Story highlights

House Republicans pull health care bill after all-day drama searching for votes

Trump has said he wants Republicans to pass the bill or live with Obamacare remaining law

Washington CNN  — 

Seven years of Republican efforts to eradicate President Barack Obama’s proudest domestic achievement ended Friday before a single vote was cast.

House Speaker Paul Ryan sensationally pulled his Obamacare repeal bill from the floor Friday afternoon, a day after President Donald Trump had threatened to walk away from health care reform if he didn’t get a vote.

“We were very close,” Trump said in the Oval Office after the bill was pulled. “It was a very, very tight margin.”

The decision to delay the vote marks an acute embarrassment for the President, who had gambled big by presenting holdout House conservatives with a take-it-or-leave it ultimatum Thursday night and put his own credibility on the line.

But Trump repeatedly pointed the finger directly at Democrats, who all opposed the measure, rather than at his own party, which holds a significant majority in the House.

“We had no Democratic support,” he said. “I’ve been saying for the last year and a half that the best thing we could do, politically speaking, is let Obamacare explode. It’s exploding right now.”

Trump reiterated the point in a tweet Saturday morning, saying, “Obamacare will explode and we will all get together and piece together a great health care plan for THE PEOPLE. Do not worry!”

The failure of the GOP plan also puts Ryan in a much weakened political position, after being defied by his own conference, which seems just as unsuited to governing in the Trump era as it was when it was effectively a protest coalition under Obama.

RELATED: Paul Ryan accepts it’s over: Obamacare is ‘law of the land’

It became clear during a day of intense political intrigue that despite fierce arm-twisting by Trump, Ryan and other leaders that the votes simply were not there to pass the bill and the leadership and the White House were headed for a lopsided defeat.

They were unable to narrow the schism between Freedom Caucus conservatives, who believe the bill keeps too much of Obamacare intact, and moderates who worry they will pay an electoral price if millions of Americans lose health insurance.

The House meltdown on Obamacare repeal has perilous implications for the American health care system, with Republicans apparently unable to repeal the law but also unwilling to fix the deficiencies that the White House says will collapse the law.

“We came up short,” Ryan told reporters. “We are going to be living with Obamacare for the foreseeable future.”

Democrats were gleeful after the failure to even hold a vote.

“In my life, I have never seen an administration as incompetent as the one occupying the White House today,” said Senate Minority Leader Chuck Schumer, the New York Democrat who spars often with Trump. “Today we’ve learned they can’t count votes and they can’t close a deal. So much for the art of the deal.”

RELATED: Dems gleeful after Obamacare victory

What happens for Trump and Ryan?

Politically, Friday’s momentous events will race like wildfire through the Republican Party’s conservative, establishment base, which has been told repeatedly by candidates that the first order of business with the GOP President in the White House would be to repeal of the Affordable Care Act.

Ryan told fellow Republicans they are “moving on” from health care, Reps. Andy Barr, R-Kentucky, and Bill Flores, R-Texas, told CNN. Trump said tax reform would be next.

Trump, the businessman who touted his ability to get things done and promised to transcend Washington politics, said he’s learned from the experience

“This was an interesting period of time. We all learned a lot,” he said in the Oval Office. “We learned a lot about loyalty and we learned a lot about the vote getting process. And we learned about very arcane rules in both the Senate and the House.

“Certainly for me it was a very interesting experience, but for me, it’ll be an experience that leads to an even better health care plan,” he added.

The White House maintained after the scrapped vote that it is confident in Ryan.

“I like Speaker Ryan. He worked very hard,” Trump said.

White House press secretary Sean Spicer said before the vote Trump has “left everything on the field when it comes to this bill.”

But Republicans had few firm commitments from conservatives and watched a continued exodus of moderates. This was exactly what House leadership was worried would happen when they changed the bill, the source said.

What’s inside the Republican health care bill?

But tax reform will be no simpler.

Trump acknowledged there are many different groups in the GOP, meaning things aren’t as simple as having one party control both the White House, House and Senate.

“Lots of different groups. Lots of factions and there’s been a long history of liking and disliking within the Republican Party long before I got here,” he said.

Freedom Caucus held out

Most prominent of those factions, the Freedom Caucus, held out until the end, saying the bill didn’t go enough to repeal Obamacare.

Freedom Caucus Chairman Mark Meadows, a North Carolina Republican, said he still wants to work to repeal Obamacare.

“I promised the people of North Carolina’s 11th District that I would fight for a full repeal of the Affordable Care Act and a replacement with a market-driven approach that brings down costs and provides more choices for the American people,” Meadows said in a statement.

Vice President Mike Pence met Friday afternoon with members of the Freedom Caucus at the Capitol Hill Club, a source familiar with the meeting said.

There are clear signs of frustration in the White House at the Freedom Caucus, which has won a series of concession but is still holding out against the bill.

Essential health benefits and why they matter

“We’ve emboldened them,” one White House aide said.

Rep. Leonard Lance, R-New Jersey, said that without a doubt, the decision to concede the repeal of essential health benefits to the Freedom Caucus definitely moved some of his colleagues to “no.”

“I suspect some became a no because of that,” Lance said. “That certainly didn’t help.”

What was in the bill

The GOP health care bill would eliminate many of the taxes and eradicate the individual mandate imposed by Obamacare, officially known as the Affordable Care Act. Instead of the Obamacare subsidies that are tied to income and premiums, the GOP plan provides Americans with refundable tax credits based mainly on age to purchase health insurance.

The bill also significantly curtails federal support for Medicaid and allows states to require able-bodied adults to work. After 2020, states that expanded Medicaid would no longer receive enhanced federal funding to cover low-income adults like they did under Obamacare, and states that haven’t expanded would be immediately barred from doing so.

However, the GOP bill doesn’t touch some of the most popular pieces of Obamacare, including letting children stay on their parents’ insurance plans until the age of 26 and including protections for people with pre-existing conditions. But it would end the requirement that insurers offer comprehensive policies that cover maternity, drugs, mental health and substance abuse.

CNN’s Jeremy Diamond, Jeff Zeleny and Tami Luhby contributed to this story.