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Tipsheet

Moment of Truth: House Scheduled to Vote on TrumpCare Today -- Or Is It?

UPDATERead this post from last night before proceeding further.  Major changes could be afoot today.

ORIGINAL POST - Here we go.  If the amended (and potentially re-amended) legislation passes later today (if the vote can even happen today, in light of very recent developments -- see update above), that will be the first of several major moments of truth for the American Health Care Act, which has thus far only cleared a series of procedural hurdles in committee. But if it fails, that would deal a devastating blow to President Trump and Speaker Ryan, who have prioritized this proposal as a critical first step in launching the president's wider agenda. They've pushed and prodded. They've compromised and cajoled. They've whipped and pressured. And soon we'll have an outcome.  As I wrote last night, it looks like this may come down to this morning's White House meeting between House conservative hardliners and the president.  Question: If things are still in flux, would Speaker Ryan pull the bill from the floor and indefinitely postpone the proceedings if he doesn't have the votes (a significant embarrassment), or will leadership roll the dice and let the process play out on live television (potentially leading to an even greater embarrassment)? Some reports have suggested this game of legislative chicken is on:

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The idea would be to more or less dare Republicans to vote against a bill that uproots much of Obamacare, zeroes out the individual mandate tax and employer tax, cuts spending by roughly $1 trillion, cuts taxes by hundreds of billions, and implements historic Medicaid reform -- especially if the 'essential health benefits' repeal is added on. As we discussed earlier in the week, the Trump/Ryan position is essentially, "will you take a major step toward keeping your 'repeal and replace' promise to voters, or will you vote with Nancy Pelosi to keep Obamacare intact?" If Ryan doesn't have a hard whip count that gets him to 216, holding the vote anyway would be a gutsy move. Hardwood's tweet from yesterday suggests that leadership is leaning in that direction -- which would at least entail the excruciating transparency of every single vote going on the record. But not so fast -- in an interview with Dana Perino on Fox News late yesterday, the Speaker was noncommittal on this point (skip ahead to the four minute mark):

Perino: If you feel like you don't have the votes, will you postpone it?


Ryan
: I'm not going to get into hypotheticals. We're working with our members. We're adding votes by the day, we're not losing votes.

That was the official line as of Wednesday evening. Then 
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all of this went down, which may have the effect of bringing House Freedom Caucus members into the fold.  Let's say that Trump and Ryan's efforts, coupled with eleventh-hour alterations, succeed in pulling this things across the finish line, despite the intense (and now possibly softening) opposition from several (but not all) conservative activist organizations.  Then it lands in the Senate, where it begins with a maximum of 48 votes prior to amendments. Where does the number 48 come from?  Three conservative Senators are openly opposed (would they change their tune if Lee's suggestion is adopted?), and one has health issues that could indefinitely preclude his ability to vote.  So for the AHCA to pass the upper chamber, it's going to need to undergo some policy legislative renovations in order to win over harder-line conservatives without pushing so far that moderates walk away.  Not to mention the new parliamentarian issue regarding reconciliation. All of which is to say that even if today's significant obstacles are overcome, there's still a difficult path ahead.  So place your bets now: Does the bill pass, fail, or get pulled?   Or does everything get a bit delayed in light of proposed new elements of the bill, in order to allow CBO to analyze it again?  Or another possibility: Is a deal reached, followed by a quick vote, with other "details" like a fresh score left for the Senate to worry about?
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Parting thought: Returning to a point I made on Tuesday and Wednesday, if whatever legislation finally gets voted upon either gets defeated or put off further, then what?  In what universe does this process become easier, especially as the calendar creeps closer to an election?  Is there a magical bill nobody has thought of that will somehow manifest itself, thus satisfying all the disparate elements of the Republican coalition -- and that will also pass procedural muster to bypass a Democratic filibuster via reconciliation?  My best analysis is that Republicans would be back at square one: Whining about Obamacare's (very real) failures without any unified plan to solve the problem.  And before you go, re-watch the very end of Ryan's segment above.  If the AHCA goes down in flames, the GOP loses its  "bonus" reconciliation package in 2017 -- and the status quo budgetary baseline would remain in place, making tax reform much more challenging.  The stakes are high today, and not just on healthcare.  And by the way, remember "phase three" of the repeal and replace plan?  It took one step forward today.  Check out the margin:

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