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Win McNamee

The bill failed, but Americans learned just how far Republicans will go to try and destroy President Obama's legacy.

After two days of frantic scrambling, hasty rewriting, and unadorned begging, House Speaker Paul Ryan was forced to pull his Trumpcare bill from the House floor before Friday's scheduled vote, delivering the most devastating blow yet to a struggling president eager to show his supporters that he is cut out for the task of governing. It's an embarrassing loss for a newly-unified Republican government, which ran on a platform promising to repeal and replace the Affordable Care Act and then, when their opportunity to do so finally arrived, pulled off the legislative equivalent of blowing a 3-1 lead in the NBA Finals.

The frenetic three weeks that have elapsed since Paul Ryan debuted the bill have, to use a medical term, sucked. Each day seemed to yield another grim estimate of how the bill would gut health care benefits for millions of Americans, followed by a hasty, ill-conceived rebuttal of those estimates from the powers that be, followed by another Paul Ryan tweetstorm of nonsensical technobabble accompanied by a picture of him standing in front of an American flag. Even as the crowds of skeptics grew larger and louder and Brietbart-ier, Republicans doubled down, insisting that their proposal would be the only opportunity to get rid of Obamacare, and that holdouts could fall in line or get wrecked in two years. The result was a poorly-understood Frankenstein's monster of a bill that was literally re-written overnight in a desperate, futile attempt to scrape together the necessary votes. Calling this debacle a goat rodeo would be an insult to the noble men and women of the goat rodeo industry who work hard to organize novelty livestock shows for your entertainment.

Hours before the Republicans' first self-imposed deadline for voting on Trumpcare, word leaked out that if Ryan wanted to cajole his party's unruly extremiststhe bald eagle belt-buckled members of the hyperconservative House Freedom Caucusinto throwing their support behind the bill, he would have to make just a few small tweaks first.

Conservatives are using their considerable leverage on the measurethe Freedom Caucus has demonstrated it has the votes to sink the legislationto extract concessions on the Essential Health Benefits section of the bill, which mandates that insurers offer plans covering 10 services: outpatient care, emergency room visits, hospitalization, maternity and newborn care, mental health and addiction treatment, prescription drugs, rehabilitative services, lab services, preventive care and pediatric services.

I'm genuinely flabbergasted. If things like prescription medicines and preventative care aren't covered, what the fuck is even left to insure anymore? Stop for a minute and think about how ludicrous it is that this gaggle of Ayn Rand-humping rubes were unwilling to support an outrageously irresponsible, universally-loathed health care proposal that would kill people unless they could put their heads to gather and find ingenious ways to ensure that it would kill more people. The Freedom Caucus' insane wish list wouldn't "reform" health care in America. It would destroy it.

The only person not named Donald Trump who comes out of this looking worse than Mark Meadows and his cronies is Paul Ryan, whose astonishing willingness to really consider their demands in a craven attempt to buy votes once again proved that his "repeal and replace" crusade was never about improving health outcomes or promoting "free markets" or finding a #BetterWay. It was about destroying anything and everything remotely related to President Obama, who spent eight years as the primary target of obsessive Republican teeth-gnashing vitriol, regardless of the implications that doing so would have for the lives of their spouses, their children, their families, and the millions of constituents whose interests they so despicably profess to represent.

Don't let the fact that Paul Ryan failed so catastrophically distract you from the fact that in the process, he revealed himself to be an amoral, unfeeling automaton who places political oneupmanship above all else, and who was ready to blame poor people for "choosing" their problems because he was either unwilling or incapable of doing the work of actually finding ways to ensure that Americans have access to the health care they need.

Trumpcare would have made life worse for Americans by just about every evidence-based metric, and it's okay to celebrate the fact that stiff, persistent, and vocal resistance helped ensure that the proposal met an ignominious end before even making it to the House floor. That said, the House Freedom Caucus' demands and the Speaker's reaction to them together revealed just how far the powers that be in charge of this country are willing to go in order to get their way on thiswhatever the consequences for the American people. Although this loss has to sting, Ryan been a dog after a bone about this issue for a solid seven years now, and it seems pretty unlikely that he'll give up on his fondest drunken fratboy dream altogether. The Affordable Care Act remains alive, but as long as the Republicans hold the White House and their legislative majorities, we are very much still in the woods.

