Under direction from President Donald Trump, House Speaker Paul Ryan, R-Wis., pulled the American Health Care Act from the House floor Friday afternoon, dashing Republican hopes of quickly repealing and replacing the ACA.
Here are five things to know about why the bill was pulled and what will happen next.
1. Republican leaders made final attempts Friday to sway Freedom Caucus conservatives.Vice President Mike Pence, White House Chief of Staff Reince Priebus and HHS Secretary Tom Price, MD, met with the Freedom Caucus at a Republican social club around noon to discuss the bill, according to The Washington Post. Members of this conservative faction represented a large chunk of the Republican opposition to the bill. President Trump himself lobbied 120 lawmakers ahead of Friday's scheduled vote, according to the report.
2. Additional Republicans defected from a yes vote Friday due to last-minute changes made to the bill. Leaders agreed to repeal essential health benefit requirements Thursday in an effort to win more conservative yes votes. However, the concession was dismissed by conservatives and condemned by moderates. According to The New York Times, the decision to add a provision repealing the essential health benefits requirement "doomed the bill."
3. Rep. Ryan visited the White House a little after noon to tell President Trump he had failed to whip the vote, according to The New York Times. With all Democrats planning to vote against the bill, the Republicans could only afford to lose 22 votes in the House for the bill to move on to the Senate. Rep. Ryan was not confident they had the votes needed to win. The White House still wanted to move forward, according to Politico.
4. Around 3:00 p.m. ET, President Trump told Rep. Ryan over the phone to withdraw the bill, according to Politico. Rep. Ryan broke the news to rank-and-file Republicans in a private meeting just 30 minutes later, according to The New York Times. Republicans needed 215 votes to pass the bill. "We just weren't quite there today," Rep. Ryan said on ABC News Live. "We will get there, but we weren't there today." Rep. Ryan said he advised the president that canceling the vote would be best, according to Politico.
5. The ACA prevails — for now. "We're going to be living with Obamacare for the foreseeable future," Rep. Ryan said, according to The New York Times.In the meantime,the administration may be able to make some adjustments to the ACA through regulation. Rep. Ryan told reporters, "I think there are some things that the secretary of HHS can do to try and sort of stabilize things."
President Trump told reporters he believed the ACA would "explode" in the near future, and when it does, he said he would be open to working collaboratively with both parties on another healthcare bill. Meanwhile, GOP senators already started pitching alternative bills Friday afternoon, which they say could pass along party lines in both the House and Senate, according to The Hill.
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