Trump, Koch brothers at odds over 'Trumpcare' Obama replacement vote

WASHINGTON, March 21 (Reuters) - Republicans considering whether or not to back U.S. President Donald Trump's healthcare reforms in a crucial House of Representatives vote this week face a painful choice.

If they vote against, they could face the wrath of a vengeful and combative president. If they vote for it, they risk retribution from the billionaire brothers Charles and David Koch and other powerful right-wing players whose money can be pivotal in re-election races.

As Trump faces the most formidable, high-stakes negotiation of his presidency, the fierce battle in the U.S. Congress over his plan to replace Obamacare is a test of whether Republicans will trust him with their political futures at the risk of alienating deep-pocketed conservative advocacy groups.

As Trump and leaders in the House round up support for the bill ahead of a planned Thursday vote, some groups are threatening to retaliate against those who do support it, including the Club for Growth, the Heritage Foundation's political arm, and Americans for Prosperity, which is part of the expansive political pressure network established by the Koch brothers.

RELATED: A look at the battle over the American Health Care Act

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WASHINGTON, DC - MAY 04: Republican House members join U.S. President Donald Trump on stage as he speaks during a Rose Garden event May 4, 2017 at the White House in Washington, DC. The House has passed the American Health Care Act that will replace the Obama era� Affordable Healthcare Act with a vote of 217-213. (Photo by Alex Wong/Getty Images)
WASHINGTON, DC - MAY 04: U.S. Sen. Bernie Sanders (I-VT) speaks during a Stop 'Trumpcare' rally May 4, 2017 in front of the Capitol in Washington, DC. Congressional Democrats joined activists for a rally to urge not to replace Obamacare, also known as the Affordable Care Act. (Photo by Alex Wong/Getty Images)
WASHINGTON, DC - MAY 04: U.S. Senate Minority Leader Sen. Charles Schumer (D-NY) (R) greets House Minority Leader Rep. Nancy Pelosi (D-CA) (L) during a Stop 'Trumpcare' rally May 4, 2017 in front of the Capitol in Washington, DC. Congressional Democrats joined activists for a rally to urge not to replace Obamacare, also known as the Affordable Care Act. (Photo by Alex Wong/Getty Images)
WASHINGTON, DC - MAY 04: U.S. President Donald Trump shares a moment with Speaker of the House Rep. Paul Ryan (R-WI) during a Rose Garden event May 4, 2017 at the White House in Washington, DC. The House has passed the American Health Care Act that will replace the Obama era� Affordable Healthcare Act with a vote of 217-213. (Photo by Alex Wong/Getty Images)
WASHINGTON, DC - MAY 04: U.S. House Minority Leader Rep. Nancy Pelosi (D-CA) (L) gestures as Sen. Patty Murray (D-WA) and Sen. Bernie Sanders (I-VT) wait for their turns to speak during a Stop 'Trumpcare' rally May 4, 2017 in front of the Capitol in Washington, DC. Congressional Democrats joined activists for a rally to urge not to replace Obamacare, also known as the Affordable Care Act. (Photo by Alex Wong/Getty Images)
UNITED STATES - MAY 4: Charlie Wood, 4, of Charlottesville, Va., plays with bubbles during rally on the East Front lawn of the Capitol to oppose the House Republicans' bill to repeal and replace the Affordable Care Act on May 4, 2017. She was born 3 1/2 months earlier and her mother Rebecca, at left, holding a picture of Charlie in the hospital, fears changes to the ACA will negatively effect her care. (Photo By Tom Williams/CQ Roll Call)
Health and Human Services Secretary Tom Price speaks in the Rose Garden of the White House following the House of Representative vote on the health care bill on May 4, 2017 in Washington, DC. Following weeks of in-party feuding and mounting pressure from the White House, lawmakers voted 217 to 213 to pass a bill dismantling much of Barack Obama's Affordable Care Act and allowing US states to opt out of many of the law's key health benefit guarantees / AFP PHOTO / Mandel NGAN (Photo credit should read MANDEL NGAN/AFP/Getty Images)
Ivanka Trump and Jared Kushner listen to US President Donald Trump speak in the Rose Garden of the White House following the House of Representative vote on the health care bill on May 4, 2017 in Washington, D Following weeks of in-party feuding and mounting pressure from the White House, lawmakers voted 217 to 213 to pass a bill dismantling much of Barack Obama's Affordable Care Act and allowing US states to opt out of many of the law's key health benefit guarantees / AFP PHOTO / Mandel NGAN (Photo credit should read MANDEL NGAN/AFP/Getty Images)
UNITED STATES - MARCH 9: Speaker of the House Paul Ryan, R-Wis., conducts a presentation in the House studio of the American Health Care Act, the GOP's plan to repeal and replace the Affordable Care Act, March 9, 2017. (Photo By Tom Williams/CQ Roll Call)
WASHINGTON, DC - MARCH 07: U.S. Secretary of Health and Human Services Tom Price compares a copy of the Affordable Care Act (R) and a copy of the new House Republican health care bill (L) during the White House daily press briefing March 7, 2017 at the White House in Washington, DC. Secretary Price answered questions on the new healthcare bill during the briefing. (Photo by Alex Wong/Getty Images)
U.S. Speaker of the House Paul Ryan speaks to the media about the American Health Care Act at the Capitol in Washington, D.C., U.S. March 15, 2017. REUTERS/Aaron P. Bernstein
WASHINGTON, DC - MARCH 13: U.S. Health and Human Services Secretary Tom Price (L) and Office of Management and Budget Director Mick Mulvaney talk to reporters following the release of the Congressional Budget Office report on the proposed American Health Care Act outside the White House West Wing March 13, 2017 in Washington, DC. Price said 'We disagree strenuously' with the findings of the CBO report about the Republican's attempt to repeal and replace the Affordable Care Act, or Obamacare. (Photo by Chip Somodevilla/Getty Images)
Speaker of the House Paul Ryan speaks at a news conference about Congressional efforts to repeal and replace Obamacare, on Capitol Hill in Washington, U.S. March 9, 2017. REUTERS/Aaron P. Bernstein