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Trumpcare Exposed the Cruel Apathy of the Republican Party - GQ Magazine

Philip Klein unloads on the GOP in the pages of the conservative Washington Examiner, calling Obamacare repeal "the biggest broken promise in political history":

What's so utterly disgraceful, is not just that Republicans failed so miserably, but that they barely tried, raising questions about whether they ever actually wanted to repeal Obamacare in the first place.

Republicans for years have criticized the process that produced Obamacare, and things certainly got ugly. But after having just witnessed this debacle, I think Paul Ryan owes Nancy Pelosi an apology.

One has to admire the commitment that Democrats and Obama had to delivering something they campaigned on and truly believed in. They spent 13 months getting the bill from an initial concept to final passage, and pressed on during many points when everybody was predicting doom. They had public hearings, multiple drafts of different bills, they kept negotiating, even worked into Christmas. They made significant changes at times, but also never lost sight of their key goals. They didn't back down in the face of angry town halls and after losing their filibuster-proof majority, and many members cast votes that they knew risked their political careers. Obama himself was a leader, who consistently made it clear that he was not going to walk away. He did countless rallies, meetings, speeches even a "summit" at the Blair House to try to sell the bill, talking about details, responding to criticisms of the bill to the point that he was mocked by conservatives for talking so much about healthcare.

The contrast between Obama and Democrats on healthcare and what just happened is stunning. House Republicans slapped together a bill in a few weeks (months if we're being generous) behind closed doors with barely any debate. They moved the bill through committees at blazing speed, conducted closed-door negotiations that resulted in relatively minor tweaks to the bill, and within 17 days, Trump decided that he'd had enough, and was ready to walk away if members didn't accept the bill as is...

There was a big debate over the course of the election about how out of step Trump was with the Republican Party on many issues. But if anything, this episode shows that Trump and the GOP are perfect together limited in attention span, all about big talk and identity politics, but uninterested in substance.

Failing to get the votes on one particular bill is one thing. But failing and then walking away on seven years of promises is a pathetic abdication of duty. The Republican Party is a party without a purpose.

Go read the whole thing.

Trump, Ryan, and McConnell's total lack of commitment to repealing Obamcare really does stand in stark contrast to Obama, Pelosi, and Reid's total commitment to passing it in the first place.

On the eve of the House ACA vote in 2010, Obama went to Democrats and implored them to cast a vote many knew would be political suicide.

Sometimes I think about how I got involved in politics. I didnt think of myself as a potential politician when I get out of college. I went to work in neighborhoods, working with Catholic churches in poor neighborhoods in Chicago, trying to figure out how people could get a little bit of help. And I was skeptical about politics and politicians, just like a lot of Americans are skeptical about politics and politicians are right now. Because my working assumption was when push comes to shove, all too often folks in elected office, theyre looking for themselves and not looking out for the folks who put them there; that there are too many compromises; that the special interests have too much power; they just got too much clout; theres too much big money washing around.

And I decided finally to get involved because I realized if I wasnt willing to step up and be true to the things I believe in, then the system wouldnt change. Every single one of you had that same kind of moment at the beginning of your careers. Maybe it was just listening to stories in your neighborhood about what was happening to people whod been laid off of work. Maybe it was your own family experience, somebody got sick and didnt have health care and you said something should change.

Something inspired you to get involved, and something inspired you to be a Democrat instead of running as a Republican. Because somewhere deep in your heart you said to yourself, I believe in an America in which we dont just look out for ourselves, that we dont just tell people youre on your own, that we are proud of our individualism, we are proud of our liberty, but we also have a sense of neighborliness and a sense of community -- (applause) -- and we are willing to look out for one another and help people who are vulnerable and help people who are down on their luck and give them a pathway to success and give them a ladder into the middle class. Thats why you decided to run. (Applause.)

And now a lot of us have been here a while and everybody here has taken their lumps and their bruises. And it turns out people have had to make compromises, and youve been away from families for a long time and youve missed special events for your kids sometimes. And maybe there have been times where you asked yourself, why did I ever get involved in politics in the first place? And maybe things cant change after all. And when you do something courageous, it turns out sometimes you may be attacked. And sometimes the very people you thought you were trying to help may be angry at you and shout at you. And you say to yourself, maybe that thing that I started with has been lost.

