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Republicans Mixed On New Health Care Bill

STEVE INSKEEP, HOST:

Having introduced a health care plan, House Republicans have to sell it. Which means their drive to replace President Obama's Affordable Care Act has reached the very moment where Obama's bill faced trouble. Sure, they've got control of Congress. And they've got legislation now. But the opposition party scorns it. And some of the majority don't like it, either. House Speaker Paul Ryan insists this plan will pass his House of Congress.

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PAUL RYAN: This is the beginning of the legislative process. We've got a few weeks. We'll have 218 when this comes to the floor, I can guarantee you that.

INSKEEP: Two hundred eighteen votes being the bare minimum to pass. But the math will be tough in the Senate, too. NPR's Scott Detrow covers Congress. He's in our studio. Scott, good morning.

SCOTT DETROW, BYLINE: Good morning, Steve.

INSKEEP: Hey, Republicans have said unanimously for years that they want this moment. So how unanimous are they now that the moment has arrived?

DETROW: You know, not that unanimous. A lot of Republicans do like this plan. But there are high-profile dissenters. And that matters. A lot of tea party Republicans, for example, say this just keeps too much of Obamacare in place. It spends too much money. Kentucky Senator Rand Paul immediately called it Obamacare lite.

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RAND PAUL: We have to admit we are divided on replacement. We are united on repeal. But we are divided on replacement. What's the best way to get past this impasse? Let's vote on what we voted on before - a clean repeal.

DETROW: But if you did a clean repeal, you'd probably lose some more moderate Republicans who are worried about creating a vacuum, not having the replacement plan in place. And it's a tricky dance for leadership because they're not expecting any Democratic votes here.

INSKEEP: No Democratic votes at all because Republicans said once upon a time, we want to have a bipartisan plan. We want to have something that at least some Democrats can get behind.

DETROW: Yeah. I mean, Obamacare is by the name clearly the signature accomplishment of President Obama. It took Democrats decades to get there. They are not willing to be onboard with getting rid of it. Here's just one example, a tweet from Senator Chris Murphy of Connecticut. He wrote, new GOP health care bill is just a skeletal slapdash, mean-spirited version of the ACA that would slash insurance coverage and spike costs.

INSKEEP: Wow. OK.

DETROW: There you go.

INSKEEP: OK. So what is the role of the White House, President Trump in all of this?

DETROW: Well, there's really only a two-vote cushion in the Senate. That's especially important. So it's going to be a narrow margin. And you're going to see the White House playing a very aggressive role in whipping Republican votes and making sure that Republicans are on board here. That's one reason why you saw Vice President Mike Pence on Capitol Hill yesterday meeting with lawmakers and delivering a public message in support of this bill.

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VICE PRESIDENT MIKE PENCE: If you like your Obamacare, you can keep it. But the American people want change. They know we can do better.

DETROW: If you like it, you can keep it. Basically saying, if you're not on board with this plan, Obamacare stays in place. And we don't accomplish our main goal.

INSKEEP: They're essentially trying to tell Republicans, you are going to end up effectively supporting Obamacare unless you get behind our situation, our bill here.

DETROW: Right. And that's the message. And it's a little bit a mixed message because President Trump said that this is a negotiation, implying there could be changes. But later in the day yesterday, he was publicly pressuring Rand Paul, saying, I feel sure that my friend Rand Paul will come along with a new and great health care program.

INSKEEP: (Laughter) OK. So how fast is this all happening, Scott?

DETROW: Very fast. They - this bill is in committee today. They want to vote on it in the House in the next few weeks. And Senate Majority Leader Mitch McConnell has said he wants to vote on the full bill by the end of April. Remember, it took almost an entire session of Congress to get Obamacare passed in the first place. So that is a really ambitious timeline.

INSKEEP: Because they have other things that they want to do like tax cuts and so forth later on.

DETROW: And a Supreme Court nomination.

INSKEEP: There's that as well. Scott, thanks very much.

DETROW: Sure thing.

INSKEEP: That's NPR's Scott Detrow. Transcript provided by NPR, Copyright NPR.

Scott Detrow is a White House correspondent for NPR and co-hosts the NPR Politics Podcast.