This article is more than 3 years old

This article is more than 3 years old

Donald Trump made a closing pitch to restive Republicans wary of their party’s proposed healthcare overhaul as conservatives steel for a showdown one day before a planned vote on the bill.

In the final hours before the House was expected to vote, Trump summoned wavering – and obstinate – Republicans to the White House while another group met with Vice-President Mike Pence. After the meeting, conservative opponents of the healthcare plan recommended Republican leadership should “start over” on a new proposal.

Louisville loyalists lap up Trump line on healthcare but Congress is a harder sell Read more

“We believe that we need to postpone the vote and get it right,” said the North Carolina representative Mark Meadows, the chairman of the House Freedom Caucus, a coalition of roughly 40 hardline conservatives largely opposed to the legislation.

“We need changes to the underlying bill before we vote on it in the House … There’s not enough votes to pass it tomorrow.”

On Wednesday, the White House press secretary, Sean Spicer, scoffed at the suggestion of starting over and expressed full confidence that the bill would pass.

“This is the only train leaving the station,” he told reporters.

“There is no plan B,” he added. “There is a plan A and plan A. We’re going to get this done.”

Later on Wednesday, a group of conservative donors, led by the powerful brothers Charles and David Koch, reportedly announced that it was putting together a new fund for Republican reelection races in 2018 – except for candidates who voted for the healthcare overhaul.

President Trump made a public pitch for repealing Obamacare during a healthcare panel for female medical professionals convened by the newly confirmed Centers for Medicare and Medicaid Services director, Seema Verma.

Trump praised the women – doctors, nurses and healthcare professionals – and then said of them: “Unfortunately Obamacare is making their lives so much more difficult, as you all know and putting enormous barriers in the way of helping patients, who we are going to help and get this thing done, and get it figured out.”

As he exited, a reporter asked whether the White House would continue to push for a healthcare overhaul if the bill failed on Thursday. “We’ll see what happens,” Trump said.

For seven years and three election cycles, Republicans have vowed to repeal Obamacare. But given the chance, they are divided on how to do so.

The plan put forward by the House speaker, Paul Ryan of Wisconsin, would end the Obamacare requirement that Americans must purchase healthcare while dramatically transforming Medicaid, one of the country’s largest social safety nets.

A Congressional Budget Office analysis forecast that 14 million fewer people would have insurance by 2018 under the Republican healthcare plan. The report also found that poorer and older Americans would be disproportionately affected by the proposal.

Republican leadership introduced a slate of revisions this week intended to placate wary factions of the Republican party. The amendment included changes to Medicaid as a concession to conservatives and additional tax credits for older Americans as an overture to moderates concerned by an analysis that predicted people aged 50 to 64 would see dramatic increases in their premiums under the current proposal.

Amid Republican disarray, Democrats on Wednesday marked the seventh anniversary of the Affordable Care Act on the East Steps of the Capitol. Vice-President Joe Biden joined Democratic lawmakers and Obamacare supporters to rally against the Republican plan.

Facebook Twitter Pinterest Former vice-president Joe Biden speaks at an event marking the seventh anniversary of the Affordable Care Act outside the Capitol Building. Photograph: Aaron P Bernstein/Reuters

The former vice-president conceded that the law needed to be changed, but cautioned that a repeal was the wrong solution.

“It ain’t going anywhere,” Biden said of the Affordable Care Act. “This is not going to pass.”

The Senate minority leader, Chuck Schumer, teasing Biden, who was memorably overheard whispering to the president that signing the ACA into effect was a “big fucking deal”, said that if Democrats were able to prevent the Republican repeal plan it would be “a BFD”.

Democrats alone do not have the votes to prevent the House from passing the legislation, but they have rallied opponents of the repeal, casting the Republican plan as a tax cut for the wealthy at the expense of older and poorer Americans.

As the last-ditch negotiations unfolded in the White House and on Capitol Hill, the American Health Care Act toiled before the House rules committee, its final procedural hurdle before Thursday’s planned vote.

The rules committee chairman, Pete Sessions, a Republican from Texas, opened what was expected to be an all-day-and-all-night hearing detailing what he viewed as the failures of the Affordable Care Act, which was signed into law by President Barack Obama exactly seven years ago.

The Republican draft legislation “empowers individuals and families to make their own healthcare decisions” and creates a more competitive marketplace.

Alabama representative Mo Brooks, a Republican and one of the Freedom Caucus members who met with Pence on Wednesday, said the White House offered “nothing substantive”. He said the White House continued to argue politics, not policy.

“We’re still holding strong and in the absence of there being substantive changes offered to this legislation, it will fail tomorrow,” Brooks said. “And, quite frankly, I think there are now more votes against the bill today than there were yesterday.”

Brooks said the plan, which he refers to pejoratively as the “Republican welfare bill”, did not go far enough and has put forward an amendment to fully repeal the Affordable Care Act.

At a Tuesday meeting with House Republicans on Capitol Hill, Trump admonished conservatives, warning that there could be political costs to opposing the bill.

Speaking at a National Republican Campaign Committee dinner later that evening, Trump said the vote was “crucial” to repealing and replacing Obamacare.