But you know what? Every once in a while, every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises that you made in all those town meetings and all those constituency breakfasts and all that traveling through the district, all those people who you looked in the eye and you said, you know what, youre right, the system is not working for you and Im going to make it a little bit better.

And this is one of those moments. This is one of those times where you can honestly say to yourself, doggone it, this is exactly why I came here. This is why I got into politics. This is why I got into public service. This is why Ive made those sacrifices. Because I believe so deeply in this country and I believe so deeply in this democracy and Im willing to stand up even when its hard, even when its tough.

Every single one of you have made that promise not just to your constituents but to yourself. And this is the time to make true on that promise. We are not bound to win, but we are bound to be true. We are not bound to succeed, but we are bound to let whatever light we have shine. We have been debating health care for decades. It has now been debated for a year. It is in your hands. It is time to pass health care reform for America, and I am confident that you are going to do it tomorrow.

With Obama, Pelosi, and Reid, Democratic voters had representatives who were as committed to their goals as they were. Republican voters should realize today that they are not so lucky.

Read more:
"The Republican Party Is a Party Without a Purpose" - Mother Jones

President Donald Trump wasnt physically there, but his presence was felt from beginning to end by Republican activist and party donors who gathered for an evening of celebration at the Trump-owned Mar-a-Lago Club.

VIP ticket-holders got a surprise visit from First Lady Melania Trump. The Friday night dinner was held in the opulent Donald J. Trump Grand Ballroom. The Lincoln Day event party favor was a signature Trump Make America Great Again red ball cap placed on the chair of each of the 692 attendees.

And the chocolate mousse bomb dessert was topped with an image of Lincoln wearing a MAGA hat.

In the midst of all-things-Trump, the guided splendor of Mar-a-Lago, and the company of fellow Republicans a combination of people who volunteered time to work in the trenches of the 2016 campaign or donated money to the partys efforts spirits were ebullient

It was a long way, in distance and mood, from the turmoil in Washington, where hours earlier Republicans suffered the collapse of their health care legislation, began pointing fingers of blame at one another, and wondered how deeply the Republican president and Congress were damaged.

Not so at Mar-a-Lago, the resort that Trump turned into a cold-weather getaway when he was a New York real estate developer and now uses as a presidential retreat.

The moods uplifting, exciting, said Tami Donnally, vice chairwoman of the Palm Beach County Republican Party. What we wanted to accomplish tonight was getting together and celebrating.

She said there was no reason the failure of the Obamacare repeal a signature campaign promise from Trump and the Republicans elected to the House and Senate should cast a pall over the gathering. I see the bigger picture, she said. A setback, yes. Something to be sad, depressed [about], no way.

As about 200 people who wrote large checks for the pre-dinner VIP reception mingled in a smaller ballroom in another part of the resort complex, there was a sudden rumbling in the crowd, according to people who were present. As people craned their necks to see what was happening, they saw the first lady.

There was whooping and hollering, from some, said former U.S. Rep. Mark Foley of Palm Beach County. It was exciting. Shes a gorgeous lady. Shes so poised.

Only a handful of people organizing the dinner knew ahead of time she would stop by. She was gone in just a few minutes. It was a surprise, said Bob Sutton, chairman of the Broward Republican Party, one of several people who described the scene and shared smartphone pictures with reporters. (A handful of reporters and photographers was kept far away from the VIP venue, Mrs. Trump could be seen from a distance when she walked up and when she left, accompanied by Secret Service agents.)

She went to an area roped off from the VIP guests, greeted the crowd and spoke to Gov. Rick Scott and the keynote speakers for the evening, Lynette Hardaway and Rochelle Richardson, the Trump supporting YouTube duo who appear online as Diamond and Silk.

She was gorgeous. She said Hi everybody, said Margi Helschien, former president of the Boca Raton Republican Club who now runs the conservative group America First. It was a total surprise. It was like, Oh my goodness!

Two attendees said they had a vantage point from which they saw the Trumps 11-year-old son, Barron, outside on a patio.

