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Trump demands Friday vote on health care plan

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UPDATE: 7:42 p.m.: President Donald Trump is demanding a vote Friday in the House on the Republican plan to repeal and replace Obamacare, White House Budget Director Mick Mulvaney said. If the bill fails, Trump is prepared to move on and leave Obamacare in place, Mulvaney said.

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President Donald Trump and House Freedom Caucus members failed to strike a deal on the GOP Obamacare replacement Thursday, endangering the prospects of passage and all but assuring any immediate vote on the measure would fail.

Hours later, House leaders canceled a planned Thursday night vote on the legislation, dubbed the American Health Care Act. There was no immediate word when a vote might be rescheduled. The House Republican Conference is planning to meet at 7 p.m. Thursday about how to proceed, with procedural votes expected later in the evening.

Negotiations between Trump and the arch-conservatives opponents of the bill reached at least a temporary impasse after Freedom Caucus members were told recent concessions from the White House and GOP leadership represented a final offer. The group rejected that, wanting more.

The setbacks triggered a series of meetings later Thursday — between Trump and the moderate Tuesday Group, and separately between the Freedom Caucus and Speaker Paul Ryan (R-Wis.).

As it stands, Trump and Ryan find themselves playing see-saw with moderates and hard-liners. Lean too much toward one faction and they lose votes from the other. So far, they’ve been unable to find a sweet spot.

Ryan can afford to lose only 22 votes on the floor. The Freedom Caucus has three dozen members, who have vowed to block the bill unless they get what they want. More than a dozen centrist Republicans have also come out against the bill, further endangering its prospects.

A senior administration official in the room for the meeting at the White House said most members left the meeting as “no’s” but suggest some flipped to “yes.” While Trump did not go around the room and ask people how they would vote, it became immediately clear GOP leaders did not appear to win over enough members to put the measure over the top.

“We’re down right now,” the official said.

Freedom Caucus chairman Mark Meadows (R-N.C.) told reporters in the Capitol Thursday afternoon that “we have not gotten enougbh of our members to get to yes at this point. … However, I would say progress is being made.” He called Trump’s engagement in the negotiations perhaps “unparalleled in the history of our country.”

A senior administration official involved in discussions with the group, however, said the “House Freedom Caucus is freeing members to vote their conscience.”

There were daunting obstacles to a deal heading into the White House meeting Thursday morning. A number of Freedom Caucus members had suggested Trump’s latest concession — repealing Obamacare’s mandate that insurance plans provide a minimum level of “essential” benefits — wasn’t enough. The group wants a complete repeal of all Affordable Care Act regulations — including popular provisions Trump promised he would maintain.

The conservatives’ target list encompasses a prohibition against discriminating against people with pre-existing conditions and a requirement that adults up to age 26 can remain on their parents’ health insurance.

“Repealing [essential health benefits], w/out making other substantial changes, would make the bill worse, not better,” tweeted Freedom Caucus member Justin Amash (R-Mich.). “It would hurt the sickest people on exchanges.”

The Freedom Caucus has been a constant thorn in the side of House GOP leadership, sinking bills its members believe were too accommodating to Democrats. The group was expected to fall in line behind Trump after he won, but it has refused to do so on the health care bill.

Now, Freedom Caucus members are threatening to trip up not John Boehner or Ryan, but a Republican commander-in-chief who remains highly popular in their districts.

Many House Republicans are furious with the Freedom Caucus, saying the group keeps moving the goal posts and that it really wants to sink the health care bill altogether.

“The president is good at negotiating, but he has to have someone who wants to get to yes,” Rep. Mike Kelly (R-Pa.), an ardent Trump supporter, told POLITICO. “I was never able to sell a car or a truck to someone who didn’t want a car or a truck. It just doesn’t work. And that’s where we are right now. I don’t think they’re really interested in getting to an ‘end.’”

He then added: “Maybe the ‘end’ is: making sure it doesn’t pass.”

Group insiders contend they haven’t changed their demands at all. They say they’ve always insisted that all Obamacare regulations be nixed.

The Freedom Caucus risks overplaying its hand if it continues to hold out support for the bill. Trump has made clear he wants to get health care passed and move on. He made clear that Wednesday’s offer was final.

If Trump loses his patience with caucus members, they could find themselves in his crosshairs.

The meeting with Trump comes not 24 hours after the group huddled with Vice President Mike Pence and Trump’s most senior advisers. In recent days, the group had been emphasizing that it needed a repeal of Obamacare’s “essential health benefits” requirement — something GOP leaders for months have said would be “fatal” to the bill in the Senate because of the chamber’s arcane budget rules.

But Trump officials asked Ryan to reassess that diagnosis, and GOP leadership agreed to add the provision.

The odds of the entire group coming on board without a commitment to axing all Affordable Care Act regulations, however, look slim.

Jake Sherman and John Bresnahan contributed to this report.

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