WASHINGTON, DC - MARCH 10: U.S. Vice President Mike Pence (4th L) delivers remarks at the beginning of a meeting with representatives of conservative political organizations to discuss the American Health Care Act in the Indian Treaty Room in the Eisenhower Executive Office Building March 10, 2017 in Washington, DC. Pence and Health and Human Services Secretary Tom Price led the meeting that included representatives from the Cato Institute, Tea Party Patriots, the American Conservative Union, Freedom Works, the American Legislative Exchange Council and other conservative groups. (Photo by Chip Somodevilla/Getty Images)
U.S. Speaker of the House Paul Ryan speaks to the media about the American Health Care Act at the Capitol in Washington, D.C., U.S. March 15, 2017. REUTERS/Aaron P. Bernstein
WASHINGTON, DC - MARCH 10: (L-R) U.S. Vice President Mike Pence and President Donald Trump greet House of Representatives committee leaders (L-R) House Budget Committee Chairwoman Diane Black (R-TN), Energy and Commerce Committee Chairman Greg Walden (R-WA) and Education and Workforce Committee Chairwoman Virginia Foxx (R-NC) before a meeting to discuss the American Health Care Act in the Roosevelt Room at the White House March 10, 2017 in Washington, DC. The proposed legislation is the Republican attempt to repeal and replace Obamacare. (Photo by Chip Somodevilla/Getty Images)
U.S. Speaker of the House Paul Ryan speaks to the media about the American Health Care Act at the Capitol in Washington, D.C., U.S. March 15, 2017. REUTERS/Aaron P. Bernstein
U.S. Health and Human Services Secretary Tom Price speaks about efforts to repeal and replace Obamacare and the advancement of the American Health Care Act on Capitol Hill in Washington, U.S., March 17, 2017. REUTERS/Joshua Roberts
A copy of Obamacare repeal and replace recommendations (L) produced by Republicans in the U.S. House of Representatives sit next to a copy of the Affordable Care Act known as Obamacare as U.S. Health and Human Services Secretary Tom Price addresses the daily press briefing at the White House in Washington, U.S. March 7, 2017. REUTERS/Carlos Barria
(L-R) U.S. House Speaker Paul Ryan, U.S. House Majority Leader Kevin McCarthy, and U.S. Representative Greg Walden hold a news conference on the American Health Care Act on Capitol Hill in Washington, U.S. March 7, 2017. REUTERS/Eric Thayer
UNITED STATES - MARCH 14: House Minority Leader Nancy Pelosi, D-Calif., and Senate Minority Leader Charles Schumer, D-N.Y., attend a news conference in the Capitol Visitor Center to voice opposition to House Republican's health care plan, the American Health Care Act, March 14, 2017. The event featured testimony from patients and doctors who benefit from the Affordable Care Act. (Photo By Tom Williams/CQ Roll Call)
UNITED STATES - MARCH 14: From left, Dr. Alice T. Chen, Senate Minority Leader Charles Schumer, D-N.Y., Sen. Maggie Hassn, D-N.H., and House Minority Leader Nancy Pelosi, D-Calif., attend a news conference in the Capitol Visitor Center to voice opposition to House Republican's health care plan, the American Health Care Act, March 14, 2017. The event featured testimony from patients and doctors who benefit from the Affordable Care Act. (Photo By Tom Williams/CQ Roll Call)
Speaker of the House Paul Ryan speaks at a news conference about Congressional efforts to repeal and replace Obamacare, on Capitol Hill in Washington, U.S. March 9, 2017. REUTERS/Aaron P. Bernstein
WASHINGTON, DC - MARCH 08: House Energy and Commerce Committee staff members work during a markup hearing on the proposed American Health Care Act, the Republican attempt to repeal and replace Obamacare, in the Rayburn House Office Building on Capitol Hill March 8, 2017 in Washington, DC. House Republicans were rushing the legislation through the powerful Energy and Commerce, and Ways and Means committees, aiming for a full House vote next week. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - MARCH 07: House Energy and Commerce Chairman Greg Walden (R-OR) (R) and House Ways and Means Chairman Kevin Brady (R-TX) (L) arrive for a news conference on the newly announced American Health Care Act at the U.S. Capitol March 7, 2017 in Washington, DC. House Republicans yesterday released details on their plan to replace the Affordable Care Act, or Obamacare, with a more conservative agenda that includes individual tax credits and grants for states replacing federal insurance subsidies. (Photo by Win McNamee/Getty Images)
White House Press Secretary Sean Spicer (L) looks on as US Secretary of Health and Human Service Tom Price (R) points to a print-out of the Affordable Care Act (ACA) and a copy of the new plan introduced to repeal and replace the ACA during the daily briefing at the White House in Washington, DC on March 7, 2017. / AFP PHOTO / JIM WATSON (Photo credit should read JIM WATSON/AFP/Getty Images)
WASHINGTON, DC - MARCH 07: House Ways and Means Chairman Kevin Brady (R-TX) (L) and House Energy and Commerce Chairman Greg Walden (R-OR) (R) answer questions during a news conference on the newly announced American Health Care Act at the U.S. Capitol March 7, 2017 in Washington, DC. House Republicans yesterday released details on their plan to replace the Affordable Care Act, or Obamacare, with a more conservative agenda that includes individual tax credits and grants for states replacing federal insurance subsidies. (Photo by Win McNamee/Getty Images)
UNITED STATES - MAY 4: Protesters yell 'shame'' to members of Congress on the East Front of the Capitol after the House passed the Republicans' bill to repeal and replace the Affordable Care Act on May 4, 2017. The protesters support the ACA. (Photo By Tom Williams/CQ Roll Call)
WASHINGTON, DC - MAY 04: U.S. Sen. Bernie Sanders (I-VT) speaks during a Stop 'Trumpcare' rally May 4, 2017 in front of the Capitol in Washington, DC. Congressional Democrats joined activists for a rally to urge not to replace Obamacare, also known as the Affordable Care Act. (Photo by Alex Wong/Getty Images)
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All three groups are "keying" the vote, which means it will be a factor in determining whether the groups deem a lawmaker to be sufficiently conservative. That opens up the possibility that some Republicans who vote in favor of the bill could face a primary challenge in next year's congressional elections and may not be able to count on help from the Kochs and others.