Many painted as bright a picture as possible over the Republican failure to keep the pre-election promise to repeal and replace Obamacare made repeatedly last year by candidate Trump and the partys candidates for U.S. Senate and House during the 2016, 2014, 2012 and 2010 election campaigns.

A vote was canceled Friday when the president and House Speaker Paul Ryan concluded they didnt have enough votes to pass what some labeled Trumpcare. Helschien said it was a topic of conversation.

A lot of people were talking about it. A lot of people were upset, she said. She downplayed the notion that its a catastrophe with lasting effects. We took a little bit of a step sideways. Were going to regroup. Its not the end of the world.

Sid Dinerstein, former chairman of the Palm Beach County Republican Party, insisted it wasnt a big deal because were winning every day. Bob Sutton, chairman of the Broward County Republican party, saw it as a learning opportunity. And Anita Mitchell, a former Palm Beach County party chairwoman, said it comes with the territory for a party in control. Governings messy.

Florida Agriculture Commissioner Adam Putnam, who once was in the upper echelons of the House Republican leadership, said it was disappointing and a setback, but would be overcome eventually. Theres time for Republicans to dust themselves off, get back on the horse, and get it done right.

Foley was less sanguine.

I just think it was poorly orchestrated, Foley said. This is depressing to me.

Foley said health care is a potent issue that, if done wrong, could send members of Congress to defeat in the next election. He said it would have made more sense for his former colleagues to have tackled something with broader support such as cutting taxes. Especially since Republicans didnt have an Obamacare replacement plan ready to roll out on Day One.

He said theres at least a temporary price for whats seen by many as a failure for Trump. It doesnt look good.

The people who attended the event snapped up the $300 a head tickets. The event sold out two months ago, said Michael Barnett, chairman of the Palm Beach County Republican Party.

The attendees activists who can form the volunteer backbone of campaigns and potential major donors are vital constituencies for candidates, and the dinner attracted multiple high profile likely 2018 candidates.

He touted the virtues of capitalism after a recent Florida poll found many young people thought socialism is as good or better; praised Scott, with whom he hasnt always been politically in sync; and urged party members to stay pumped up to ensure victories in 2018. Enthusiasm matters, he said.

Scott praised the president; talked about spending a day last month at the White House (He doesnt eat the most healthy food); and criticized Republican rivals in Tallahassee who want to scale back government subsidies for businesses and tourism marketing.

Before Friday nights dinner at Mar-a-Lago, he avoided a small group of reporters. He didnt participate in the traditional entrance of elected officials. After speaking and picking up the Statesman of the Year award, he left early.

From beginning to end, the absent Trump got the crowd most energized.

Early on, Barnett reminded diners that the country has a new president. They burst into applause and cheers.

At the end, keynote speakers, Diamond and Silk, made their presentation in the style of the videos that have made them an Internet sensation. The South Caroline sisters often speak in rhyme and offer a comment and response routine. Hardaway, who is Diamond, says something positive about Trump, and Richardson, who is Silk, responds with facial contortions and brief words of praise.

Before leaving the stage, Hardaway asked the crowd, Are we on the Trump train?

She and Richardson then proceeded to lead the crowd in a repeated call and response. When I say choo choo, you all say all aboard.

aman@sunsentinel.com, 954-356-4550

Read more:
Republican donors, activists gather at Trump's Mar-a-Lago | Video - Sun Sentinel

The one question you never hear journalists ask Republicans is why?

Why do so many Republicans want to throw 24 million struggling Americans off the health insurance rolls? Why does the allegedly populist Trump administration submit a budget that slashes job training programs for the very same jobless white folks he claimed to represent?

Why cut Meals on Wheels, child care, after-school programs and learning centers for the poor, affordable housing and aid to the homeless? Why zero out occupational safety training and economic growth assistance in distressed communities in Appalachia and the Mississippi Delta (more Trump constituents)? Why slash legal aid and medicine and food for the sick and hungry in the developing world, among many others?

Journalists ask Republicans about policies, mechanisms and money, but those are technical questions when the real and simple question they should be asking is a moral one: Why do Republicans seem intent on hurting the most vulnerable among us?

