The bill to repeal Obamacare is teetering on the brink of failure, and Republicans facing tough re-election races in 2018 are hesitant to take a vote that could have serious political consequences in 18 months.
There are 23 House Republicans who represent districts won by Democratic presidential candidate Hillary Clinton in the 2016 election, and more than half of that group are either opposed or undecided on the GOP health care bill as of Tuesday afternoon. None of the 23 Republicans is vocally in favor of the bill.
The list of undecided or opposed members includes incumbents used to tough re-election fights, like Rep. Carlos Curbelo of Florida, and members who represent districts that flipped to Clinton in 2016, like Rep. Ryan Costello of Pennsylvania.
"Each of us individually is evaluating it based on commitments we have made, public statements we have made," said Costello, who is opposed to the bill. "I voted the bill out of committee and I made certain representations during committee and to my constituents so that if a bill is ultimately going to get to the floor that contradicts statements that I've made, that becomes very problematic."
Opponents of the bill argue that the new language introduced last week by Rep. Tom MacArthur of New Jersey and approved by conservative members of the Freedom Caucus would give states the ability to strip health insurance from people with pre-existing conditions, something that many Republicans said is a non-starter for them in the past.
And Democratic campaign operatives are waiting to pounce on any perceived flip-flopping by Republicans facing a tough fight in 2018.
"Almost all of them have promised specifically not to cut the pre-existing conditions protections," said Democratic Congressional Campaign Committee spokesman Tyler Law. "At an individual level if they support this, they are breaking their own promises. That's where I think you'll see a heightened level of blowback."
Credit: Charles Rex Arbogast
Credit: Charles Rex Arbogast
Law said that Republicans sitting in competitive districts face a twofold challenge: Their conservative base may sit out the 2018 election if the party fails to deliver on one of its central campaign promises, while emboldened Democrats will turn out in droves if the bill becomes law. The Democratic Congressional Campaign Committee is using the health care issue to run digital ads against Republicans in Democratic-leaning districts.
Rep. Kevin Yoder of Kansas, a Republican who is running for re-election in a suburban Kansas City district that Clinton narrowly won, remains undecided on the bill. Yoder is a member of the leadership team designed to rally support for the bill, and the fact that he's not on board yet — at least not publicly — shows the challenge House Speaker Paul Ryan is facing with Republicans running in blue-leaning or purple districts.
"There's lots of this I like. We still have some concerns about the cost and the coverage. We may only get one shot of this," Yoder said to McClatchy's Kansas City Star. "Because if Congress fails, single payer is knocking at the door and we don't like that."
Other Republicans are less than enthused with questions over whether they support the bill.
"The congressman is not going to be part of this D.C. insider game," said Curbelo spokesperson Joanna Rodriguez in a statement to the press. "He's hearing out his constituents' concerns, reviewing the implications of the policies on the table and working with several senators to see if the legislation would be adequately improved in the Senate before a finished product returns to the House. Until those conversations are complete, he's going to remain undecided."
Clinton won Curbelo's Miami-area district by 16 percentage points over Trump.
The National Republican Congressional Committee is preparing to defend potentially vulnerable incumbents from the political fallout over the health care bill. The NRCC announced on Tuesday that six members in districts carried by Clinton will participate in the Patriot Program, which gives members fundraising and organizational assistance. The new Patriot Program members include Curbelo and California Rep. Jeff Denham.
"It's not about political cover, it's about policy cover and there's plenty in the policy as long as they can articulate it," said Freedom Caucus chairman Mark Meadows, R-N.C.
Rep. Chris Collins of New York, a member of the moderate Tuesday Group and an ally of President Donald Trump, acknowledged that Republicans in competitive districts are in a tough spot.
"The pre-existing condition issue will be exploited by Democrats in the next election cycle," said Collins, who supports the health care bill. "They will misstate it, exaggerate it and run commercials. I think it's that political in nature. Of course everyone is going to worry about their next election. You run every two years. And for any of us who have been on the wrong side of distorted, exaggerated, nontruthful commercials, including ones I faced two weeks ago, we'd say why would we open ourselves up to that?"
There is no indication that GOP leadership is close to obtaining enough votes for a health care bill to pass, and prominent House Republicans like Rep. Fred Upton of Michigan announced their opposition to the rewritten bill after supporting the first version in March.
The House leaves for a weeklong recess on Thursday. If 22 House Republicans vote against the bill, it will fail.
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