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Risky House healthcare vote to test Trump's negotiating skills

By Susan Cornwell and Richard Cowan

By Susan Cornwell and Richard Cowan

WASHINGTON (Reuters) - U.S. President Donald Trump on Friday faces the first concrete test of how well the deal-making skills he honed in his real estate business will translate on Capitol Hill in a high-stakes vote on new Republican health care legislation.

The House of Representatives is set to vote on a bill to replace Obamacare late on Friday afternoon. The bill, backed by Trump, has proved a tough sell to both conservative and moderate factions in his own Republican party.

Democrats in the House are dead set against the bill, and it was unclear late on Thursday night whether Republican leaders had enough support from their own members to pass it, despite a series of last-minute sweeteners intended to broaden its appeal.

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It is the first foray into legislation for Trump, a New York Republican businessman and reality television star known for his book, "The Art of the Deal." He had not held public office before winning the Nov. 8 presidential election.

The vote on the American Health Care Act had originally been set for Thursday. In an embarrassing setback, it was postponed because of the tepid support.

By Thursday evening, Trump signaled he was done negotiating and demanded lawmakers support the bill, or face the consequences.

"The message is ... it's done tomorrow, or Obamacare stays," said Representative Chris Collins of New York, a Trump ally.

Replacing the signature health care plan of former Democratic President Barack Obama was a key campaign pledge for Trump and Republicans, who viewed Obama's 2010 Affordable Care Act as overly intrusive and expensive.

Obamacare aimed to boost the number of Americans with health insurance through mandates on individuals and employers, and income-based subsidies. Some 20 million Americans gained insurance coverage through the law.

The House replacement plan would rescind taxes created by Obamacare, repeal a penalty against people who do not buy coverage, slash funding for the Medicaid program for the poor and disabled, and modify tax subsidies that help individuals buy plans.

Conservatives felt the bill did not go far enough to repeal Obamacare and moderates felt the plan could hurt their constituents.

House leaders agreed to four pages of last-minute amendments, including allowing states to choose which "essential benefits" are required in insurance plans, keeping a 0.9 percent surcharge on Medicare for high-income Americans for six years, and giving states more money for maternal health and mental health.

It was unclear whether that was enough to win over skeptics.

During the past few weeks, Trump has remarked that healthcare was more complicated than he expected and has said he looks forward to moving on to other priorities like tax cuts and trade deals.

But a defeat in the vote will cast doubt on his ability to work with Congress to deliver on tax reform and infrastructure investments. Uncertainty over the healthcare bill rattled financial markets this week as investors worried that failure to push it through could postpone other business-friendly Trump priorities.

Even if the House passes the plan on Friday, the legislation faces an uphill battle in the Republican-controlled Senate.

The House and Senate had hoped to deliver a new healthcare bill to Trump by April 8, when Congress is scheduled to begin a two-week spring break.

Graphic on Obamacare and Republican healthcare bill (http://tmsnrt.rs/2n0ZMKf)

Graphic on shifting positions in the U.S. Senate on Republican healthcare bill (http://tmsnrt.rs/2mUE4Xf)

Graphic on poll on Americans' views of the Republican healthcare bill ( http://tmsnrt.rs/2n7f3e4)

(Additional reporting by David Morgan, David Lawder, and Amanda Becker; Writing by Roberta Rampton; Editing by Simon Cameron-Moore)

 
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