GOP pulls health care overhaul off House floor

File: House Speaker Paul Ryan (R-WI) departs from the White House after meeting with President Donald Trump, on March 24, 2017 in Washington, D.C. Ryan met with Trump regarding issues related to repealing and replacing the Affordable Care Act or Obamacare.
File: House Speaker Paul Ryan (R-WI) departs from the White House after meeting with President Donald Trump, on March 24, 2017 in Washington, D.C. Ryan met with Trump regarding issues related to repealing and replacing the Affordable Care Act or Obamacare.
Mark Wilson/Getty Images

In a humiliating setback, President Donald Trump and GOP leaders pulled their "Obamacare" repeal bill off the House floor Friday after it became clear the measure would fail badly.

It was a stunning defeat for the new president after he had demanded House Republicans vote on the legislation Friday, threatening to leave "Obamacare" in place and move on to other issues if the vote failed. The bill was withdrawn minutes before the vote was to occur.

Speaker Paul Ryan, R-Wis., withdrew the legislation after Trump called him and asked him to halt debate without a vote, according to Ryan spokeswoman AshLee Strong. Just a day earlier, Trump had demanded a House vote and said if the measure lost, he would move on to other issues.

The president's gamble failed. Instead Trump, who campaigned as a master deal-maker and claimed that he alone could fix the nation's health care system, saw his ultimatum rejected by Republican lawmakers who made clear they answer to their own voters, not to the president.

Ryan said the collapse of the House Republican health care bill means former President Barack Obama's health care law will be around for the foreseeable future.

Ryan said pulling the bill was "a setback, no two ways about it."

The speaker chided Republicans who refused to back the legislation for being too inflexible. He said lawmakers must be "willing to give a little to get something done."

Many conservative and moderate Republicans opposed the legislation.

Trump meanwhile said his health care reform fell short because it lacked support from Democrats.

He said he would be willing to reopen negotiations for a health care bill with Democrats if the Affordable Care Act fails.

Trump said he has a great relationship with the Republican Party and isn't going to speak badly about GOP lawmakers. Still, he said he was a little surprised by the bill's rejection from the conservatives in the House Freedom Caucus.

Trump also said he "never said repeal and replace it within 64 days," though he repeatedly promised during the campaign to do it on Day One of his term.

Republicans have spent seven years campaigning against former President Barack Obama's health care law, and cast dozens of votes to repeal it in full or in part. But when they finally got the chance to pass a repeal bill that actually had a chance to get signed, they couldn't pull it off.

What happens next is unclear, but the path ahead on other priorities, such as overhauling the tax code, can only grow more daunting.

And Trump is certain to be weakened politically, a big early congressional defeat adding to the continuing inquiries into his presidential campaign's Russia connections and his unfounded wiretapping allegations against Obama.

The development came on the afternoon of a day when the bill, which had been delayed a day earlier, was supposed to come to a vote, come what may. But instead of picking up support as Friday wore on, the bill went the other direction, with some key lawmakers coming out in opposition.

Congressman Rodney Frelinghuysen of New Jersey, chairman of a major committee, Appropriations, said the bill would raise costs unacceptably on his constituents. Rep. Barbara Comstock of Virginia, a key moderate Republican, and GOP Rep. David Joyce of Ohio also announced "no" votes.

The defections raised the possibility that the bill would not only lose on the floor, but lose big.

In the face of that evidence, and despite insistences from White House officials and Ryan that Friday was the day to vote, leadership pulled back from the brink.

The GOP bill would have eliminated the Obama statute's unpopular fines on people who do not obtain coverage and would also have removed the often-generous subsidies for those who purchase insurance.

Republican tax credits would have been based on age, not income like Obama's, and the tax boosts Obama imposed on higher-earning people and health care companies would have been repealed. The bill would have ended Obama's Medicaid expansion and trimmed future federal financing for the federal-state program, letting states impose work requirements on some of the 70 million beneficiaries.

The nonpartisan Congressional Budget Office said the Republican bill would have resulted in 24 million additional uninsured people in a decade and lead to higher out-of-pocket medical costs for many lower-income and people just shy of age 65 when they would become eligible for Medicare. The bill would have blocked federal payments for a year to Planned Parenthood.

Democrats were uniformly opposed. "This bill is pure greed, and real people will suffer and die from it," said Rep. Pramila Jayapal of Washington state.

House Minority Leader Nancy Pelosi (D-San Francisco) mocked her Republican colleagues for failing to repeal and replace President Barack Obama's health law.

"Quite frankly I thought they might have accomplished something in the first few months," she said of Trump and Congressional Republicans. "They have absolutely no record of accomplishment."

In response to Trump's criticism of Democrats for being uniformly against the bill, Pelosi said, "We'll take credit for that."

The GOP's health bill "was an imperfect approach and I believe that we can do better," said Republican Congressman Darrel Issa (R-Vista). He vowed that his party "will go back to the drawing board and get this right for each and every American concerned with high costs in their health care and ever-dwindling choices and access to care."

The "millions of Californians who had their insurance plans canceled, lost access to their doctors, suffered premium increases and sky-high deductible hikes are depending on us to repeal and replace Obamacare once and for all," he said. "We must deliver relief from this law and return choice back to the people."

The bill's downfall "is a victory for Americans’ healthcare," said Rep. Judy Chu (D-Monterey Park). "Now is the time to refocus our efforts on improving the Affordable Care Act to build on its success."

Dr. Ted Mazer, president-elect of the California Medical Association, expressed relief that the bill failed.

"We were greatly concerned about the cuts to the Medicaid program that would end up really hurting California, hurting California patients’ access to care," he said.

"Now that this package is off the table, it doesn’t mean an end to the discussion," said Mazer. "It means that we still have to deal with the things that are not working in the [Affordable Care Act], and ... go back to the table and figure out what changes are possible, what changes are necessary, to make sure that those people who have coverage and gained coverage don’t lose it, and that they have more than coverage, that they have access to care."

He cited rising premiums, narrowing provider networks, and inadequate funding for Medi-Cal as problems that need addressing. "The networks that were created to get care to Medi-Cal beneficiaries remained inadequate, particularly for specialty care," he said.

The head of a group that lobbies on behalf of California's community health centers was pleased by the day's developments.

"We have truly dodged a bullet," said Carmela Castellano Garcia, president and CEO of CaliforniaHealth+ Advocates.

"We represent the low-income communities of California," she said. "These are folks that prior to the [Affordable Care Act] were uninsured in huge numbers, so for this segment of the population, the [Affordable Care Act] has been a blessing."

Garcia said supporters of Obamacare "need to continue the fight for access to affordable health care … The fact that we came so close to losing everything shows that we need to do more to push for … health care access for everyone."

This story has been updated.