Paul Ryan's health-care ordeal probably won't end well

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The House Freedom Caucus remains largely opposed to the American Health Care Act as now drafted and members plan to file amendments at the Rules Committee markup Wednesday (March 22) in a bid to further change the bill before it hits the House floor Thursday.

The House Budget Committee moved the legislation ahead Thursday morning, passing it through committee by a close 19-17 vote with three GOP defections.

After presenting an initial timeline to advance the AHCA to a full House vote by next week, Ryan also backed off his planned schedule on Wednesday. But in the dark corners of the House "Freedom Caucus", populated by the far-right tea party fringe of the already pretty far-right Republican party, TrumpCare is bad because it doesn't go far enough in repealing the ACA.

President Trump says he changed some minds on the House GOP bill to replace ObamaCare.

Michigan Rep Justin Amash, asked how many members of the Freedom Caucus remain solidly opposed, said, "I believe more than enough to defeat the bill on the House floor so it's on leadership to decide whether they want to do that or not". In private, Freedom Caucus members have indicated to Independent Journal Review that they have doubts as to whether Ryan will allow a vote on the amendment.

But the Idaho Republican said that now that leaders and the White House are indicating to them and others that no major changes will be added "it means the bill is going to fail".

While Meadows was cagey about an exact whip count ― as well as whether some members of the group might waver if Trump applied all the pressure at his disposal ― other Freedom Caucus members were confident that conservatives controlled their own destiny.

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"This is the conservative health care vision that we've been talking about for years", Budget Committee chairman Diane Black of Tennessee said before the vote. Susan Collins (R-Maine). Four Republicans who initially opposed the bill because the original Medicaid provisions were too harsh - Sens. The conservatives want to repeal ObamaCare's insurance regulations, such as the essential health benefits that mandate which health services an insurance plan must cover. "We ended up with a technocratic crap sandwich", said one lawmaker.

And Ryan, who had until recently insisted that the House would pass the bill with few changes, admitted on Thursday that tweaks were likely needed to get passed. "We've been led to believe that there are no more amendments that will be allowed that substantially change things, and so if that's the case I think it makes it very hard if not impossible to get to 216 tomorrow".

Labrador made his opposition to the bill clear.

"The president is getting deeply involved", he said.

The late backroom changes and deal sweeteners undermine Speaker Paul Ryan's promise of an open legislative process, but even with the slapdash lawmaking, leaders continue to project confidence with regard to the bill.

"Clearly the main parts of this bill are going to stay exactly as they are but we're making improvements and refinements", he said.

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