Health Care Defeat Is a Stunning Setback for Republicans

By Victoria McGrane, The Boston Globe

25 March 17

resident Trump and House Republicans admitted defeat Friday and canceled a vote on a plan to replace former president Barack Obama’s Affordable Care Act, a stunning setback for a political outsider who campaigned as a tough deal-maker who would swiftly fulfill GOP promises to repeal the law.

The collapse means Obama’s health care law will stay on the books for the foreseeable future despite years of attempts by Republicans to repeal it. It also highlighted deep divisions among congressional Republicans, who were unable to unite behind a repeal and replace measure.

His first legislative initiative having failed, Trump immediately expressed a desire to move on to the rest of his agenda, saying he next wants to seek passage of big tax cuts. He predicted Americans would now watch the Affordable Care Act “explode’’ and he sought to blame Democrats for not joining with Republicans to fix what he sees as a flawed law.

Trump indicated he harbored no hard feelings toward archconservative House Republicans who foiled attempts by the White House and Speaker Paul Ryan to ram through the sweeping but highly unpopular health care bill.

“They’re friends of mine,’’ Trump said of members of the House Freedom Caucus. “I’m disappointed. I’m a little surprised.’’

Ryan traveled to the White House to personally inform Trump on Friday afternoon that despite days of wrangling and concessions designed to appease conservatives, the bill was well shy of the support it needed to pass.

“Moving from an opposition party to a governing party comes with growing pains, and we’re feeling those growing pains today,’’ Ryan told reporters. “I will not sugarcoat it. This is a disappointing day for us. Doing big things is hard.’’

In a meeting with Republicans earlier Friday, Ryan said there are no plans to refile the legislation.

The failure was a harsh blow to Trump’s young presidency — and not the first. Trump continues to bump up hard against the limitations of his office: The courts have stayed his ban on travel from certain majority-Muslim countries twice, and his budget proposal was widely panned. And now his own allies in the GOP-controlled House have stymied his promise to repeal Obamacare and replace it with legislation that he had promised would be “terrific.”

But Trump, in office for little more than two months, had pushed for rapid action from a Congress that rarely moves that quickly on complex legislation. He plunged ahead without doing the sort of painstaking spadework — bringing on board interest groups and factions of lawmakers — that is typically needed for major policy measures.

For the political maverick who steamrolled the Bush and Clinton dynasties and upended the Republican Party, this week demonstrated in a painfully public way that he cannot muscle past the separation of powers that limits the executive branch authority.

Trump’s more subdued tone after the defeat late Friday afternoon contrasted with the tone from the White House on Thursday night, when the president dispatched top aides to Capitol Hill to tell House Republicans he was done negotiating with them and wanted a vote on Friday regardless of the outcome.

The GOP legislation aimed to repeal the requirement in the Obama law that people obtain insurance or face a penalty. It would have cut back on subsidies to buy insurance and limited spending on Medicaid.

In the end, those lawmakers who opposed the bill from both the moderate and far-right wings of the party called his bluff, and the measure collapsed without tough votes being cast. Polls show the GOP legislation was unpopular, and the Congressional Budget Office reported that as many as 24 million people would have lost coverage with its passage.

The president tried to control the message even in defeat, calling a Washington Post reporter to declare, “We just pulled it,” beating Ryan to the punch. The reporter tweeted out Trump’s announcement just as House Republicans were trudging into a hastily called meeting at which Ryan told them he was canceling the vote.

“I think that’s probably the end of it, truthfully,” said North Carolina Republican Walter Jones, who opposed the bill. “There’s going to be a lot of egg on certain people’s faces, and they’re going to have to wash it off.’’

The collapse of the GOP health care bill, known as the American Health Care Act, was also a major setback for Ryan, who was not only the key architect of the measure but also the figure who is supposed to be leading the way for a conservative agenda on Capitol Hill now that Republicans control all the levers of power. Trump from the Oval Office praised Ryan for working “very hard.’’

Texas Representative Louie Gohmert blamed House GOP leadership for not working with rank-and-file lawmakers as they wrote the bill. While Ryan held “listening sessions,” in the end opponents complained House leaders wrote the bill they wanted and told Republicans to vote for it.

“If I were the president, I wouldn’t deal with health care anymore, but, as legislators, it is a problem, and we should pick it right back up, do it the right way,” he said. “The president did everything he could do with a bad bill. It’s not his fault.”

Several lawmakers defended Ryan. “If he can’t deliver [the votes], they can’t be delivered,” said New York Representative Chris Collins, a close Trump ally, speaking earlier Friday but already fuming at his “no” vote colleagues for not being good team players. “I’m certainly not blaming Paul Ryan in the least.”

While both Ryan and the White House indicated they wanted to move on to other big-ticket items like tax reform, many in Washington believe the health care setback will make it harder politically to score wins on other tricky policy issues.

“This one’s tough, but tax reform clearly is not easier,” said Representative Kevin Cramer, Republican of North Dakota. Moreover, without the budget savings that were to be generated by the GOP’s American Health Care Act, there’s about $1 trillion less to play with when it comes to cutting taxes, Ryan told reporters.

Trump, in his remarks to reporters in the Oval Office, shifted blame to Democrats and to Obama’s bill.

“I think the losers are Nancy Pelosi and Chuck Schumer because now they own Obamacare,” he said, targeting the House and Senate minority leaders. “I’ve been saying for the last year and a half that the best thing we can do politically speaking is let Obamacare explode. It is exploding right now.”

Hillary Clinton, defeated by Trump just a few short months ago, issued a statement by Twitter, saying that the outcome was “a victory for anyone who believes affordable health care is a human right.’’

To many Democrats, the Republican disarray on health care seemed like nothing but good news.

“In my life, I have never seen an administration as incompetent as the one occupying the White House today,” Schumer said. “So much for the Art of the Deal.”