Trump demands Friday health-care vote and Ryan says 'we're proceeding'

White House: Didn't want to start a vote late at night
White House: Didn't want to start a vote late at night

President Donald Trump has demanded a Friday vote by the House on the plan to repeal and replace parts of the Affordable Care Act, putting intense pressure on lawmakers to back a bill that lacked the support to pass the chamber on Thursday.

Republican leaders failed to rally enough support to pass the GOP bill in a vote in the House, as conservative and moderate flanks found reasons to oppose the legislation and sought changes.

At a high-stakes Republican House caucus meeting Thursday night, Office of Management and Budget Director Mick Mulvaney said Trump is done negotiating details of the proposal, NBC reported. If Trump does not get a vote on the proposal, he will move on to other priorities and leave the ACA, popularly known as Obamacare in place, Mulvaney said.

House Speaker Paul Ryan — who delayed a planned press conference Thursday amid a scramble to find votes for the plan he championed — said Thursday night he will seek a vote.

"We have been promising the American people that we will repeal and replace this broken law because it's collapsing and it's failing families and tomorrow we're proceeding," Ryan said following the Republican meeting.

It is unclear if Republicans can garner the needed support to pass the plan Friday, and Rep. Mark Meadows, chairman of the hard-line conservative caucus that threatened the bill's passage, told reporters he remains a "no." Lawmakers added last-minute changes to the bill to appease both conservatives and moderates.

The postponement Thursday was a sobering setback for Republicans, who aimed to approve health-care legislation before moving to other parts of their agenda, particularly tax reform. The GOP had timed Thursday's now-aborted vote to the seventh anniversary of the passage of the ACA.

A senior GOP aide told CNBC that a House floor vote could take place from 2 to 4 p.m. ET on Friday.

Trump met with the House Freedom Caucus for two straight days, aiming to persuade the conservative group to vote to pass the plan. He also talked to the moderate Tuesday Group as more center-right lawmakers expressed concerns about the plan.

Members of the Freedom Caucus have opposed the current replacement proposal, saying it does not go far enough to repeal Obamacare. A Freedom Caucus source told CNBC earlier there is "no way" a bill will pass on Friday.

Republicans have tried to assuage concerns of conservative House members without losing too many votes from moderates, and vice versa. The current plan has shown to be unpopular in early opinion polls on it, complicating matters for lawmakers.

The White House gave the House Freedom Caucus what one lawmaker called a "final offer" Thursday in its effort to win enough votes for the legislation. After the vote delay, Meadows told reporters "We have not gotten enough of our members to get to 'yes'" but added that "progress is being made."

"I am still a 'no' at this time, I'm desperately trying to get to 'yes' … with all of the Freedom Caucus, they're really trying to get to 'yes,'" the North Carolina Republican said. He added that he expects the GOP needs "another 30 or 40 votes" to pass the bill.

Changes added to the plan include a temporary extension of a 0.9 percent Medicare tax on people making more than $200,000, a move to please moderates, according to NBC News. The revision is expected to raise $15 billion for the Patient and State Stability Funds.

Another tweak would change Essential Health Benefits from being a federal requirement to allowing states to determine which they want to include.

Moments before reports surfaced that the Thursday vote would be delayed, Trump told trucking industry executives at the White House that "today, the House is voting to replace the disaster known as Obamacare." Asked about the postponement reports shortly after, Trump shrugged, according to The Associated Press.

Less than three hours earlier, the White House said it still expected the vote to happen Thursday.

"It's going to pass. So that's it," White House press secretary Sean Spicer told reporters when asked what would happen if the bill did not pass.

Trump and Republican leaders have made health care their top legislative priority since Trump took office with a GOP congressional majority in January. While they ran on repealing Obamacare, Republicans walk a political tightrope, as most independent estimates have shown the current GOP plan will lead to more people uninsured.

"Clearly we don't have the votes yet, but clearly no one is walking away from the table. Not the conservatives, not the moderate, not the president. Certainly none of us are," GOP Rep. Kevin Brady, chairman of the House Ways and Means Committee, told CNBC on Thursday evening.

Trump has said the repeal and replacement of Obamacare must happen before action can be taken on his other plans, including a major tax reduction. Republicans needed 215 votes Thursday for passage.

"They don't have the votes to pass a bill that spikes premiums, cuts coverage, raises deductibles and guts benefits?" said Andy Slavitt, who had overseen Obamacare for the Obama administration as head of the Centers for Medicare and Medicaid Services. "I'm disappointed that they even have as many votes as they apparently do."

Some public opinion polls have also shown that voters strongly oppose the proposal in its current form.

The Freedom Caucus has leveraged its power in high-stakes negotiations before. Some members of the group pressured former House Speaker John Boehner, contributing to him stepping down in 2015. That led to Ryan's elevation as speaker.

— CNBC's Dan Mangan, John Harwood and Kayla Tausche contributed to this report