House to Vote on Health Care Bill Thursday

WASHINGTON (AP) — The House will vote Thursday on the GOP's long-sought legislation to repeal and replace portions of former President Barack Obama's Affordable Care Act, Republican leaders announced on Wednesday. House Majority Leader Kevin McCarthy confidently predicted success after a day of wrangling votes and personal arm-twisting by President Donald Trump.

After an earlier failure when Republican leaders were forced to pull the bill for lack of votes, the decision to move forward indicated confidence on the part of GOP leaders. A successful outcome would be the culmination of seven years' worth of promises by Republicans to undo Obama's signature legislative achievement, but could also expose House Republicans to political blowback by endorsing a bill that boots millions off the insurance rolls.

And there's no guarantee that the bill, if passed by the House on Thursday, will actually become law. First the Senate must work its will, and the House legislation has generated significant opposition in the upper chamber. Nonetheless, victory in the House would provide some vindication of the GOP's ability to govern in Republican-controlled Washington, and provide a long-sought win for Trump, who has been in office more than 100 days without a significant congressional victory save Senate confirmation of a Supreme Court justice.

As he announced the vote would go forward, McCarthy was asked if leaders were confident they had the votes and he replied: "Yes."

The announcement Wednesday evening came at the end of a day when House Republican leaders and Trump intensified their already fierce lobbying to save the long-promised legislation, agreeing to changes that brought two pivotal Republicans back on board.

Democrats stood firmly united against the health bill. But they generally applauded a separate $1 trillion-plus spending measure to keep the government running, which passed the House on a bipartisan vote of 309-118.

On the health care front, Reps. Fred Upton of Michigan and Billy Long of Missouri emerged from a White House meeting with Trump saying they could now support the bill, thanks to the addition of $8 billion over five years to help people with pre-existing conditions.

"Today we're here announcing that with this addition that we brought to the president and sold him on in over an hour meeting in here with him, that we're both yeses on the bill," Long told reporters. The potential defections of Upton and Long over the previous 48 hours had emerged as a possible death knell for the bill, and with it seven years' worth of GOP campaign promises to repeal and replace Democrat Barack Obama's Affordable Care Act.

"'We need you, we need you, we need you,'" Long described as the message from Trump.

The latest iteration of the GOP bill would let states escape a requirement under Obama's law that insurers charge healthy and seriously ill customers the same rates. Overall, the legislation would cut the Medicaid program for the poor, eliminate Obama's fines for people who don't buy insurance and provide generally skimpier subsidies. The American Medical Association, AARP and other consumer and medical groups are opposed. The AMA issued a statement saying Upton's changes "tinker at the edges without remedying the fundamental failing of the bill - that millions of Americans will lose their health insurance as a direct result."

If the GOP bill became law, congressional analysts estimate that 24 million more Americans would be uninsured by 2026, including 14 million by next year. Even if the GOP secures a win in the House, the Senate is expected to change the bill.

Separately, on the spending bill to keep the government running, Trump and GOP leaders hailed it as a victory, citing increases in money for the military. But Trump himself has undermined that message by complaining over Twitter about the need for Democratic votes on the bill and suggesting that a "good 'shutdown'" might be in order.

Some Republicans were not on-message either about the $1.1 trillion spending bill, the bipartisan result of weeks of negotiations in which top Democrats like Pelosi successfully blocked Trump's most controversial proposals, including a down payment on his oft-promised Mexico border wall, cuts to popular domestic programs, and new punishments for so-called sanctuary cities.

"From my point of view, we pretty well got our clock cleaned," said Republican Sen. Lindsey Graham of South Carolina.

Democratic votes were needed to pass the measure even though Republicans control both the White House and Congress, which made Pelosi and Senate Minority Leader Chuck Schumer powerful participants in the talks. That resulted in bipartisan outcomes like $407 million to combat Western wildfires and a $2 billion increase for medical research at the National Institutes of Health. Schumer has crowed over the outcome in a series of interviews, seemingly irking the White House.

Now that it's passed the House, the mammoth, 1,665-page measure to fund the government through September heads to the Senate, which is also expected to approve it. Despite his complaints, Trump has promised to sign it.

When the health bill does come to a vote Thursday it will be without an updated analysis from the nonpartisan Congressional Budget Office about its cost and impacts, a point Democrats complained about bitterly.

And even with Upton and Long in the "yes" column, GOP leaders spent the day hunting for votes among wary moderates. More than a dozen opponents — including Kentucky's Tom Massie, New Jersey's Chris Smith and Leonard Lance and Pennsylvania's Patrick Meehan — said they were still no despite the changes. GOP leaders can lose only 22 from their ranks and still pass the bill, and an Associated Press tally found 19 opposed.

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Associated Press writer Andrew Taylor contributed.