President Donald Trump has publicly expressed enthusiasm about the bill. But in conversations with aides, he has turned back to one topic: What can the White House do that is seen as "repeal and replace?" | Evan Vucci/AP Photo Trump publicly backs health care effort, privately harbors doubts While the president appears all in some in the White House wonder about Graham-Cassidy’s contents and its chances.

In public, President Donald Trump is all-in on the Senate’s final chance to repeal Obamacare. But privately, there’s ambivalence in the White House about the bill’s contents and its chances of clearing the tightly divided chamber next week.

Trump spent time between meetings at the United Nations calling senators and other senior White House officials about the Graham-Cassidy bill, asking for updated vote tallies and how to woo senators for the bill. White House officials have considered tweaking the state funding to win a vote from GOP Sen. Lisa Murkowski of Alaska — and others. Trump has also publicly excoriated Kentucky Sen. Rand Paul for voting against the legislation, telling aides he would go after other senators.


"Repeal and Replace!" he said. Trump also defended Sen. Bill Cassidy (R-La.) from Jimmy Kimmel’s scathing criticisms of the bill, concluding that Cassidy is a “class act.”

The public stance is coupled with a sense of doubt inside the White House, though, about the bill and deep concerns about whether it can pass the Senate or House, according to administration officials and congressional sources. These people say the president and his team have little sway with some key members, like GOP Sens. Susan Collins of Maine, John McCain of Arizona and Murkowski, the trio that tanked Republicans’ repeal attempt in July.

In fact, many Republicans on Capitol Hill believe that Trump cost them Murkowski’s vote in a private phone call this summer. And the president has refrained from making as many calls this go-round, one person familiar with his whipping said.

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Several White House officials described the president as determined to sign something — anything, really. And they noted that the bill has drawn concerns from conservative groups for enshrining some parts of Obamacare and taking attention away from tax reform.

“That’s not a very ringing endorsement, when people start out with it’s better than nothing,” Paul said when asked about the White House and leadership argument. “They think that people just want us to do something and do anything."

Vice President Mike Pence's office is seen on the Hill as being more involved in the bid, though, led by legislative affairs head Marc Short. Seema Verma, the head of CMS, has also held a number of meetings with senators and their aides.

The White House and Sens. Lindsey Graham (R-S.C.) and Cassidy have received praise from some anti-abortion groups because the bill will allow states to strip Planned Parenthood’s funding, and the bill would end the subsidies they hate. But people in the White House privately admit it is nowhere near what they wanted.

One official said the concerns from governors have alarmed some in the White House — and that "we really aren't sure what the impact will be” of passing the bill. They also fear that the bill could bring political blowback from the left and right.

Trump has publicly expressed enthusiasm about the bill, tweeting about it repeatedly. But in conversations with aides, he has turned back to one topic: What can the White House do that is seen as "repeal and replace?" a phrase he likes to repeat.

So far conservatives are hesitant to describe the bill in that way.

"I don't think it is repeal or replace. We shouldn't tell people it is. It is a step toward repeal," said David McIntosh, who leads the influential Club for Growth.

Yet in the Senate, the majority of the caucus’s 52 Republicans are excited about one last go-around, and many have bought into the binary argument that leaders and the president are making: That the bill to block grant federal health care funding to the states is far better than keeping the status quo.

“Everybody speaks for themselves. But the more I learn about Graham-Cassidy, I think it’s a heck of an improvement over everything we’ve come up with,” said Sen. Richard Shelby (R-Ala.). “If you want to get rid of Obamacare, this is a great way to do it. But not just to do it: But to do something with a lot of potential.”

But concern among the half-dozen or so undecided senators centers more on the massive transfer of federal spending from blue states to red states, the centerpiece of the Graham-Cassidy proposal. Several senators are still awaiting state-specific reports on the Graham-Cassidy bill and are uncomfortable voting for the legislation without a better idea of how it affects their states, according to Republican sources.

Trump’s whipping operation is focused around Sen. Lindsey Graham (R-S.C.), who has been speaking to both Trump and Pence on a regular basis, according to a person briefed on the calls. Graham is updating Trump and the White House on the current state of play on the Senate, and has both publicly and privately urged Trump to “fight” for Obamacare repeal. Graham’s also triangulating the effort by speaking regularly with Senate Majority Leader Mitch McConnell (R-Ky.).

And both GOP leaders and the White House seem to be relying on the idea that if they get Murkoswki and McCain, the rest of the party will fall in line. Sens. Rob Portman (R-Ohio), Cory Gardner (R-Colo.) and Shelley Moore Capito (R-W.Va.) are still undecided, for example, but whipping efforts have been concentrated elsewhere.

Trump has also spoken to Paul, but he has resisted the president’s entreaties and a tweet targeting him as a negative presence on Obamacare. He is the firmest “no” in the Senate, surpassing even Sen. Susan Collins (R-Maine), a moderate who is expected to oppose the bill.

With that margin, the president and McConnell have no further room for error, even as their allies try to project a sunny mood.

““I’m from Texas so I’m an optimist,” said Senate Majority Whip John Cornyn of Texas. “You hear a lot of loud voices but I think we’ve got an opportunity to get things done.”

