By Meg Wagner
‘Trumpcare’ up for a vote this week
President Donald Trump on Tuesday warned House Republicans that they could lose their jobs if they don’t pass legislation to repeal and replace Obamacare, one day after party leaders unveiled 43 pages worth of revisions to the health care bill in a bid to get it more votes.
Republicans’ American Health Care Act — dubbed “Trumpcare” because it is intended to replace the 2010 Affordable Care Act (ACA), known as Obamacare — is expected to face a vote in the House on Thursday.
“I honestly think many of you will lose your seats in 2018 if you don’t get this done,” President Trump reportedly told Republican lawmakers during the private Tuesday meeting inside the U.S. Capitol. “I’m asking for your vote on Thursday.”
On Monday night, House Republican leaders released a set of changes to their original bill, aimed at winning the support of conservative representatives who criticized the first draft. While the bill removed fines for those who don’t have insurance (one of Republicans’ major issues with the ACA), some Republicans have still insisted Trumpcare doesn’t repeal the ACA thoroughly or quickly enough.
The revised bill moves up the repeal of Obamacare taxes from 2018 to 2017, which could placate some Republicans demanding more repeals. Another change allows states to add an employment requirement to their Medicaid programs, meaning that non-disabled, low-income Americans would need to work in exchange for health care benefits, an idea championed by many conservatives.
The revisions also include a provision that would allow the Senate to increase tax credits for older Americans — but it doesn’t increase the tax credits itself. Democrats slammed the first draft of the bill after reports showed that older, low-income Americans would pay thousands of dollars more for health care if it passed.
Backlash from all sides
The Trumpcare plan has faced fierce backlash from conservatives, liberals, and moderates alike since it was unveiled on March 6.
The legislation still provides federal funds for health care expenses — like Obamacare — but changes the way that money is doled out. Where Obamacare provided large federal subsidies to low- and middle-income Americans to purchase insurance, the new plan gives out age-based tax credits, with older Americans getting larger payouts. The fact that Trumpcare still provides federal funds to individuals for healthcare hasn’t gone over well with conservatives, who have called it “Obamacare 2.0” and “Obamacare-lite.”
Meanwhile, Democrats have insisted that Trumpcare’s likely less-generous tax breaks would harm low- and middle-income families.
A March 13 report from the Congressional Budget Office added to liberals’ fury. The nonpartisan congressional group found that the Trumpcare plan will double the number of uninsured Americans in the next decade: 52 million people won’t have coverage in 2026 compared with the 28 million who wouldn’t if Obamacare stays in place.
And Democrats and Republicans alike have balked at the bill’s plan to phase out expanded Medicaid programs, which provided about 11 million low-income Americans with insurance.
Predictions of failure and pressure from activists
The revisions — and the pep talk from President Trump — may not be enough to get Trumpcare through the House, as right-wing lawmakers and activists continue to condemn the legislation.
The chairman of the House Freedom Caucus, a conservative congressional faction, has predicted that the bill will fail. On Monday, Rep. Mark Meadows (R-N.C.) said there are enough no votes in his caucus alone to strike down the legislation.
If the Democrats stand united against the bill — which they are expected to do — Republicans can only afford 21 no votes. There are 40 members in the House Freedom Caucus.
Conservative activists are continuing to pressure Republican lawmakers into blocking the bill, too. On Tuesday, the right-wing policy group Heritage Action announced it will “key vote” the bill, negatively scoring any member of Congress who votes for it. Heritage Action, the activist branch of conservative Heritage Foundation think tank, keeps (and promotes to its members and followers) scorecards on lawmakers determined by how they vote on certain legislation the organization deems important to conservatives.
Last year, Heritage Action key-voted 15 House bills, including a bill authorizing water projects, including aid to Flint, Mich. (The group encouraged representatives to vote “no.”)
If House Republicans do rally enough votes to get the bill through, the legislation will still need to pass in the Senate. Assuming all Senate Democrats vote against the bill, 50 of the 52 Republican senators would need to vote for it to pass.