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President Donald Trump told House Republicans Tuesday that they could lose re-election in the 2018 midterms if they vote against the GOP health care bill later this week that would undo much of Obamacare.
Trying to help wrangle enough votes for passage, Trump went to Capitol Hill to meet privately with Republican lawmakers and said they are putting the GOP majority at risk with opposition to the bill, pushed by Speaker Paul Ryan.
“And I don’t care if the press prints that,” Trump said, according to a source in the room.
Trump took the trip down Pennsylvania Avenue to make the final sale of the American Health Care Act, a Republican leadership-written bill that nixes the subsidies provided in Obamacare to help people purchase insurance and winds down the Medicaid expansion.
Both conservative and moderate Republicans have expressed concern with the bill, which is scheduled to be voted on in the House on Thursday.
Trump reminded the members that they have voted to repeal the Affordable Care Act, also known as Obamacare, as many as 60 times over the past six years, and that now is the time to adhere to their campaign pledge to repeal it. The president said he thinks many members will lose re-election if they don’t support it.
"We had a great meeting and I think we are going to get a winner vote," Trump told reporters as he left the Capitol. "They want a tremendous health care plan, that's what we have. There's gonna be adjustments to it, but i think we'll get the vote on Thursday."
Speaking Tuesday night at the Republican National Congressional Committee dinner, Trump made a special appeal to conservatives.
"These are the conservative solutions we campaigned on, the conservative solutions the American people asked us to deliver on," the president told those in attendance of his agenda.
Ryan said after the meeting with House GOP members that Trump got the job done.
"'President Trump was here to do what he does best, and that is to close the deal. He is all in and we are all in to end this Obamacare nightmare," Ryan said. "This is our chance and this is our moment. It's a big moment. And I think our members are beginning to appreciate just what kind of a rendezvous with destiny we have right here."
In the meeting that lasted about 30 minutes, Trump specifically called out Rep. Mark Meadows, who has been one of the most vocal opponents of the measure.
"I ask for your support. You can blame me if you want. Mark did you hear that? You can blame me,” Trump said, according to the source.
"Oh Mark, I'm gonna come after you,” Trump added, a quip that received laughter. "I hope Mark will be with us in the end."
As of now, Meadows isn’t with Trump on the bill.
There have been changes in the past few days to help win more support from conservatives, including giving states the option to require Medicaid recipients who aren’t disabled and have children over 6 to work or be enrolled in school or job training classes. They changes to the bill to appease conservatives also include a component that gives a new option for states to receive Medicaid funding: in the form of a block grant, a mechanism that is likely to largely reduce the number of people eligible for Medicaid.
Meadows said that if his opposition to the GOP health care measure causes him to lose his seat, so be it.
“I serve at the pleasure of the people of North Carolina,” Meadows said. “When you serve at their pleasure, it’s only those 750,000 people that can send you home and it’s a temporary job and I’ve known that since Day One.”
GOP leaders in the House can afford to lose only 21 Republicans in the vote or else the bill will fail, and it's some conservatives who are withholding support. NBC's latest count has 17 Republican members who plan to oppose the measure.
They say that the bill doesn’t do enough to lower the cost of health insurance. The Congressional Budget Office estimated that the GOP plan would reduce premiums by 10 percent in 10 years — too little for conservatives. Some on the right also want the repeal of requirements imposed on health insurance companies on what services they need to provide, which critics say drive up the cost of health care.
Rep. Morgan Griffith, R- Virginia, said he’s still not fully on board. “I’m still a lean yes, but I want to see the final product,” he said.
Changes to the bill were also meant to appease moderate Republicans concerned that the tax credits offered for people to purchase insurance weren’t generous enough.
Rep. Tom MacArthur, R-N.J., said he “got the things that I thought mattered the most.”
Those revisions in the latest version of the bill provide additional money for Medicaid older and disabled Medicaid recipients. Another change sets aside about $85 billion for people aged 50 to 64 who purchase health insurance through the individual market and who were set to see their insurance costs increase 700 percent – from about $1,200 per year to $14,000 per year.
“That’s about a $150 billion of funds to people who need it the most, and that’s what moved me from a likely no to a yes,” MacArthur said.