GOP leadership announced series of votes, though it was unclear whether enough wary members would back bill to ensure its passage

Emissaries for Donald Trump have told Republicans that the president was done negotiating over healthcare legislation and that the House of Representatives must vote on the current bill Friday or he would leave the Affordable Care Act in place.

White House budget director Mick Mulvaney reportedly told a conference of House Republicans: either vote or lose your chance to replace the healthcare law.

Donald Trump makes last-ditch pitch to Republicans to back healthcare bill Read more

For their part, the Republican leadership announced a series of votes for Friday, including one on an amendment to repeal essential health benefits in Barack Obama’s signature law.

A vote on the full bill was planned for later on Friday, after a vote initially planned for Thursday was delayed, in spite of the fact that it was extremely unclear late Thursday whether the Republican leadership, or the president, had persuaded enough wary members to back the bill to ensure its passage.

The insistence on a vote, whatever the whip count, set up a potentially dramatic defeat for House speaker Paul Ryan and – depending on how voters end up viewing the proceedings – the president himself, after years of Republican promises to “repeal and replace” the Affordable Care Act (ACA), also known as Obamacare.

However, multiple House members have switched positions in recent days on the bill, which itself has evolved, and there was still a chance that the legislation was headed for an extremely narrow passage. If the bill clears the House it would then proceed to the Senate, where further changes have been promised.

Earlier on Thursday, members of both the hard-right Freedom Caucus and the moderate Tuesday Group went to the White House as Trump tried to personally persuade them to back the plan introduced by Ryan.

Moderates objected to last-minute legislative additions that rolled back Medicaid and were even more suspicious of the Freedom Caucus’s push to get rid of so-called essential benefits, that require insurance to cover benefits such as maternity and mental health care.

GOP hardliners demand maternity benefits be nixed from healthcare bill Read more

By contrast, conservatives objected to any legislation that didn’t repeal all regulations in the landmark health insurance reform of 2010.

That left Republicans who campaigned to “repeal and replace” Obamacare, but never reached a consensus about the phrase’s meaning, deadlocked.

As the far-right Freedom Caucus and the center-right Tuesday Group tried to set up a meeting for Thursday night, text of an amendment emerged summarizing the Freedom Caucus demands. Among them: repealing the essential health benefits in the Obama law; reversing a ban on lifetime or annual coverage caps; and erasing rules to limit out-of-pocket-costs for preventive care such as mammograms.

The White House threw its top political talent into the fray, sending the people who four months ago won the big election – chief strategist Steve Bannon; presidential counselor Kellyanne Conway; White House chief of staff Reince Priebus; and unknown others – to a different meeting of House Republicans on Thursday night.



The president, who prides himself on being the ultimate deal-maker, put himself at the heart of the effort to get the bill passed, travelling to Capitol Hill to meet with reluctant lawmakers, hosting talks at the White House and staging a rally in Kentucky, home state of Senator Rand Paul, a key Republican opponent on the measure.



Republicans had hoped to pass the bill on the seventh anniversary of Obama signing the ACA, which allowed for the greatest expansion of healthcare coverage in more than a generation. Obama, on Thursday, urged lawmakers to work together to “make our healthcare system better, not worse for hardworking Americans”, in one of his most significant interventions in US politics since leaving office.

The Republican plan, known as the American Health Care Act, ends ACA taxes, eliminates the requirement that all Americans have insurance and dramatically cuts Medicaid, the healthcare program for low-income Americans. Instead of subsidies, the plan would offer tax credits to help people purchase health insurance.

A new Quinnipiac University poll showed that Americans disapprove of the healthcare overhaul by a margin of 56% to 17% – with support among Republicans hovering at just 41%. The same poll showed 20% felt the ACA should be repealed in total and 50% in part.

“Do I think it gives the president a loss?” asked Mark Meadows, the chairman of the Freedom Caucus. “Absolutely not. We are going to get to the finish line.”

The North Carolina representative gave credit to Trump for progress. “We are hopeful as we start to make progress in these negotiations with some of the things the White House shared with us,” said Meadows. “We would not be where we are today in even considering this if it had not been for President Trump’s personal involvement ... He’s moved this a very long way. Not only for House Freedom Caucus but for other members.”

Facebook Twitter Pinterest Members of the House Freedom Caucus meet back on Capitol Hill after their meeting with Donald Trump at the White House. Photograph: Jonathan Ernst/Reuters

He said that the vote on Thursday night had been an artificial deadline and more time was needed because, “we believe some of the things we are being asked to consider are not in enough of a form to make a good informed decision on”. But he insisted that a vote would happen because repealing the ACA was something that he, the Freedom Caucus and the president had all campaigned on.

Other Freedom Caucus members were also optimistic a deal would be reached. Scott Perry of Pennsylvania told reporters: “I think a lot of us are going to get yes, we just gotta keep working through it.” He noted his fellow conservatives “have been been negotiating with administration and leadership the whole time. Obviously, sometimes it takes a little bit longer to get there.”

Andy Harris of Maryland said the Freedom Caucus had rejected the administration’s offer to remove the requirement that the healthcare plan include the 10 essential benefits without meeting other conservative demands, including getting rid of the ban on insurance companies denying coverage for lifetime limits.

He said “we want to get to yes”, but added that the Freedom Caucus was now waiting for another counter-offer and felt no pressure to moderate their demands. “We are not in the position to offer a legislative solution,” said Harris. “The people who are in the position are the administration and the leadership.”

It did not appear that the bill was improving. The Congressional Budget Office released an appraisal late Thursday that said the amended bill would cost more while doing nothing to save any of the 24 million people estimated to be ejected from health coverage over the network under the original version of the legislation.

On Thursday afternoon, Trump, seemingly oblivious to the announcement of the vote delay, met with a delegation of truckers at the White House, jumping into the cab of an 18-wheeler to pose for photographs, and telling them the vote was pressing ahead that night. “We have a great bill, and I think we have a very good chance,” he said, adding: “Obamacare has inflicted great pain on American truckers. Many of you were forced to buy heath insurance on the Obamacare exchanges. You experienced a crippling rise in premiums, and a dramatic loss in options.”