Like it or not, Trumpcare will define this president, and everyone in Trump’s Washington seems to know it.
While the White House is already trying to distance Trump from the House Republican bill to “fix” Obamacare, they’re quietly working behind the scenes to help him deliver on the GOP’s main campaign promise from the past three election cycles. But the GOP’s long awaited health care bill is on life support and that has Republicans and White House officials scrambling to save the president’s face.
With Republican leaders rushing to pass the bill ahead of their Easter recess in April, they’ve been frustrated by the numerous roadblocks being thrown up by conservative and moderate Republicans alike.
The upcoming votes will test party unity in the House and Senate, while also providing the White House its first chance of proving that Trump is the master dealmaker he’s promised to be. But the halls of Congress are a lot different from a boardroom, as this new administration is learning.
The bill that codifies the GOP’s seven-year-old campaign slogan—Repeal and Replace—into a concrete proposal has sparked a civil war between the party’s conservative and moderate wings, and that’s awakened and focused the White House like nothing that’s been witnessed since Trump was sworn in just two months ago.
Much like under President Obama, Republicans seem to sense that what happens with health care will hang around President Donald Trump’s neck for years to come, which is why the White House is trying to both distance the president from the proposal while also working behind the scenes to get it over the finish line.
While White House press secretary Sean Spicer and Health and Human Services Secretary Tom Price have refused to label the new package Trumpcare, the president’s fingerprints are now all over the controversial legislation.
Vice President Mike Pence was at the Capitol three times this week—twice on Thursday alone—to try to calm the GOP troops who are freaking out after going home and either facing rowdy town hall meetings or avoiding their angry voters altogether.
It may have worked; for now at least. After unveiling the bill on Monday night, the legislation was swiftly dragged through two key committees, even as internal part spats fights spilled out into the open.
On Wednesday it was ushered through the tax writing committee and on Thursday, after a marathon 27 some odd hour markup, the bill made it out of the Energy and Commerce Committee on a party line vote, but there’s dissention in the ranks.
“House health-care bill can’t pass Senate w/o major changes,” Sen. Tom Cotton (R-AR) tweeted to the dismay of party leaders. “To my friends in House: pause, start over. Get it right, don’t get it fast.”
The speed may be for a reason.
S&P Global Ratings released an estimate this week that the bill could rip health insurance out of the hands of up to 10 million people. Republican leaders are under fire from some in the party for moving forward with the bill without waiting for an official score from the nonpartisan Congressional Budget Office.
“It’s kind of crazy they’re voting without a score,” Sen. Bill Cassidy (R-LA) bemoaned to a gaggle of reporters just off the Senate floor. The physician said it’s mind boggling to advance a bill to overhaul one-fifth of the nation’s economy without an estimate on the proposal would mean for people’s pocket books and their insurance coverage.
“So kind of my training for 25 years is to wait until I have that data to kind of make a more informed decision, because what you don’t want to do is create a misimpression based upon half the data,” said Cassidy who has teamed up with Sen. Susan Collins (R-ME) on a proposal to allow states who like Obamacare to keep it, which is anathema to the Tea Party wing of the party.
The House Freedom Caucus—a group of 30 or so far right-wing conservatives—remains opposed to anything short of a full Obamacare repeal, and they seem to have the ears of some of the top brass in the White House.
The director of the Office of Management and Budget, Mick Mulvaney, spent Tuesday night at a Mexican restaurant with the group trying to keep the party’s rightward flank form bolting. The newly minted OMB director also invited some members of the Freedom Caucus to the White House next week for a night of bowling and Obamacare negotiations. And Trump and the first lady hosted Obamacare’s arch nemesis, Sen. Ted Cruz (R-TX), and his family for a presidential dinner this week.
While those conservatives are asking to shorten the lifeline of the Medicaid expansion under Obamacare, they seem to be fluid and report not drawing a line in the sand on that demand yet.
“It’s sand, so there’s no permanent line. I mean what I’d say is it’s one of the things we’re striving for and pushing toward,” Rep. Mark Sanford (R-SC) told The Daily Beast before being pressed on why the Freedom Caucus is so vocally opposing Speaker Ryan’s health care bill and calling for an outright repeal like they sent to President Obama. “That’s not a slap in the face, that’s a call for consistency. That’s saying that what’s good enough for a Democratic president ought to be good enough for a Republican president as well.”
Speaker Ryan is frustrated with the dissent, which was on full display at the Capitol. His usual weekly press conference turned into a seminar on healthcare as the speaker took off his suit coat, rolled up his starched white sleeves and treated a surprised room of about 50 reporters and dozens of cameras to a town hall-style presentation on his Obamacare replacement plan.
The slideshow—replete with images of stethoscopes, first aid kits, and balloons!—was lost on the press corps, who eagerly sat through the half-hour lecture so they could question the speaker. But in the end he only took three questions and cut off one skeptical reporter with, “Don’t interrupt me!”
But the speaker seems to have been making another pitch to the party’s wary base and the conservatives who want to tank the bill.
“This is the closest we’ve been to a repeal and replacement of Obamacare,” the speaker lectured. “And this is the closest we’ll ever get to repealing and replacing Obamacare.”
The bill now has to go through the House Budget Committee and then the Rules Committee before hitting the floor where the magic number is 216, because of some vacant seats. If, and it’s a big “if,” Ryan and Trump can get the troops in order in the House, the legislation will move to the Senate where 50 Republicans are needed to ship the bill to the White House.
“It is hard math,” Sen. John Thune (R-SD) told The Daily Beast. “That’s why it’s not easy stuff and everybody has slightly different equities, everybody cares about different features of this bill, or the broader healthcare debate generally. I think that’s why you got to listen, you got to be patient.”
The slowly churning legislative wheels are trying the president’s patience, though, as he continues to promise interest groups, like conservative activists, swift action on Obamacare, or Trumpcare, as it will be known if it ever makes it to his desk for his signature.