Trump himself warned House Republicans in a meeting on Tuesday that their seats will be at risk next year if they do not support his healthcare bill, which would modify but not eliminate Obamacare, formally known as the Affordable Care Act, Democratic former President Barack Obama's signature healthcare legislation passed in 2010.

"He warned us that there are consequences if we don't come together for us as a party and also for individuals," Representative Richard Hudson of North Carolina said after the meeting. "He wasn't threatening in any way. He was just giving us a pretty clear warning."

Trump also told Representative Mark Meadows of North Carolina, an outspoken critic of the bill, that he was "coming after" him, according to people in the meeting. Meadows later said the president was joking.

'OUTSIDER' JOINS ESTABLISHMENT

Some Conservatives believe the bill does not go far enough in dismantling Obamacare and have not been satisfied by the White House's attempts to mollify them. NBC News reported on Tuesday that 26 House Republicans oppose the bill, which would leave House Speaker Paul Ryan short of the 216 votes he needs. No Democrat is expected to support the bill.

The conflict has created an odd dynamic: Trump, who ran as an "outsider" candidate siding with the Republican political establishment against the hard-line conservatives who were some of his most ardent supporters.

SEE ALSO: President Trump to Republicans: Vote for Obamacare repeal or lose your seat

At the same time, Trump has never been a favorite of libertarian conservatives such as the Kochs, or of groups such as the Club for Growth, because, among other things, he has never taken a strong stand on reining in federal spending. They opposed him during the Republican presidential campaign.

For them, the healthcare vote is a test of their continued relevance in a party seized by Trump.

The Koch network spent an estimated $250 million on last year's election. The Koch-run Americans for Prosperity, which has chapters in more than 30 states and boasts that it can deploy 3.2 million citizen activists, spent almost $14 million on the 2016 elections, according to federal records. Freedom Partners, another Koch entity which largely targeted Democrats with attack ads, spent $30 million.

Tim Phillips, president of Americans for Prosperity, would not say directly that Republicans who support the bill will face consequences next year, but noted, "Members of Congress know how serious we take a vote like this."