Unfortunately, the answer may just be, to paraphrase Clint Eastwoods Dirty Harry on why serial killers murder: because they like it.

Sure, we know the rote answers. Republicans love to talk about choice and freedom and markets and deficit reduction and personal responsibility and all sorts of ideological claptrap that seems to slap principle on what really is punishment. At best these are smokescreens, at worst traps that have succeeded in entangling the media, Democrats and Americans generally in arguments about tactics or priorities rather than arguments about motives and their real-life consequences.

There was a time when Republicans worried they might be perceived as being on the wrong side of morality, even if that worry didnt move them to get on the right side. They used to dress up their cruelty not only in those old Milton Friedman free market clichs but in new ones like compassionate conservatism, because even as they knew there was nothing compassionate about it, they also knew that most Americans werent buying into letting the poor fend for themselves. That wasnt American. That wasnt human.

Some of that window dressing remains in the Trump era, but not much. Republicans still feel obliged to declare that their health care plan will cover more Americans at a lower cost, but everyone knows they are lying. By one report, when the White House ran the numbers, it predicted 26 million would lose health coverage 2 million more than the Congressional Budget Office figure.

Speaker Paul Ryan was more than sanguine about those sufferers. He flashed a vulpine smile in recounting the CBO numbers, actually saying they were better than he had thought, which is to say that the American Health Care Act, as they call it, may have been intended to deny coverage, just as Trumps budget clearly was intended to hurt the most vulnerable, including those vulnerable supporters of his. To my mind, these werent collateral effects. They were the very reasons for the AHCA and the budget.

So, again, why? What kind of people seem dedicated to inflicting pain on others?

It is not an easy question to answer, since it violates all precepts of basic decency. I suspect it comes from a meld of Calvinism with social Darwinism. From Calvinism, conservatives borrowed both a pinched and unsparing view of humanity as well as the idea of election namely, that God elects some folks for redemption, which, when rebooted for modern conservatism, has an economic component. Plain and simple, rich people are rich because they are better than poor people.

By the same token, poor people are poor because they are worse. This is Gods edict, so to speak. (The so-called Calvinist revival has an awful lot in common with Trumpism.) From social Darwinism, they borrowed the idea that this is the way the world should be: winners and losers, those who can succeed and those who cant. It is a world without luck, except for tough luck.

From this perspective, conservatives may not really think they are harming the vulnerable but instead harming the undeserving, which is very different. In effect, conservatives believe they are only meting out divine and natural justice. Its convenient, of course, that this justice turns out to be redistributive, taking resources from the poor and middle class and funneling them to the wealthy, who happen to be the benefactors of conservatism as well as its beneficiaries. (Just note how Republicans howl about redistribution when it is the other way around.) Where many of us see need, they only see indolence and impotence. It is, by almost any gauge, not only self-serving but also plainly wrong moralistic rather than moral.

But if Republicans see their moral duty as denying help to the weak, that denial is part of a larger and even uglier social equation. In a recent New York Times column, Linda Greenhouse recalled an exchange 30 years ago between Robert Bork and Illinois Sen. Paul Simon during Borks confirmation hearings for the Supreme Court. Simon asked Bork about a speech he had given two years earlier, in which the judge said:

when a court adds to one persons constitutional rights, it subtracts from the rights of others.

The senator asked, Do you believe that is always true?

Yes, Senator, Judge Bork replied. I think its a matter of plain arithmetic.

Sen. Simon: I have long thought it is kind of fundamental in our society that when you expand the liberty of any of us, you expand the liberty of all of us.

Judge Bork: I think, Senator, that is not correct.

Remember that although (or perhaps because!) his Supreme Court nomination failed, Bork is a conservative deity. As far as conservatives and Republicans are concerned, to give anything to the less fortunate is to subtract it from everyone else a zero-sum game between the rich and the rest of America.

This isnt politics. This is bedrock conservative philosophy. And it may have no more eager avatar than Donald Trump, who is all about winning and losing. Trump has always professed to want to blow up the system. He is like a child knocking down a tower of blocks, only in his case the blocks are American democracy and decency.

But with the AHCA and his Draconian budget, one that even a few Republicans no doubt fearing voter retribution blanched at, Trump may not have blown up the system so much as he has blown the Republicans cover. He even seems to have emboldened some of them to come out of hiding and admit that any assistance for the poor is too much.

