Budget Committee OKs Obamacare repeal over objections from conservatives

WASHINGTON — The House bill to repeal and replace Obamacare moved one step forward Thursday with a narrow victory in the House Budget Committee despite three Republican members voting against the legislation.

The committee voted 19-17 to move the legislation forward. No Democrats voted for it.

Reps. Dave Brat, R-Va., Mark Sanford, R-S.C., and Gary Palmer, R-Ala., joined Democrats and voted against moving the legislation forward. The three lawmakers are all members of the House Freedom Caucus, a group of roughly 40 hardline conservatives who have criticized the bill in its current form, mostly on the grounds that it does not go far enough in repealing Obamacare and does not do so quickly enough.

“We have one opportunity to answer the healthcare crisis the American people are facing. In my opinion, the current bill does not answer this crisis. I voted against the American Health Care Act in the Budget Committee because the promises of changes in the future are insufficient," Palmer said in a statement Thursday. "Now that the bill has been reported out of committee, I will continue to work for the changes that are necessary to ensure Medicaid is a viable and affordable program to provide healthcare to the people who need it most."

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Brat told USA TODAY Wednesday that he intended to vote no because “President Trump wants competition across state lines and the price of insurance to come down.” The legislation does not include across-state competition because Republicans are trying to use a budget process that allows for bills to pass without Democratic support but only if they are restricted to budgetary items.

On Thursday afternoon, Brat said that while he would have rather the legislation be stopped in the Budget Committee and sent back to the previous committees for further negotiations, he saw other opportunities to negotiate ahead.

“The whole thing is a negotiation, so this would have immediately sent it back to the committees for homework, and so now we’re going to have to wait,” Brat said. “There’s no where near the votes” for the bill to pas the House without changes, Brat said.

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This is the third House committee that has voted on the bill, but it is the first panel that included a significant number of conservatives who have spoken out against the legislation in its current form. The bill passed the House Energy and Commerce and Ways and Means committees previously, but the Republicans on those panels had either worked on the legislation themselves or were allies of House leadership.

The Budget Committee process does not allow for amendments to legislation; instead the lawmakers vote on non-binding motions.

Brat offered no motions because "they're important symbolically, but they're not going to change the substance on the bill," he said.

But Palmer introduced a motion that passed the committee, 21-13,  to support a work requirement for Medicaid recipients who are “able-bodied adults without children.” A work requirement has been endorsed by many conservative Republicans.

“When Medicaid was created, it wasn’t intended to become an entitlement for able-bodied adults,” Palmer said when introducing the motion. “We should be encouraging people to enter the workforce, not giving them an incentive to stay home.”

Texas Republican Rep. Jodey Arrington endorsed the motion, saying, “Let’s prevent idleness, let’s encourage personal responsibility.”

Democrats attacked the motion. Rep. Barbara Lee, D-Calif., called it "yet another baseless attack on the poor, on struggling families and on the unemployed.”

House Speaker Paul Ryan celebrated the bill's progress.

“Today, the House Budget Committee took up the American Health Care Act. It is the third committee to debate this bill as part of our ongoing open and transparent regular order process. We look forward to strong support there, putting us another step closer toward keeping our promise — keeping our promise to repeal and replace Obamacare. From there, the bill will go to a fourth committee before it goes to the House floor," Ryan said in a statement Thursday.

House Freedom Caucus Chairman Mark Meadows, R-N.C., said he wasn't telling his members how to vote during the Budget Committee markup.

"We want to negotiate in good faith," Meadows told reporters Wednesday night. If Freedom Caucus members killed the bill in the Budget Committee, "we would have no vehicle to amend this bill. And so we want to be able to amend this bill."

The Freedom Caucus plans to introduce an amendment to the repeal legislation as early as Friday. Meadows said he believes that the amendment will make it possible for skeptical conservatives to get to "yes" on the legislation and also satisfy moderate Republicans.

Currently there must be 216 votes for a repeal to pass the House. Because no Democrats are expected to vote in favor of the legislation, Republicans can lose no more than about 20 votes. Meadows is confident there are more than 20 people who would vote "no" if the legislation came up in its current form.

Meadows has been in near-daily conversation with the White House, which he called a "very willing partner" to negotiate the details of the plan. But conversations with House leadership regarding the bill are far less frequent. Meadows told reporters that besides a quick conversation earlier this week with Majority Whip Steve Scalise, R-La., about vote counts, he hasn't had any substantial meeting with a member of leadership in two weeks.

Trump said Wednesday night on Fox News that he remains open to amending the bill. "I think we're going to have negotiations," he told host Tucker Carlson. "This is very preliminary."