS, BYLINE: Hey, Kelly.

MCEVERS: So this is the one campaign promise that has unified the Republican Party. Every single Republican in Congress ran on this, and so did President Trump. Why can't they get there?

DAVIS: You know, they have a very narrow path to find the right mix of votes to get it passed, and they're just not there yet. The driving force of the opposition right now that's keeping them from getting there is focused on a group called the Freedom Caucus. It's a group of about 30 what we would call hardline conservatives whose argument is that the bill doesn't go far enough to make good on that campaign promise to repeal the Affordable Care Act.

MCEVERS: And the opposition seems to be growing elsewhere as well in the party. I mean the Republicans who have come out as noes on this bill today are more moderate mainstream Republicans. Is it losing support basically from all wings of the party at this point?

DAVIS: Yes. I mean this is where you have this sort of pressure model where for every concession you give to the far-right, you lose Republicans a little bit closer to the middle. You know, the Freedom Caucus conservatives say that they want to lower costs, and the way that they say they want to do that is they want to repeal something called essential health benefits. It's this set of basic - ten basic medical needs that were outlined in the Affordable Care Act that said every insurance policy has to cover it. But conservatives say that's what's driving up costs. You know, this is why your premiums are so high, so we should get rid of this and lower costs. That is one set of issues.

MCEVERS: Right.

DAVIS: Then, as you said, the other side is that what this bill does to Medicaid has given a lot of more moderate Republicans pause. A lot of the votes that have come out today as noes aren't about that issue. It's about people looking at the changes to Medicaid and saying, I'm not sure I can go home and campaign on this.

MCEVERS: I mean at this point Republicans control everything - right? - the House, the Senate and the White House. What does this say about House Speaker Paul Ryan and President Trump's abilities to close a deal in Washington if they can't get this one done?

DAVIS: There is a lot on the line for both of them, especially because throughout the course of this process, the thing we've heard from both is that - hand in glove was their term. We're working hand in glove this whole process. There's no daylight. And this bill is really the brainchild of the speaker. These are his ideas. He has been the most passionate advocate for what this bill aims to do. And he's got members on the line who have to face voters every two years, so he sees the political stakes here. But Trump is - this is his brand, right? He's the closer.

MCEVERS: Right.

DAVIS: This is what he won an election on, saying, I can go to Washington, and I can cut deals. And if a Republican White House and a Republican Congress can't agree with themselves on what has been essentially their core campaign promise for the better part of the past decade, it would kind of perhaps be a destabilizing event for them that - they would question their ability to move forward with all kinds of ambitious things they've outlined this year to reform the tax code or to, you know, rebuild infrastructure in this country.

So it's not just about the short-term policy fight that they can't get passed. Failure here would really change the mood inside the Capitol and I think at the other end of Pennsylvania Avenue.

MCEVERS: I mean one of the things Trump said to some of these lawmakers was, you know, if you don't vote with me, you're going to face consequences in 2018. Was it just that these lawmakers were like, nope, we won't?

DAVIS: Yeah, well, you know, and it's - it depends on the district, right? A lot of the conservatives who are against this now come from really red districts, so they're not too worried about losing their election. A lot of the opposition you're seeing from today are from more moderate members who have Democrats in their district, who have independents in their district and are looking at this bill and saying, you know, if I vote for this, it might not be so good for me back home. And so there's an effort to maybe slow it down and take a pause.

MCEVERS: NPR's Susan Davis at the Capitol, thank you.

DAVIS: Thanks, Kelly.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.