This we always suspected. What is harder to parse is the joy conservative Republicans seem to get in hurting the weak, making the GOP not just the punishment party, but also the schadenfreude party. Or put in different terms: Conservatism didnt create meanness, but meanness sure created conservatism.

We might be able to understand that sense of smug moral and social superiority from doctrinaire Republicans who spout Ayn Rand and detest those whose hurdles are the highest. We all know hate can be intoxicating. But these past two weeks Ryan and Trump have been gambling on something else that many of their fellow Americans agree with them, that these Americans share a deep and abiding hostility to those who need government assistance. Whether Ryan and Trump are right may very well determine the fate of this administration and the country.

So the second big question, alongside why Republicans and conservatives seem to luxuriate in cruelty, is why any other ordinary American would. There have been predictions on the left that once those ordinary Americans feel the sting of losing health care or job training or work safety regulations or clean water and air, they will revolt, and Trump will be dust. But there is no certainty to this. A recent New York Times piece on this very issue indicated that at least some Trump supporters know they will suffer from his budget and still support him.

Another Times article, by Eduardo Porter, quoted a Harvard economist suggesting that the white working class feel they get so little benefit from the so-called welfare state that they see things through the same zero-sum prism as Bork, Ryan and Trump. Whatever the poor gain, the white working class loses.

When you think how much the government does for so many across such a wide spectrum, you wonder what world these people are living in. Indeed, a signal achievement of conservatism, decades in the making, has been pitting the have littles against the have nots while the have lots stayed above the fray. Of course, by that calculation, you might think the struggling white working class would be on the loser side of the ledger, sentenced to defeat by their own deficiencies in our Darwinist world. But in another neat trick, Republicans have managed to convince them they are victims of twin demonic forces, government and liberal elites, that disrupt the natural order of things. In this way, many Republicans helped turn many Americans into brutes and our American community into a state of nature. There couldnt have been a President Trump without it. There couldnt have been an ACHA or a Trump budget either.

This, then, is a vital moment for American morality and, to the extent the two are intertwined, American democracy. You cant pretend Trump and his Republican pals are trying to achieve good ends by different means. They arent. You cant act as if they give a damn about the millions of poor and working-class Americans. They dont.

But even as their cover is blown, someone needs to keep asking them the fundamental question again and again and again: Why?

More:
Has the Trump budget blown Republican's cover? - Salon

House Speaker Paul Ryan speaks to reporters after a meeting with President Trump, who came to Capitol Hill to rally GOP lawmakers behind the Republican health care overhaul. J. Scott Applewhite/AP hide caption

House Speaker Paul Ryan speaks to reporters after a meeting with President Trump, who came to Capitol Hill to rally GOP lawmakers behind the Republican health care overhaul.

Republicans will be tested today on the strength of party unity in the Trump era and their party's ability to deliver on the promises they've made to the voters that sent them here.

"This is our chance and this is our moment. It's a big moment," House Speaker Paul Ryan told reporters earlier this week. "And I think our members are beginning to appreciate just what kind of a 'rendezvous with destiny' we have right here."

The moment is particularly defining for Ryan, the reluctant speaker who is facing the toughest legislative battle of his nearly 20-year congressional career. "One of the reasons I don't want this bill to fail is I don't want Paul to fail," said Rep. Mike Simpson, R-Idaho, an ally of the speaker who supports the bill.

The speaker has put the full weight of his office behind passing legislation that goes much further to repeal and replace key pillars of Obamacare, to remake Medicaid into a block grant program that caps federal spending. The entitlement program predominantly helps the poor and currently has an open-ended funding stream.

It's the kind of conservative reform that Ryan has jokingly said he's dreamed about since his keg party days, but it might not be enough even with Republicans in control of both chambers of Congress and the White House.

The House Freedom Caucus, a bloc of about 30 hard-line conservatives, maintain going in to today's scheduled vote that they have enough members on their side to defeat the bill. Their opposition has not softened, despite continued efforts by President Trump, Vice President Pence and their senior White House aides to grant concessions and cajole lawmakers from districts Trump won by big margins last November.

