Donald Trump suffered a big blow as Republican leaders postponed a vote on the party's healthcare Bill following their failure to unite conservatives around the effort to replace the Obamacare law that they had spent years vowing to repeal.
Paul Ryan, the Republican Speaker of the House, abandoned the vote on Thursday afternoon after a final effort by the White House to convince conservative rebels to support the Bill failed.
Hardline conservatives left a meeting with the president earlier in the day without an agreement, but the White House had tried to put a positive gloss on events, saying the two sides were on “a great trajectory” towards passing the Bill.
The push to get a Republican repeal of Obamacare through Congress has turned into the biggest test of Mr Trump’s ability to deliver on his campaign promises and unite his party.
Biggest clash
The Bill, which had been due for a vote in the House on Thursday, set the stage for the biggest clash on Capitol Hill since Mr Trump took office, with Republican leaders squaring off not just against Democrats but members of their own party.
The Koch brothers, two of the biggest financial backers of the conservative movement, have opposed the legislation and pledged to support Republicans who defy Mr Trump and their party leadership.
Referring to the likely vote count in the House, Sean Spicer, the White House spokesman, said on Thursday: "We continue to make progress day by day . . . We continue to see the number go up, not down, and that's a very positive sign."
Conservatives are pressing to eliminate more of the government requirements embedded in Obamacare, but any concessions to them risk alienating moderate Republicans worried about people losing health insurance.
Mr Obama also weighed in on the proposed legislation,one of the few moments that the former president has commented on current political events since leaving office.
“If Republicans are serious about lowering costs while expanding coverage to those who need it, and if they’re prepared to work with Democrats and objective evaluators in finding solutions that accomplish those goals – that’s something we all should welcome,” Mr Obama said in a statement commemorating the anniversary of his own healthcare act, which was published seven years ago on Thursday.
“But we should start from the baseline that any changes will make our healthcare system better, not worse for hardworking Americans,” he said.
Ambitious agenda
Failure to pass the new Bill would cast doubt on Mr Trump’s capacity to unify his party and advance the rest of the new president’s ambitious agenda in Congress. It would also be a blow to Republican lawmakers who have spent the past seven years zealously focused on getting rid of Obamacare.
Ahead of a meeting with the president, some hardline conservatives who had vowed to vote against the Bill said the White House was signalling a readiness to make a change they wanted – narrowing the range of conditions insurers are obliged to cover.
But the Koch brothers underscored the depth of the rifts the Bill has reopened among Republicans as Freedom Partners, a political group they back, criticised the Bill in its current form.
"The AHCA in its current form fails to fully repeal Obamacare and would lead to even higher costs and fewer choices for Americans," said Nathan Nascimento, Freedom Partners' vice-president of policy, referring to the Bill that is known as the American Health Care Act.
“Absent major changes, the AHCA will fail to deliver relief for Americans, and we’ll stand with principled lawmakers who recognise this and vote against it,” he said.
The White House is seeking to pull off a difficult balancing act because any concessions that win over right-wing lawmakers risk losing the votes of Republican moderates.
Holdouts
American voters disapprove of the Republican plan to replace Obamacare by 56-17 per cent, with 26 per cent undecided, according to a Quinnipiac University national poll released on Thursday. Just 41 per cent of Republicans support the party's plan, with 24 per cent opposed, according to the poll.
In the days since Republican leaders first introduced the legislation, Mr Trump has made repeated attempts to court his party’s holdouts, inviting them over for numerous meetings and social gatherings at the White House, and attempting to allay concerns.
Mr Trump has repeatedly asserted that he believes the Bill will pass the House, and the White House has not laid out a plan B to repeal and replace the current healthcare programme should this Bill fail.
Copyright The Financial Times Limited 2017