James Davis, a spokesman for Freedom Partners, said "network organizations will stand with principled lawmakers who will oppose the House healthcare proposal."

Davis said the Koch network would spend between $300 million and $400 million ahead of the 2018 elections.

KOCH INFLUENCE

Last year, Americans for Prosperity and the Club for Growth targeted an incumbent House Republican, then-Representative Renee Ellmers of North Carolina, for being too close with House leadership and not holding the line on government spending. Ellmers lost in a primary fight.

House Republicans have been nervous about primary challenges since 2014 when Eric Cantor, then the majority leader, lost to a little-known conservative named David Brat.

RELATED: 2016 Koch event attracts leading Republicans

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2016 Koch event -- Rubio, Paul, Cruz, Walker
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2016 Koch event -- Rubio, Paul, Cruz, Walker
MIAMI, FL - DECEMBER 18: Sen. Marco Rubio (R-FL) speaks to the media as he is joined by other congressional people as they address the decision by President Barack Obama to change the United States Cuba policy on December 18, 2014 in Miami, Florida. Mr. Rubio was joined by Rep. Ileana Ros-Lehtinen (R-FL) and Rep Mario Diaz-Balart (R-FL) as they held the press conference to denounce the changes to U.S.-Cuba policy by the Obama administration. (Photo by Joe Raedle/Getty Images)
DES MOINES, IA - JANUARY 24: U.S. Sen. Ted Cruz (R-TX) speaks to guests at the Iowa Freedom Summit on January 24, 2015 in Des Moines, Iowa. The summit is hosting a group of potential 2016 Republican presidential candidates to discuss core conservative principles ahead of the January 2016 Iowa Caucuses. (Photo by Scott Olson/Getty Images)
Senator Ted Cruz, a Republican from Texas, right, is greeted by Representative Al Green, a Democrat from Texas, center, before Barack Obama delivers the State of the Union address to a joint session of Congress at the Capitol in Washington, D.C., U.S., on Tuesday, Jan. 20, 2015. Obama declared the U.S. economy healed and said the nation now must begin work to close the gap between the well-off and the wanting. Photographer: Pete Marovich/Bloomberg via Getty Images
MYRTLE BEACH, SC - JANUARY 18: Senator Ted Cruz (R-TX) greets supporters at the South Carolina Tea Party Coalition convention on January 18, 2015 in Myrtle Beach, South Carolina. A variety of conservative presidential hopefuls spoke at the gathering on the second day of a three day event. (Photo by Richard Ellis/Getty Images)
MYRTLE BEACH, SC - JANUARY 18: Senator Ted Cruz (R-TX) receives a standing ovation during his speech to the South Carolina Tea Party Coalition convention on January 18, 2015 in Myrtle Beach, South Carolina. A variety of conservative presidential hopefuls spoke at the gathering on the second day of a three day event. (Photo by Richard Ellis/Getty Images)
DES MOINES, IA - JANUARY 24: Wisconsin Gov. Scott Walker speaks to guests at the Iowa Freedom Summit on January 24, 2015 in Des Moines, Iowa. The summit is hosting a group of potential 2016 Republican presidential candidates to discuss core conservative principles ahead of the January 2016 Iowa Caucuses. (Photo by Scott Olson/Getty Images)
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Phillips said his organization last year was instrumental in getting Republican incumbents Senators Rob Portman of Ohio and Pat Toomey of Pennsylvania re-elected. The two leading Koch groups sat out then-Senator Kelly Ayotte's tight race in New Hampshire. Ayotte lost by 0.1 percent of the vote.

"Groups such as the Kochs have been an important part of a coalition of outside Republican money," said Nathan Gonzales, a congressional political analyst in Washington. "If that coalition falters, that could contribute to Democratic gains."

But several lawmakers interviewed by Reuters were dismissive of the opposition by conservative groups.

"For me, this healthcare bill is an absolute no-brainer," said Representative Devin Nunes of California, a close Trump ally. "Any conservative group who opposes it, I don't even understand how they can categorize themselves as being a conservative group."

The bill's supporters have argued that voters are more likely to punish Republicans who do not act to replace Obamacare when given the chance. "If it fails there are going to be a lot of people who are looking for work in 2018," said Representative Mike Conaway of Texas.

SEE ALSO: Republicans revamp health bill, boost benefits to older Americans

The political implications of the bill, though, remain largely unclear.

Even if it passes the House, the bill faces a difficult path in the Senate, where several conservatives have declared their opposition. Veteran House members recall in 2009, when then-Speaker Nancy Pelosi forced a vote on a bill that would cap carbon emissions. The bill did not pass the Senate, and many Democrats from coal states lost their seats in the 2010 elections for their votes. (Additional reporting by Susan Cornwall and Steve Holland; Editing by Jason Szep and Bill Rigby)

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