High stakes for Trump on healthcare vote

It's time for Donald Trump, the man who bills himself as the consummate dealmaker, to flex his negotiating muscle - or else.
The American Healthcare Act, which rolls back portions of the Obamacare health-insurance reforms, is scheduled for a vote in the House of Representatives on Thursday, and at the moment it's far from certain that there are the 215 votes necessary for passage.
According to the latest media reports on vote counts, there are 29 Republicans currently in the "no" column. Assuming all the Democratic lawmakers present stick together - which seems fairly certain at this point - it would only take 23 Republican defections to sink the bill.
On Tuesday morning the president was on Capitol Hill, to make his final push to rally support for the bill. He reportedly told Republican lawmakers that a loss was "not acceptable" and went with a traditional carrot-and-stick approach.
Vote yes, and Republicans could pick up as many as 10 Senate seats in the midterm elections next year. Send the legislation down to defeat, however, and their congressional majorities were in peril.
"Many of you came in on the pledge to repeal and replace Obamacare," Mr Trump said. "I honestly think many of you will lose your seats in 2018 if you don't get this done."
If that wasn't clear enough, Mr Trump pointed to Congressman Mark Meadows, leader of the recalcitrant group of libertarian-leaning conservative congressmen known as the Freedom Caucus: "I'm going to come after you, but I know I won't have to, because I know you'll vote 'yes'."
Press Secretary Sean Spicer would later say that Mr Trump meant that as a joke, but in politics a joke is often a threat delivered with a smile.
Mr Meadows, by the way, is still a solid no.

Meanwhile, House Speaker Paul Ryan, whose reputation as speaker is being put to his first big test this week, was talking up the president's prowess.
"President Trump was here to do what he does best, and that is to close the deal," he said.
The president as the "closer" has been the theme of the week. Spicer said it on Wednesday, as did Congressman Greg Walden on Monday.
"He knows how to put this together," said the House Energy and Commerce Committee chairman, who helped shepherd the repeal legislation onto the House floor. "He's got great negotiating skills, and we're coming together with it."

All of this underlines what is at stake for the president, Mr Ryan and the rest of the Republican Party leadership. In Washington, power begets power. Successfully wielding it makes you stronger, while failure reveals weakness and engenders future failure.
The White House and the speaker have put their reputations on the line, and a loss on Thursday night would force them to restart the entire healthcare repeal process. Not only that, it would delay work on the rest of their legislative agenda, including tax reform - a heavy political lift on its own - and an infrastructure bill.
The Republicans had set out an ambitious schedule for passage of the healthcare bill, with a Senate vote expected as early as next week. Any delay will probably push a final bill, if it can be achieved, well past the Easter congressional recess.
That's why Spicer said during his Wednesday afternoon press briefing that victory was Plan A and there was no Plan B.