The House GOP’s seven-year crusade to abolish Obamacare all comes down to Thursday.

Republican leaders have called a vote on a plan to replace the health care law, signaling surging confidence that they’re on the cusp of earning enough support to pass it. Though it’s still unclear whether House Speaker Paul Ryan and his team have commitments from the 216 members necessary to pass the bill, scheduling a vote suggests they believe they’re closer than ever.


The moment still promises to be heart-pounding. About 18 Republican lawmakers are publicly opposed to the GOP plan, leaving leaders room for only a handful of additional defections. And at least two dozen members are still publicly undecided. House vote-counters crisscrossed the chamber late Wednesday, pigeonholing reluctant colleagues in a last -ditch bid to put the measure over the top.

The vote will be a defining moment of President Donald Trump’s early tenure. The president spent his political capital on enacting the measure, known as the American Health Care Act, devoting Tuesday and Wednesday to lobbying undecided lawmakers in a flurry of phone calls.

And he helped muscle through two series of revisions that helped revive the legislation after it appeared destined to fail. Another failure could doom GOP efforts to repeal Obamacare — a promise since the legislation passed in 2010 — and strain relations between the White House and Capitol Hill Republicans.

Trump helped engineer the late-Tuesday jolt that brought the AHCA back from its latest brush with failure. After top Republican Rep. Fred Upton of Michigan broke against the bill, Trump called him and asked him why. Upton said he told Trump that the GOP bill’s latest iteration broke earlier pledges to protect people with pre-existing conditions.

“You wanted this to be as strong on preexisting as Obamacare. Quite frankly, it’s not,” Upton said he told the president, even reading Trump his own quote from over the weekend making that promise. “I’ve been working on language that would fix it.”

Trump convened with Upton and another holdout, Rep. Billy Long of Missouri, on Wednesday morning in the Oval Office, where he signed off on a proposal to plow an additional $8 billion of support into a fund to help cover people with pre-existing conditions. “He accepted fairly quickly,” Upton said.

Though doctors and patient advocates, as well as policy experts, dismissed the funding as woefully insufficient to meet the needs of people with preexisting conditions, the negotiation delivered a burst of momentum on Capitol Hill, and leaders began signaling that a vote was in the offing.

There were concerns the revised measure might repel conservatives already reluctant to back the GOP plan, but early signs suggested most would remain on board.

“I believe they will find broad support among [House Freedom Caucus] members for their amendment,” HFC Chairman Rep. Mark Meadows of North Carolina said in a statement to Politico.

But it’s unclear whether Upton’s effort — hatched by House leaders and agreed to during a meeting of Upton, Speaker Paul Ryan and other top House leaders on Tuesday — is making inroads with lawmakers who have wavered on the AHCA.

“I don’t know,” Upton said Wednesday, when asked whether his amendment had won new support for the bill. “I’m not on the whip team. I’m not twisting arms.”

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And many of the 18 holdouts — from Mark Amodei of Nevada and Leonard Lance of New Jersey to John Katko of New York and Patrick Meehan of Pennsylvania — reiterated their opposition to the measure.

The last-minute talks appeared to pay dividends with some fence-sitting moderates in the House. Shortly after Upton and Long visited the White House, Rep. Mike Coffman of Colorado said in a statement that if House leaders “work to tighten” protections for people with pre-existing conditions, he would support the bill. A spokeswoman for Rep. Carlos Curbelo (R-Fla.) said the congressman would “review” the amendment to see whether it addressed his concerns with earlier versions of the bill.

Despite some lingering uncertainty, the White House has been leaning heavily on GOP leaders for a quick vote. Two senior White House officials said they feared members leaving for a planned recess Thursday without voting could doom chances of eventual passage.

Upton’s opposition threatened to derail delicate last-minute negotiations to pass the legislation. Long, a staunch Trump ally, also threatened to scramble the GOP whip count.

After the White House meeting, Long told reporters at first he resisted pressure from Trump to support the bill.

“We need you, we need you, we need you,” Long said Trump told him in phone calls on Tuesday. “I said, ‘I’m a no’ and I stayed a no. I said, ‘Fred Upton and I have been working on some language, if we can get [it] in there, it can get us both in a position we need to be on pre-existing conditions and make sure those people are covered. Because they need to be covered. Period.’”

Jennifer Haberkorn, Burgess Everett and Matthew Nussbaum contributed to this report.

