No summer holiday for US Republicans unless they can agree on healthcare

US President Donald Trump addressing a lunch meeting with Senate Republicans to discuss healthcare at the White House in Washington, on July 19, 2017. Left to right: Senators Shelley Moore Capito,(WShow more

It is crunch time for the Republicans on health care. They must thrash out a way of rescuing an unpopular push to repeal Obamacare before they leave for their August holiday - or they won't be leaving.

President Donald  Trump has made it clear they must come up with a deal  "or nobody leaves town." So instead of winding down for the summer holiday, Republican senators are in virtual lockdown, trapped in a series of crisis meetings.

They were bussed in on a coach  on Wednesday, like schoolchildren on an excursion and then met long into the night but broke up without reaching agreement.

It marks the latest twist in Mr Trump’s erratic efforts to overhaul America’s healthcare system.

Critics say it highlights how a political novice in the White House is struggling to find a way to get his agenda through Congress. In response, Mr Trump and his allies are laying the blame on Republicans intent on sabotaging an outsider president.

The latest Senate proposal would simply repeal Obamacare – dropping a promise to replace it with a new system – and would mean as many as 32 million people would lose their coverage during the next decade, according to an analysis by the Congressional Budget Office.

Hours before their late-night meeting, Mr Trump stepped up the pressure on his senators to pass a bill before their August holiday.

"For seven years you promised the American people that you would repeal Obamacare. People are hurting. Inaction is not an option and frankly I don't think we should leave town unless we have a health insurance plan," he told the 49 senators at a White House meeting.

His intervention came a day after a Republican healthcare bill to repeal and replace Barack Obama’s Affordable Care Act sank in the Senate. With only a slim  majority of 52-48, Republicans could not afford the slew of defectors who said the plans went either too far or not far enough.

At first, Mitch McConnell, the Republican leader in the Senate, indicated he was ready to put aside healthcare, leave Obamacare to collapse under its own weight, and move on to other issues such as tax reform.

Mr Trump had other ideas. He invited  senators to lunch at the White House and, beneath the portrait of  Abraham Lincoln in the State Dining Room, he turned the issue into one of personal loyalty.

With cameras rolling, he delivered a clear threat to the man seated to his right, Dean Heller, one of the dissenters.

"Look, he wants to remain a senator, doesn't he? And I think the people of your state, which I know very well, I think they're gonna appreciate what you hopefully will do," Mr Trump said, delivering his words in jocular fashion.

“Any senator who votes against starting debate is really telling America that you're fine with Obamacare.”

A Trump-aligned super political action committee has already begun running anti-Heller TV adverts in his home state of Nevada, and Mr Trump has let it be known he is encouraging candidates to run against another healthcare dissenter.

Mr Trump’s gamble is that he can get senators to repeat last year’s repeal vote when Republicans passed a bill they knew would be doomed once it arrived at the White House for Mr Obama’s signature.

If it fails this time, he can at least say to the American public that he did his bit but was let down by disloyal senators. The vote will also give him a tally of who is with him and who is against.

After nearly two hours of lunchtime discussion, the group agreed to meet lhat night . But  that second meeting produced no breakthrough either.

Ted Cruz, senator for Texas, said afterwards: "We still have some issues that divide us.”

Among Trump supporters, there is growing anger that Congressional Republicans are failing to heed a mandate delivered in the presidential election.

“Republicans don’t really want this to be repealed and don’t really want Trump to win,” Rush Limbaugh, a hardline talk show host, told his listeners. “They never sell the plan.”

However, establishment Republicans insist the blame lies with the president whose political inexperience means threats are his only tool.

“Right now, nobody’s afraid of Trump, and that’s a real problem,” Rob Jesmer, the former executive director of the National Republican Senatorial Committee, told The New York Times.

Democrats highlighted what they said was an inevitable result of electing a president who delighted in being a Washington outsider.

Richard Durbin, a Democratic senator from Illinois, said: “He has limited experience in government and politics, he lacks a deep and experienced team, and his poll numbers are disastrous.”

The proposals have also failed to win over insurers, doctors and hospitals which lobbied against straight repeal citing the Congressional Budget Office (CBO)figures. Opinion polls also suggest a majority of Americans are in favour of Obamacare for the first time since it was introduced.

“CBO projects half the country would have no insurers in the individual market by 2020 under the new repeal bill. That's a true death spiral,” tweeted Larry Levitt, vice president at the Kaiser Family Foundation, a healthcare research group.

Charles Schumer, Democratic leader in the Senate, said: "President Trump and Republicans have repeatedly promised to lower premiums and increase coverage, yet each proposal they offer would do the opposite."