WASHINGTON — Bolstered by President Trump’s warning of a potential bloodbath in the 2018 midterm elections if House Republicans fail to pass health-care legislation after seven years of broken promises to replace – according to a member present in the meeting – GOP congressional leaders forged ahead Wednesday toward advancing legislation that would repeal Obamacare.

The American Health Care Act, legislation that would eliminate the individual mandate to obtain health insurance contained in Obamacare and include tax incentives meant to encourage Americans to purchase coverage, was unveiled by Republicans Monday.

The House Ways and Means and Energy and Commerce Committees began “mark up” sessions Wednesday, which consist of debating and potentially amending the bill.

The Trump administration formally backed the House GOP’s plan and met with House lawmakers at the White House Tuesday urging support for the proposal.

“I’m proud to support the replacement plan released by the House of Representatives and encouraged by members of both parties,” Trump said.

The president argued in a tweet that the bill will be the Republicans’ best chance for repeal.

“Our wonderful new health-care bill is now out for review and negotiation. Obamacare is a complete and total disaster – is imploding fast!” the president wrote.

Trump warned House Republicans there could be a “bloodbath” in the 2018 midterm election if conservative leadership fails to pass health-care legislation after seven years of broken promises to replace it, according to a member present in the meeting.

Vice President Pence said separately, “We’re certainly open to improvements and to recommendations in the legislative process,” but he warned conservative lawmakers who want to scrap it, “This is the bill.”

Although Republicans control both chambers of Congress and the White House for the first time in a decade, the Obamacare-repeal law faces a difficult path. Lawmakers across the ideological spectrum oppose the legislation. Democrats, conservative and moderate Republican lawmakers have criticized specific provisions of the plan, which Trump has endorsed.

“Phasing out Medicaid coverage without a viable alternative is counterproductive,” Ohio Gov. John Kasich, who opposes Obamacare, warns.

The House leadership’s proposal includes a refundable tax credit to help people buy insurance.

Key conservative Republicans in the House and Senate argue that the plan’s refundable tax credits represent a “new entitlement program.” A vote to repeal Obamacare, they contend, should be a separate measure from legislation to replace former President Obama’s signature legislation.

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In a press conference Tuesday, members of the House Freedom Caucus — a bloc of about 40 of the most fiscally conservative House Republicans – denounced the bill offered by Republican leadership. They warned the plan does not have the votes necessary to pass the lower chamber, and some conservatives pledged to introduce their own bill, a “clean” repeal of Obamacare that would deal with replacement later.

“This is not the Obamacare repeal bill we’ve been waiting for. It is a missed opportunity and a step in the wrong direction,” said Sen. Mike Lee, R-Utah.

Rep. Jim Jordan, R-Ohio, said he would offer an alternative bill Wednesday that would simply repeal the Affordable Care Act.

Sen. Rand Paul, Ky., who has been an outspoken critic of the health-care roll out proposal, called the House plan “Obamacare Lite.”


In an interview with CNN, Paul said he breaks with the Trump-endorsed bill because of tax credits, continuation of Obamacare taxes, subsidies to insurance companies and what he called a “form of the individual mandate.”

The House Freedom Caucus found support from a slew of conservative groups. Club for Growth, the Heritage Action, Freedom Works, Americans for Prosperity and Heritage Action issued statements opposing the plan, arguing it falls short of the Republicans’ promise to usher in conservative, free-market principles.

Freedom Works promised a six-figure ad buy, saying its activists are “furious at this betrayal.”

Trump took to Twitter Tuesday evening in an attempt to win over Paul’s support for the legislation.

“I feel sure that my friend @RandPaul will come along with the new and great health-care program because he knows Obamacare is a disaster!” he wrote.


At the moment, that does not seem likely.

Wednesday, Paul doubled down, telling Breitbart News that House Speaker Paul Ryan, R-Wis., is “trying to pull the wool over the eyes of the president.”

Democrats contend the Republican measure will take away health insurance from millions of Americans, benefit the rich and hurt the ability to extend Medicaid coverage to those who need it, particularly those needing mental health and addiction services.

The House bill leaves in place protections for people with pre-existing conditions, including mental illness, and it keeps in place the essential health benefits requirements for individual plans.

Rep. Tim Murphy, R-Pa., plans to offer an amendment during the Energy and Commerce Committee markup that would codify federal parity protections for people seeking mental health and substance-abuse treatment.

Assuming all Democrats vote against the legislation, the GOP cannot afford to lose more than 21 votes in the House and two in the Senate.

Ryan guaranteed Tuesday during a news conference that the legislation would have 218 votes when it hits the floor, arguing that it is conservatives’ best chance for overhauling Obamacare.

“We are doing an act of mercy by repealing [the ACA] and replacing it with patient-centered health-care reforms,” Ryan said. “If we did nothing the law would collapse and leave everybody without affordable health care.”

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