Paul Ryan
Race for health care votes is on, again
02:39 - Source: CNN
Washington CNN  — 

The most conservative congressmen in the country were a major roadblock in President Donald Trump’s first push to replace Obamacare. Now, a second attempt’s fate is in the hands of a moderate Republican faction – putting to the test the power of Democratic resistance.

Progressives have protested at those Republicans’ town halls, marched through major cities and filled lawmakers’ voicemails.

If they’ve convinced those lawmakers in swing districts their passion is real – and could cost them their seats in the 2018 midterms – it could translate into a long-term Democratic victory over conservatives in setting the nation’s health care policy.

As President Donald Trump makes another push to repeal Obamacare around the 100-day mark of his tenure in office, House Speaker Paul Ryan and Republicans appear to have solved their problems with hardline conservatives but haven’t yet rounded up enough support from moderates to give Trump the 216 votes he needs.

Already, the White House’s hopes of a vote this week were dashed, with mostly moderate Republicans either opposing the measure or refusing to take a public position and Ryan saying he won’t move forward with a bill that’s at risk of being defeated on the House floor.

“What we’re seeing is that the famed negotiator can’t deliver,” House Democratic Caucus Chairman Joe Crowley of New York said at an event hosted by the liberal think tank Center for American Progress. “And the consequences are no longer limited to shareholders or investors. It’s the American people who suffer.”

While Trump and Ryan have the most on the line, the strategies and tactics that have driven the Democratic resistance to Trump – particularly on health care – in recent months also face a stress test.

A deal that got hardline conservatives on board with Obamacare repeal-and-replace legislation they’d previously opposed has left the bill’s fate solely in the hands of more moderate Republicans.

Those Republicans are the lawmakers who typically face the toughest re-election fights – and are the ones progressives have targeted most heavily through town hall protests and more.

“I spent the whole work period hearing from people pissed about pre-existing conditions,” one moderate lawmaker told CNN on Wednesday.

The progressive groups leading these protests – Indivisible chapters, and others – say they’ve seen signs of turning enough moderates to block Trump and Ryan from ever moving an Obamacare repeal.

“You have anonymous Republicans walking around the Capitol and telling reporters they’re scared to vote for Trumpcare because they’ll lose their job,” said Indivisible chief communications officer Sarah Dohl.

Pointing to moderate Republicans from Colorado and Pennsylvania who have recently announced they oppose the new legislation, Dohl said: “Just look at Mike Coffman, Pat Meehan, who were previously ‘yes’ or undecided on Trumpcare last time around and have now announced they’re opposed – these are two men who have been endlessly pressured by local groups of constituents at home. The pressure is working.”

Two moderate lawmakers who had supported an earlier version of the bill say a new one with tweaks to appease the Freedom Caucus could cost the GOP their support.

Rep. Mario Diaz-Balart, R-Florida, said he is trying to understand how changes – in the form of a Rep. Tom MacArthur amendment – makes things better, but has some concerns.

“There are a lot of red flags,” he said.

Another moderate House Republican, Brian Mast of Florida, told CNN he’s undecided on the latest health care tweak, saying he still needed to read it. He was a “yes” on the last version of the bill.

The MacArthur amendment gives states broader ability to opt out of Obamacare regulations and roll back protections for individuals with pre-existing conditions.

Rep. Charlie Dent, a moderate Republican from Pennsylvania, called it “an exercise in blame shifting.”

To be sure, the left isn’t casting a potential vote on health care as a do-or-die moment – saying they’ll have an opportunity to force moderate Republicans to pay a price in the 2018 midterms if they do repeal Obamacare and replace it with a law that removes cost protections for those with pre-existing conditions, among other changes.

“You will see the impact of the resistance in one of two ways: either this bill will fail, or voters will send many of the Republicans who voted for this bill packing in 2018,” said Anna Galland, the executive director of

“We hope it’s the first,” Galland said, “but the second is possible too.”

CNN’s Lauren Fox and Deirdre Walsh contributed to this report.