Donald Trump really, really wants a victory on healthcare. Speaker Paul Ryan (R-Wis.) might need one.
The president and Speaker, still desperate for their first major legislative win in this new Republican era, are pulling out all the stops to corral 216 votes and pass a long-stalled healthcare bill through the House.
GOP leaders voiced confidence Wednesday night that the vote would happen on Thursday and that their legislation would be approved.
“We have enough votes. It will pass. It’s a good bill,” House Majority Leader Kevin McCarthy (R-Calif.) said.
The stakes are high for both Trump and Ryan.
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The president is still smarting from a barrage of bad headlines over the weekend saying he marked his 100th day in office without a significant legislative victory despite his party controlling both chambers of Congress. He doesn’t appear concerned about the policy specifics — he just wants a win.
Ryan is under enormous pressure to deliver that victory.
Trump’s budget chief, Mick Mulvaney, repeatedly has called for a vote this week in media interviews and news conferences. And influential voices on the right, including Fox News host Sean Hannity and Fox Business’s Lou Dobbs, are agitating for Ryan’s ouster if he can’t push the bill through his chamber after weeks of trying.
Few on Capitol Hill believe that Ryan could be forced out. He’s developed a relationship with Trump and speaks to him almost daily. He raises millions of dollars for the party and his colleagues each month. And there’s a concern that no one else could immediately step in and do the job as well as him.
But Ryan’s allies don’t want to test that theory and hand more ammunition to his critics.
Ryan has framed ObamaCare repeal as a moment of truth for his party, telling rank-and-file members in a private meeting this week that what they do will “define” Republicans for years to come.
The Speaker has hammered home that Republicans have vowed in election after election to repeal and replace ObamaCare, which they say is failing. Now, the party must fulfill that promise.
“The American people elected a Republican majority in the House and the Senate and the White House. [Repeal] was key to why we won,” Rep. Bill Shuster (R-Pa.), a Ryan ally and GOP committee chairman, told The Hill. “That pressure is coming from our constituents.”
The bulk of House Republicans say the time for talking and negotiating is over. They want to vote.
In addition, House lawmakers are set to head home for another weeklong recess, and jittery moderates are sure to get an earful from pro-ObamaCare protesters.
“It is not a critical moment, it is the critical moment,” said Rep. Mark Walker (R-N.C.), chairman of the conservative Republican Study Committee and an early negotiator of the bill, titled the American Health Care Act.
“The momentum is there. This is the time to do it,” added Rep. Joe Wilson (R-S.C.), a Tea Party favorite who famously shouted “You lie!” at former President Obama during a healthcare address.
Ryan and his leadership team have been cautious in the run-up to a new healthcare vote.
In March, leaders scheduled a vote, then yanked the bill off the floor, an embarrassing defeat for Trump and Ryan.
They also want to make sure the legislation doesn’t go down in flames on the House floor.
“Overall, we’ve got to do what we campaigned on and what the president wanted to do,” Rep. Robert Aderholt (R-Ala.), another early bill negotiator, told The Hill. “Needless to say, you’ve got to make sure everyone is in support of the bill before you move forward with it.”
If it fails on the floor, “it’s a bad reflection on the leadership,” Aderholt continued. “If I was the leader, if I was the Speaker, I’d want to make sure I had the votes before it goes to the floor.”
Passing the bill out of the House would put the onus on the Senate to act, but Republicans in the upper chamber are trying to help Ryan. Worries that Ryan’s job could be in trouble if he fails are being heard in the upper chamber, one senator indicated.
They don’t want to see him go.
“Paul Ryan is a talented and thoughtful legislator and leader. It’s important for him to succeed,” said one GOP senator.
Sen. Cory Gardner (R-Colo.) says his colleagues recognize their public badmouthing of the House’s first ObamaCare repeal-and-replace effort hurt Ryan and they want to do things differently this time.
“People recognize the need to move forward and have conversations about how to make a bill better, but to do so less from a soapbox and more from a position of working together and collaboration,” Gardner said.
In the House, the whip operation is at full throttle as the White House and GOP leaders hunt for more votes.
Vice President Pence made his third trip to the Capitol in as many days to corral votes. And Trump himself has been burning up the phone lines, pleading with Republicans who are opposed to or still undecided on the ObamaCare repeal-and-replace plan.
“Billy, we really need you, we need you, man,” Rep. Billy Long (R-Mo.) says Trump told him in one call. Both Long and Rep. Fred Upton (R-Mich.) flipped from no to yes Wednesday after they secured more funding for insurance for people with pre-existing conditions.
Meanwhile, Ryan, Majority Whip Steve Scalise (R-La.) and other GOP leaders have been hauling holdouts into their offices and buttonholing them on the House floor to see if they can resolve their individual concerns with the bill.