Conservatives just dealt 'Trumpcare' a significant blow

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Jonathan Ernst/Reuters

President Donald Trump

The American Health Care Act, the House GOP leadership's bill to repeal and replace Obamacare, may have hit a serious roadblock Wednesday evening.

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Rep. Mark Meadows, who leads the conservative House Freedom Caucus, told reporters that he has enough votes to block the AHCA in a vote in the House.

According to reports from CNN and BuzzFeed, Meadows told reporters as many as 40 to 50 members ready to vote "no." And 20 more are on the fence, he said.

Without those votes and with all Democrats likely voting against the legislation, the bill would not be able to advance beyond the House.

Meadows and the House Freedom Caucus believe the bill does not go far enough in its repeal of Obamacare, the law officially known as the Affordable Care Act. They have argued for changes to strip out some of the ACA's regulations and proposed elements of the new AHCA.

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Meadows, according to reports, said he has a number of changes the Freedom Caucus wants to make to the AHCA. They plan to present it to members on Friday.

The developments add more uncertainty to the legislation after a number of moderate Republicans in the Senate also suggested that they would not vote for the bill in its current form, screeching to a halt the AHCA's progression in the upper chamber.

Negotiations

Perhaps sensing the resistance, both President Donald Trump and House Speaker Paul Ryan opened the door wider for changes to the AHCA during media appearances on Wednesday.

Speaking to Fox News' Tucker Carlson on Wednesday, Trump said that the AHCA was "preliminary" and that the GOP is "going to have a negotiation" on the bill.

"I'm, in a little way, I'm an arbitrator," Trump told Carlson. "We have the conservatives, we have the more liberal side of the Republican Party, we have the left, we have the right within the Republicans themselves, we got a lot of fighting going on, we have no Democrats, again, no matter what we do, we're never going to get a Democrat. Maybe we'll get one along the way."

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Ryan echoed the comments during his weekly press briefing on Wednesday, saying now that Republicans have received a score from the Congressional Budget Office, they can make "refinements and improvements" to the AHCA.

"What's happening in this legislative process is we're getting feedback from various members on how we can improve the bill now that we have the [CBO] score we know exactly what we're dealing with," Ryan said. "So now that we have the score, we can incorporate feedback to improve this bill, to refine this bill, and those kinds of conversations are occurring between the White House, the House, and the Senate and our members. It's premature to get into the conclusion of those things."

Ryan also said the GOP is looking for a "sweet spot that gets us a big vote count, that gets us our passage, that makes all members happy."

After presenting an initial timeline to advance the AHCA to a full House vote by next week, Ryan also backed off his planned schedule on Wednesday. He said House Majority Leader Kevin McCarthy would have a better sense and that the GOP was dealing with "snow day issues" after the Capitol was closed for business on Tuesday.

In the end, however, Ryan said that he was "confident our members will keep their word" to repeal and replace Obamacare.

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The bill faces its next major test as it heads for a mark up, a process of adding amendments and making changes, with the House Budget Committee on Thursday.