* White House plays down next week as goal for passage
* Trump has no major legislative victory since taking office
* Republicans can't afford defections with Democrats opposed
By Susan Cornwell
WASHINGTON, April 21 President Donald Trump,
striving to make good on a top campaign promise, is pushing his
fellow Republicans who control Congress to pass revamped
healthcare legislation but the same intraparty squabbling that
torpedoed it last month could do it again.
Trump is looking for his first major legislative victory
since taking office in January. House of Representatives
Republicans are exploring compromises aimed at satisfying the
party's most conservative members without antagonizing its
moderates, but it remained unclear on Friday whether a viable
bill would emerge.
Trump on Thursday talked up the bill's prospects and said he
saw "a good chance of getting it soon," either "next week or
shortly thereafter." White House spokesman Sean Spicer on Friday
played down setting next week as the goal for passage.
"We're going to get it done when it's appropriate in terms
of getting to that 216," Spicer said, referring to the number of
votes needed to win passage in the House before the bill goes to
"If it gets done next week, great," Spicer told reporters,
downplaying the desire for passing it before Trump reaches his
100th day in office next weekend.
Congress, returning from a recess next week, also will be
working against the clock to pass legislation to keep the
government funded past April 28 and avert a federal shutdown.
Trump's party cannot afford defections because Democrats
remain unified against the Republican quest to repeal and
replace the Affordable Care Act, Democratic former President
Barack Obama's signature domestic policy achievement, dubbed
Obamacare. Trump campaigned on a pledge to discard Obamacare.
In a stinging setback for Trump, Speaker Paul Ryan pulled
the legislation from the House floor on March 24 before allowing
it to come to a vote amid a revolt by conservatives in a faction
called the House Freedom Caucus and moderates unhappy with
concessions to the conservatives.
"The plan gets better and better and better. And it's gotten
really, really good," Trump said, without identifying what he
saw as the improvements from the previous plan he had embraced.
Republicans have called Obamacare a government overreach.
The law enabled 20 million Americans to obtain insurance, many
through an expansion of the Medicaid program for the poor.
A senior House Republican aide said it was not clear whether
the latest Republican plan can attract 216 votes in the House,
adding that without a legislative text it was not possible to do
a vote count to assess its chances.
Moderate Republican Representative Tom MacArthur is pushing
a proposal to allow states to waive some Obamacare provisions,
and his office said he has discussed it with other Republican
lawmakers, the House leadership and the White House.
No text has emerged, but an outline of his proposal said
states could seek to relax essential benefits that Obamacare
requires insurance plans to cover such as emergency room trips,
maternity and newborn care, and mental health services.
States also could request waivers to Obamacare's ban on
insurers charging sick customers higher premiums than healthy
customers. But states would have to set up "high-risk pools"
that use government funds to help pay for insurance for people
with costly medical conditions.
Representative Rodney Davis told CNN on Friday he did not
know what was in the deal, but added, "I'm not going to be for a
plan that is going to allow for pre-existing conditions to not
be covered." MacArthur and Davis are members of the centrist
House Republican Tuesday Group.
Freedom Caucus member Representative Dave Brat told CNN the
new proposal gives states more say healthcare but was the "same
fundamental bill" that collapsed last month.
The Republican plan, as written last month, would end the
Medicaid expansion, let states impose work requirements on some
Medicaid recipients, rescind a range of Obamacare taxes, get rid
of a penalty on people who refuse to obtain insurance, and ditch
Obamacare's income-based subsidies to help people buy insurance
while creating less-generous age-based tax credits.
The nonpartisan Congressional Budget Office forecast that
the earlier version of the plan would increase by 24 million the
number of Americans without medical insurance by 2026.
During a conference call on Thursday with House Democrats,
their leader, Nancy Pelosi urged them to remain united against
the Republican legislation, according to an aide who was on the
According to the aide, Pelosi said the party's message will
continue to be that the Republican plan would cause higher
healthcare costs, provide less insurance coverage and eliminate
important protections in Obamacare.
(Reporting by Susan Cornwell; Additional reporting by Richard
Cowan, Doina Chiacu and Mohammad Zargham; Editing by Will