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Trump Faces High Stakes Fight In Push For Republican Health Care Bill

AUDIE CORNISH, HOST:

It's the eve of the Trump administration's first big legislative test - the expected House vote on the Republican plan to replace the Affordable Care Act. The bill's passage is by no means a lock, so the president, House Speaker Paul Ryan and others are working to win over reluctant House Republicans.

NPR national political correspondent Mara Liasson joins us from the White House now to talk about all this haggling. And Mara, what is President Trump doing to try to get his American Health Care Act - that's the name of the Republican plan - over the finish line?

MARA LIASSON, BYLINE: He's doing a lot. He had more members up to the White House today. You know, Donald Trump prides himself on being a great closer, and that's what the White House and Republican members are calling him. He's been boasting about all the no votes that he's managed to flip to yes. Today Sean Spicer said that he feels they're getting closer piece by piece and member by member. But when you ask people about the vote counts, it still sounds like the vote could go either way.

They don't have the votes yet. They can only afford 21 no votes among Republicans, assuming no Democrats vote for it. And when asked today what would happen if the bill failed, Donald Trump just said, quote, "we'll see what happens." It was pretty subdued for a guy who usually is predicting great success in every way, shape and form.

Now, according to NPR's congressional correspondent Sue Davis, there's been a division of labor. The White House is focusing on the House Freedom Caucus, the conservatives. Paul Ryan is focusing on the moderates. These two groups have very different problems with the bill, and it's very hard to satisfy them both at the same time.

CORNISH: And what kind of leverage does the White House have over any of these lawmakers?

LIASSON: The biggest leverage the president has really is the fear of defeat. As Sean Spicer said today, there is no plan B. Now, this is what often happens when a White House gets to crunch time on legislation. Basically there's no choice but to vote yes on this. And as Spicer said today, this is the only train leaving the station.

(SOUNDBITE OF ARCHIVED RECORDING)

SEAN SPICER: If you want to see Obamacare repealed and replaced, this is the vote. This is the time to act. This is what people have told the American people is going to happen. This vote needs to happen. If you're waiting for your chance, this is it. We need to act.

LIASSON: This is it. That's the message to Republicans. You promised you wanted to repeal Obamacare. Do you want to repeal it or not? And do you want to hand your new president a stinging defeat on his very first piece of legislation?

Now, when Donald Trump met with members yesterday, he warned them half-joking and half-threateningly that he would, quote, "come after them" if they voted no. And that's leverage, too, because Trump is known to be vindictive. He's more than willing to unleash his Twitter account against people who displease him. And while his overall approval ratings are very low, he remains very popular among Republican primary voters, so he does have a lot of political clout within his own party.

CORNISH: So those are the potential consequences for those Republican lawmakers. What are the political consequences for the White House of a defeat?

LIASSON: They would just be huge. It would be extraordinary for a president with complete control of Congress to lose on his first big legislative initiative. It would say that he couldn't keep his own members in line on a promise they've made for seven years. And more than that, it would make it much more difficult to do the next pieces of his agenda - tax reform, for instance.

Tax reform would be much more difficult politically if health care lost but also as a practical matter because the budget math for massive tax cuts is so much harder if Republicans can't pocket the tax cuts they would get from repealing Obamacare and reversing all those Obamacare tax hikes.

CORNISH: Before I let you go, Mara, I want to tackle one other issue. The Associated Press is reporting today that Trump's former campaign chairman Paul Manafort did work for a Russian billionaire a decade ago that was aimed at advancing the goals of Russian President Vladimir Putin. Did the White House have anything to say about this?

LIASSON: Yes, they said that nothing in the story implicates the president or any White House official. They emphasize that Manafort's actions happened a long time ago. President Trump was unaware of the ties when he hired Manafort to run his campaign. But Sean Spicer today was very candid when he was asked why Manafort was fired by Trump back in August.

(SOUNDBITE OF ARCHIVED RECORDING)

SPICER: There were some issues coming up with his ties to Ukraine that were becoming a distraction. And secondly, he was I think 16 points down at the time, and he was down in the 20s in women. And I think the President recognized that he need to make a change.

LIASSON: Yes, the president was trailing at the time, but those connections to the pro-Russian politicians in Ukraine are why Manafort was let go, as you just heard Spicer say, and that just shows you how the questions about the Russian connection have dogged the Trump campaign for a very long time and don't seem to be going away anytime soon.

CORNISH: That's NPR national political correspondent Mara Liasson. Mara, thank you.

LIASSON: Thank you. Transcript provided by NPR, Copyright NPR.

Mara Liasson is a national political correspondent for NPR. Her reports can be heard regularly on NPR's award-winning newsmagazine programs Morning Edition and All Things Considered. Liasson provides extensive coverage of politics and policy from Washington, DC — focusing on the White House and Congress — and also reports on political trends beyond the Beltway.