Seeing defeat, Republicans pull bill to replace health care bill

President Trump and House Speaker Paul Ryan, facing a catastrophic defeat that had the potential to cripple their ability to govern early in the new administration, cut their losses Friday by pulling their legislation to repeal and replace the Affordable Care Act.

Trump delivered a last-minute ultimatum Thursday night aimed at forcing House Republicans to unify behind the replacement bill, but conservatives, moderates and a widely overlooked group of mainstream Republicans representing districts Hillary Clinton won last November had gelled in opposition.

On health care, the decision to try to pass an enormous and complex piece of legislation that the nonpartisan Congressional Budget Office estimated would cause 24 million Americans to lose their coverage was the first test of a novice president with no experience in public office and a speaker who is a veteran of Congress but only assumed his leadership job a year and five months ago.

The replacement bill kept the basic architecture of current law, but substituted skimpier tax credits for the Affordable Care Act’s subsidies, while cutting $880 billion from Medicaid, which had been expanded to cover lower income people, largely to pay for $600 billion in taxes cuts for higher income people and corporations.

In a last-ditch effort to appease conservatives, Trump acceded to an amendment to remove 10 “essential health benefits” that current law requires insurers to cover in their policies.

Pitching the vote as a “binary choice” between backing Trump or voting with San Francisco Democratic leader Nancy Pelosi to “keep Obamacare,” Trump and Ryan hoped to put an end to negotiations with GOP factions trying to shift the legislation their

Hastily assembled behind closed doors by House leaders, including Majority Leader Kevin McCarthy of Bakersfield, the legislation was rammed through two committees before Republicans even knew how many people it would affect or how, its fallout on the budget or its consequences for the 17 percent of the economy that the health care sector comprises.

Rep. Mark Amodei, a Nevada Republican who voted no, blasted the hasty, almost casual, way the bill was sped through the House, dismissing the two committee hearings as “listening sessions” rather than lawmaking, saying “no effort” was made to bring in governors, industry or anyone else affected.