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President Trump threw a curveball at Capitol Hill this morning where negotiations over health care were already tense. He tweeted that Republicans should consider repealing the Affordable Care Act first and figuring out a replacement for it later. Congress is still at work on a bill that does both. What's unifying most Republicans right now is the view that doing nothing on health care is their worst option of all. NPR congressional correspondent Susan Davis has more.
SUSAN DAVIS, BYLINE: No one on Capitol Hill knows exactly how Congress is going to get a bill to President Trump, not even House Speaker Paul Ryan. But like most Republicans, he believes they will because of this.
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PAUL RYAN: We have a promise to keep, and the promise we made is we would repeal and replace this health care law.
DAVIS: That promise has been the single unifying campaign pledge of the Republican Party for the past four elections, which is why Texas Congressman Bill Flores says failing to pass a health care bill is the most politically devastating option on the table.
BILL FLORES: We told the American people that we were going to repeal and replace Obamacare. And if we fail on that, A, it makes the rest of our agenda hard. And B, I just think the American people are going to be terribly disappointed in us.
DAVIS: Flores's concern is shared by most Republicans - that failing on health care would make moving the party's other top legislative priorities nearly impossible.
FLORES: If we can't work together and get this done, it doesn't portend well for working together to get tax reform done - which is not easy, either - or to get infrastructure done.
DAVIS: Lawmakers are well aware of the risks they face with this bill. Nevada Republican Mark Amodei voted for the bill even though it's not popular back home. He explains the choice Congress is facing this way.
MARK AMODEI: There's a fire burning on the west side of town, and the wind's blowing out of the West. And it's time to see who's a firefighter and who's going to leave town and hope that their house doesn't burn. And it's like, I'd rather burn up fighting it.
DAVIS: But a few Republicans do think it's better to leave town without fighting that fire. In other words, passing a new law with Republican votes alone is a mistake, says Pennsylvania's Charlie Dent.
CHARLIE DENT: The problem that the Democrats had with the ACA or Obamacare is that they muscled that law through on a partisan basis, and we have been fighting about Obamacare ever since. As Republicans, we should not make that same mistake.
DAVIS: Dent is a moderate who is 1 of just 20 Republicans who voted against the House bill. He says he won't vote for the Senate bill either if it comes back to the House. He's one Republican who thinks his colleagues are miscalculating the risks of defeat.
DENT: I am not of the opinion that if we fail to pass this legislation that somehow that will bring about the end of our party.
DAVIS: Conservative activists like David Bozell disagree. He says the only way for Republicans to succeed is to keep the party's base united. Here he is on a conference call with Grassroots Groups.
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DAVID BOZELL: The one constant between President Obama's victories and President Trump's victory is that to win, each party needs its base fired up and motivated to turn out.
DAVIS: Bozell says failing on health care would deflate that Republican base and risk the party's control of Congress in next year's midterm elections. Adding to the pressures on Congress are activists like Ken Cuccinelli, who say the Republican health care bill under negotiation doesn't make good on their original campaign promise.
KEN CUCCINELLI: The Republican base, including conservatives, libertarians, tea party people, traditional Republicans, all want repeal. They want what was promised.
DAVIS: Conservatives don't like a bill that doesn't go far enough. Moderates don't like it for going too far. And party leaders are in the middle, trying to find a balance between the two. New Jersey Republican Tom MacArthur helped craft the compromise that got the bill through the House. He believes the bill is good policy and the public will ultimately support it.
TOM MACARTHUR: I think it would be healthy to get a bill passed and then actually educate the American people about what that specific bill actually does over time because right now, there's a lot of fearmongering going on.
DAVIS: But in order to find out, Republicans have to keep their promise to enact a health care law. Susan Davis, NPR News, Washington. Transcript provided by NPR, Copyright NPR.
