The House of Representatives is set to vote on a bill to replace
Obamacare late on Friday afternoon. The bill, backed by Trump, has
proved a tough sell to both conservative and moderate factions in
his own Republican party.
Democrats in the House are dead set against the bill, and it was
unclear late on Thursday night whether Republican leaders had enough
support from their own members to pass it, despite a series of
last-minute sweeteners intended to broaden its appeal.
It is the first foray into legislation for Trump, a New York
Republican businessman and reality television star known for his
book, "The Art of the Deal." He had not held public office before
winning the Nov. 8 presidential election.
The vote on the American Health Care Act had originally been set for
Thursday. In an embarrassing setback, it was postponed because of
the tepid support.
By Thursday evening, Trump signaled he was done negotiating and
demanded lawmakers support the bill, or face the consequences.
"The message is ... it's done tomorrow, or Obamacare stays," said
Representative Chris Collins of New York, a Trump ally.
Replacing the signature health care plan of former Democratic
President Barack Obama was a key campaign pledge for Trump and
Republicans, who viewed Obama's 2010 Affordable Care Act as overly
intrusive and expensive.
Obamacare aimed to boost the number of Americans with health
insurance through mandates on individuals and employers, and
income-based subsidies. Some 20 million Americans gained insurance
coverage through the law.
The House replacement plan would rescind taxes created by Obamacare,
repeal a penalty against people who do not buy coverage, slash
funding for the Medicaid program for the poor and disabled, and
modify tax subsidies that help individuals buy plans.
Conservatives felt the bill did not go far enough to repeal
Obamacare and moderates felt the plan could hurt their constituents.
House leaders agreed to four pages of last-minute amendments,
including allowing states to choose which "essential benefits" are
required in insurance plans, keeping a 0.9 percent surcharge on
Medicare for high-income Americans for six years, and giving states
more money for maternal health and mental health.
It was unclear whether that was enough to win over skeptics.
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During the past few weeks, Trump has remarked that healthcare was
more complicated than he expected and has said he looks forward to
moving on to other priorities like tax cuts and trade deals.
But a defeat in the vote will cast doubt on his ability to work with
Congress to deliver on tax reform and infrastructure investments.
Uncertainty over the healthcare bill rattled financial markets this
week as investors worried that failure to push it through could
postpone other business-friendly Trump priorities.
Even if the House passes the plan on Friday, the legislation faces
an uphill battle in the Republican-controlled Senate.
The House and Senate had hoped to deliver a new healthcare bill to
Trump by April 8, when Congress is scheduled to begin a two-week
spring break.
Graphic on Obamacare and Republican healthcare bill (http://tmsnrt.rs/2n0ZMKf)
Graphic on shifting positions in the U.S. Senate on Republican
healthcare bill (http://tmsnrt.rs/2mUE4Xf)
Graphic on poll on Americans' views of the Republican healthcare
bill (http://tmsnrt.rs/2n7f3e4)
(Additional reporting by David Morgan, David Lawder, and Amanda
Becker; Writing by Roberta Rampton; Editing by Simon Cameron-Moore)
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