"We're being asked to sign a blank check and hope it works out," said Rep. Scott Perry, R-Pa., a member of the Freedom Caucus, "And in the past that hasn't worked out real well for this process, so I think we're right to be skeptical."

Perry was one of about 25 Freedom Caucus members who huddled with Vice President Mike Pence and White House adviser Kellyanne Conway on Wednesday. It didn't change his vote. Conservatives like Perry want the bill to go even further to repeal President Obama's health care law. Specifically, these conservatives want assurances the final bill would ultimately repeal the essential health benefits included in the Affordable Care Act, which cover 10 categories of health services insurance plans must cover, including prescription drugs and prenatal care.

"We want free market competition and how can you have free market competition when the government is mandating what's going to be included?" Perry said. Conservatives argue that eliminating the essential health benefits will allow insurance companies to offer cheaper insurance plans with more tailored coverage. Opponents say it will only increase out-of-pocket costs for consumers.

Conservatives also received some political cover from outside conservative activist groups like Heritage Action and FreedomWorks, which came out in opposition to the bill.

The network of political action groups funded by Charles and David Koch, wealthy libertarian-minded donors who have not supported Trump, are putting money behind their opposition to the bill. Two Koch-funded groups, Americans For Prosperity and Freedom Partners, announced last night they would establish a seven-figure fund "to stand by principled lawmakers who keep their promise of fully repealing Obamacare by opposing the American Health Care Act (AHCA) unless there are significant changes." It amounts to a promise of protection for members who might fear a primary challenge for breaking with Trump.

As the day unfolded yesterday, it became clear that conservatives were not the only weak link in the vote count. With every new "yes" vote announced, a "no" vote would appear. Reps. Lou Barletta of Pennsylvania and Steve King of Iowa announced they would support the bill on Wednesday, but their support was offset by fresh opposition from lawmakers including Don Young of Alaska, David Young of Iowa, and Frank LoBiondo of New Jersey.

The trio of opponents are mainstream Republicans, the kind of rank-and-file members party leaders can usually rely on to pass their agenda. But the policy in the GOP bill, the American Health Care Act, would disproportionately affect older, poorer Americans the very constituents who make up many GOP lawmakers base of support back home.

For instance, LoBiondo said in a statement that his South Jersey district and its retirees would suffer under AHCA. "Three South Jersey counties have more than 30% of their residents receiving Medicaid assistance. Medical professionalsour hospitals, doctors, nurses are opposed," he said.

The speaker focused on more moderate members of the GOP, working members during House votes on Wednesday and holding one-on-one meetings in his office throughout the day.

"If you don't recognize how much is on the line, you haven't been paying attention," said Rep. Tom Cole, R-Okla. He supports the bill and, like many lawmakers, remained optimistic that the votes would come together to pass it. Cole even suggested they might have to win the vote on the floor. "You never know about these things until you actually get to the vote," he said.

With five vacancies in the 435-member House, Republicans can lose 21 votes and still pass the bill. Every Democrat is expected to vote against it. House Republicans enjoy one of their largest majorities in decades, so the 21-vote cushion is much larger than past GOP-controlled congresses have enjoyed.

Cole said most Republicans were aware of the importance of this vote: "It's a very consequential vote. It really is: 'Can you govern or can't you?' "

For their part, Democrats are unified against the bill, which undoes President Obama's signature domestic achievement. Former Vice President Biden returned to Washington to voice his opposition to the bill at a rally outside the U.S. Capitol.

"Look, folks, here's the deal: When you cut to the chase, we're talking about eliminating close to a $1 trillion in benefits that go to people to be able to meet the commitment we made that health care is a right, and we're transferring all of that to the wealthy," Biden said. "That's what this is all about, it's about a transfer tax, basically. Eliminating the Affordable Care Act means eliminating an awful lot of things that people need."

If the House approves the bill on Thursday, the thrill of victory will be short-lived. The bill still needs to pass the Senate, and it faces a new round of opposition and legislative hurdles in that chamber. The bill then would need to back to the House again to approve any Senate-passed changes before it could go to Trump's desk.

Read more here:
In Final Hours, GOP Leaders Scramble For Votes On Bill To Gut 'Obamacare' - NPR