Dramatic vote looms on Republican health plan, high stakes for Trump

As the clock ticked on Friday toward a high-stakes vote demanded by Donald Trump to overhaul the U.S. healthcare system, fellow Republicans in Congress scrambled to secure enough votes to avoid a loss that could hobble his presidency.

The dramatic showdown on the House of Representatives floor follows Trump’s decision to cut off negotiations to shore up support inside his own party. On Thursday night he had issued an ultimatum that lawmakers pass the legislation that has his backing or keep in place the Obamacare law that Republicans have sought to dismantle since it was enacted seven years ago.

The House was tentatively set to vote by 4:45 p.m. ET (2045 GMT) on Friday on the bill to replace Democratic former President Barack Obama’s signature domestic policy achievement, the 2010 Affordable Care Act, widely known as Obamacare.

“We’ll see what happens,” Trump said at the White House, adding that House of Representatives Speaker Paul Ryan, who has championed the bill, should keep his job regardless of the outcome.

Republicans struggled to overcome their differences, with the most conservative lawmakers as well as moderates wavering. The president and House Republican leaders cannot afford to lose many votes in their own party because Democrats are unified in opposition, saying the bill would take away medical insurance from millions of Americans and leave the more-than-$3 trillion U.S. healthcare system in disarray.

Republican supporters said the plan would achieve their goal of rolling back the government’s “nanny state” role in healthcare.

House Democratic leader Nancy Pelosi said: “What’s happening today is a lose-lose situation for the Republicans. It’s a lose-lose for the American people, that’s for sure. But the people who vote for this will have this vote tattooed to their foreheads as they go forward.”

Even if the legislation passes, it will have an uncertain future in the Senate, where many Republicans are dissatisfied with it. Failure of the measure would call into question Trump’s ability to get other key parts of his agenda, including tax cuts and a boost in infrastructure spending, through a Congress controlled by his own party.

Trump, a real estate magnate who touted his deal-making prowess in the 2016 presidential campaign, faced the first major test of how well his skills would work with Congress. Days of negotiations led to some changes in the bill but failed to produce a consensus deal.

If all House members were to vote on the measure, Republicans could afford to lose only 21 votes. At least 35 Republicans still plan to vote against the bill, according to CBS News.

White House budget director Mick Mulvaney told ABC it was not clear if Republicans had enough votes but the Republican chairman of the Rules Committee, Pete Sessions, said “I would anticipate we’ll pass the bill today.”

Trump put fresh pressure on the House Freedom Caucus, which includes some of the chamber’s most conservative members and strongest critics of the bill. Trump said it would be ironic that opposition by anti-abortion lawmakers would preserve federal funding for Planned Parenthood, the women’s healthcare provider that includes abortions in its programs.

While Planned Parenthood is barred from using federal funds for abortions, conservatives argue that any federal money for other health services frees the organization up to use its own money on abortions.

U.S. stocks were higher Friday as some of the worry investors about a possible failure of the bill appeared to be ebbing ahead of the scheduled vote in the House. Some analysts suggested a failure could be a catalyst to bring forward action on tax reform, which has always been a greater priority for investors.

“Lawmakers will have to be accountable as to why they didn’t vote to get rid of Obamacare when they had the chance and that chance is today,” Mulvaney said on CBS’s “This Morning” program.

The vote had been set for Thursday, the seventh anniversary of Obama’s signing of the 2010 law, but in an embarrassing setback it was postponed because of uncertain support.

Health Secretary Tom Price put pressure on Republican holdouts on Friday.

“It’s time to put up,” he said on Fox News. “This is the first step and they need to get on board.”

Trump added on Twitter, “This is finally your chance for a great plan!”

The partisan, emotional debate expected in the House on Friday was previewed during a testy early-morning hearing of the House Rules Committee.

“I don’t have to be nice to nobody when you are being nasty to poor people,” Democratic Representative Alcee Hastings of Florida said during an exchange with Republicans on the panel.

A Quinnipiac University poll released on Thursday found 56 percent of U.S. voters opposed the House bill, with only 17 percent supporting it. Quinnipiac said its poll had a margin of error of plus or minus 3 percentage points.

The bill is the first foray into legislation for Trump, who took office on Jan. 20 with no political experience.

Replacing Obama’s signature health care plan was a key campaign pledge for Trump and Republicans, who view it as overly intrusive and expensive.