Trump warns House GOP: The midterms will be a bloodbath if this health-care bill doesn't pass

Which bloodbath is bigger, though? The one they’ll face if they can’t pass anything, or the one they’ll face if they pass the House bill and analysts are right that millions of people will lose their insurance?

You can understand in light of the “bloodbath” comment why the White House might be willing to wheel and deal on the bill, though. In the near term, as a matter of politics, passing something is more important than passing something good, especially for a president who swept into Washington as a can-do strongman who’d get government moving again. Trump, more so than any of his recent predecessors, needs to show his base that Congress will obey when he tells them that failure is not an option.

Trump vowed to throw his full support behind the effort to repeal and replace the Affordable Care Act during a meeting with House GOP leadership, saying he is “proud” to support a GOP-authored plan to replace Obamacare and told members behind closed doors that he would support it “100%,” according to sources in the room.

But he warned lawmakers of the high-stakes nature of the effort, citing a potential electoral “bloodbath,” a member present said…

While Trump said he was committed to the bill, he did indicate he was open to making changes. Sources in the room, however, said that the changes would have to win broad support and be passed through the amendment process, making it difficult to amend the contours of the legislation in any meaningful way.

Said Raul Labrador after the Freedom Caucus’s meeting with Trump, “What I have heard from the president, from the vice president, from the director tonight, is that they’re open to negotiation. So I find it a little bit intriguing when I hear our leadership say that they have a bill, a set bill, and the president is fully supportive of the bill. I think he is fully supportive of the process.” Right. Trump’s not an ideologue like Ryan or Tom Price; he’s probably willing to go along with whatever can pass. He’s being a good soldier for his party right now by backing the House bill enthusiastically because it’s the only proposal on the table and he knows that without him demanding party unity there’s zero chance of getting it through Congress. But if the bill looks like it’ll tank and someone offers a possibly viable Plan B? Sure, why wouldn’t he go for that?

Question: Given that he’s not really wedded to the House bill, how many stories like this will he need to read before he starts looking around for alternatives himself?

Millions of people who get private health coverage through the Affordable Care Act would be at risk of losing it under the replacement legislation proposed by House Republicans, analysts said Tuesday, with Americans in their 50s and 60s especially likely to find coverage unaffordable.

Starting in 2020, the plan would do away with the current system of providing premium subsidies based on people’s income and the cost of insurance where they live. Instead, it would provide tax credits of $2,000 to $4,000 per year based on their age.

But the credits would not cover nearly as much of the cost of premiums as the current subsidies do, at least for the type of comprehensive coverage that the Affordable Care Act requires, analysts said. For many people, that could mean the difference between keeping coverage under the new system and having to give it up.

Older Americans are a core part of the GOP base and famously turn out at high rates for elections. Pissing off a few million 60-year-olds whose subsidies have suddenly dropped from $10,000 a year to $4,000 is … perilous, let us say. S&P Global Ratings estimated yesterday that somewhere between six and 10 million people could lose coverage if the bill passes, and Republican defenders like Price and Mick Mulvaney pointedly aren’t making any promises about maintaining the number of people currently insured, presenting the bill as a victory for affordability more so than coverage. The suspense for Trump and Ryan right now has to do with the CBO score, which hasn’t been issued yet. If it ends up looking gruesome, Republicans will publicly scoff and note that CBO’s been wrong many times before in its projections, starting with ObamaCare, but it’ll be a political fact of life they’ll have to live with. How long will Republican unity last if CBO predicts a deficit spike due to Republican tax-cutting and, say, four million fewer people with insurance?

However bad it gets, Trump might have the political cachet to scare House Republicans into line. They’re all up in two years and most of them come from districts won by the president. The more loudly he supports the bill — e.g., he’s meeting with conservative groups tonight to make the pitch to them directly — the more nervous they’ll be about voting no:

That seems plausible. The Freedom Caucus’s bark is usually worse than its bite. The trick is finding 50 votes in the Senate when Rand Paul and Mike Lee have already come out strong against the House bill. Probably McConnell figures that the sheer weight of the pressure on Senate Republicans to rubber-stamp the bill if it passes the House will force everyone into line. It’s easy for Paul to talk tough about the bill being DOA when the House hasn’t voted yet and the Freedom Caucus is barking about it not being conservative enough. But let’s see what happens if Ryan gets it through and McConnell lines up 49 other Senate Republicans to bring it to Trump’s desk. Is Paul going to kill singlehandedly what may be the party’s best chance of replacing O-Care? Trump won Kentucky, his home state, by 30 points. Paul’s more ideological than most Republicans in Congress but even he’s not immune to the political logic, such as it is, that a bad bill is better than no bill. Until, that is, voters have to start living with it.

Here’s Kellyanne Conway this morning insisting that Trump is “all in” on the House bill (at around 4:30 of the clip). Certainly seems that way. For the moment.

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