Donald Trump suffered a major legislative reversal on Friday as Republicans were forced to pull their repeal of the Affordable Care Act from the House floor.
After weeks of contentious negotiations over the American Health Care Act (AHCA), Republicans were forced to admit defeat as they could not gain sufficient support from their own side for the plan to overhaul US health insurance.
Earlier this afternoon White House press secretary Sean Spicer had insisted the vote would go ahead at 3.30pm ET. “Has the team put everything out there, have we left everything on the field? Absolutely,” he told reporters at his daily briefing. “But at the end of the day this isn’t a dictatorship and we’ve got to expect members to ultimately vote how they will according to what they think.”
However, as the 3.30pm deadline slid by, first reports emerged that Trump had asked for the vote to be pulled. Minutes later House Republicans, short of votes, had withdrawn the health bill.
Many moderates in swing districts were wary of supporting the legislation, which included major cuts to Medicaid and was estimated by the nonpartisan Congressional Budget Office to lead to 24 million fewer Americans having health insurance over the next 10 years.
Conservatives also objected to the legislation for keeping too much of the architecture of the Affordable Care Act (ACA), frequently referred to as Obamacare. Although the Republican leadership made a major concession to them on Thursday by removing the federal mandate that health insurance plans cover “essential health benefits” such as maternity care and mental health care, this was not enough to win them round.
As Nevada Republican Mark Amodei put it, the GOP caucus “didn’t spend a lot talking about a unified Republican vision for what we should do with healthcare in the House”. Paul Gosar, a member of the hard-right Freedom Caucus, which was instrumental in this setback, pointed a finger at White House staff.
The result is a major political blow to Paul Ryan, a healthcare policy specialist who led the effort in pushing the AHCA. It also leaves Trump in a vulnerable position. The president ran on a platform of repealing the “disaster” of Obamacare and replacing it with “something terrific”. However Trump, author of the Art of the Deal, failed to accomplish that goal in his first major attempt to negotiate on Capitol Hill.
Friday began with Republican leaders paving the way for an afternoon vote, but by midday it became clear that more than 30 Republicans were holding out and Ryan had to go to the White House to inform Trump he did not have enough votes to pass the bill.
However, the White House continued to insist that a vote would go ahead at 3.30pm as they tried to push the House Republicans to go ahead, even while they were short of the 216 votes needed for a majority and staring at defeat. Spicer said: “The question is can we get to 216. But make no mistake about it the president made clear last night, that this is it.”