Sun Sentinel Palm Beach Edition

Health reform effort dead

Trump vows to revisit idea

- By Lisa Mascaro and Noam N. Levey

WASHINGTON — President Donald Trump, elected on a promise to use his deal-making prowess to get Washington working, blinked Friday in the face of defeat, abruptly pulling a House vote on a GOP health care overhaul amid crumbling Republican support.

The move came hours after the White House insisted the vote would go forward regardless of the outcome, and followed Trump’s ultimatum Thursday night, when he told rebellious lawmakers that if they didn’t vote for the bill, he would move on to other priorities.

To avoid an embarrassi­ng vote, Trump asked

House Speaker Paul Ryan to abandon the effort.

The collapse of the bill — legislatio­n that managed to displease both Republican conservati­ves and centrists — dashed the party’s immediate hopes of fulfilling a longtime campaign promise to repeal and replace President Barack Obama’s signature health care law, also called Obamacare.

Trump made a last-minute push for the GOP bill. His spokesman said Friday that the president “left everything on the field.”

In an Oval Office appearance after the vote was pulled, Trump described it as a “very interestin­g experience.” He praised his fellow Republican­s and deflected blame on Democrats — who opposed the bill. He also said he’d learned something about “loyalty,” apparently referring to the GOP defections.

Trump predicted the country would eventually need to revisit the issue, saying, “We will end up with a truly great health care bill in the future after this mess that is Obamacare explodes.”

Both Trump and Ryan, however, said the Republican Party had no plan to revive the repeal-and-replace effort anytime soon.

The defeat exposed Trump’s limits as negotiator in chief and raised doubts about his administra­tion’s ability to achieve the rest of its conservati­ve agenda, including tax cuts, deregulati­on and trade overhaul.

The fallout was also a setback for Ryan. Critics say the legislatio­n was crafted too quickly and without enough input from other lawmakers or consultati­on with industry and interest groups.

“Hopefully there will be a lesson learned (to) work together to write the bill instead of writing it in private,” said Rep. Louie Gohmert, RTexas.

Though Trump signaled his continued support for Ryan to remain in his post, and many lawmakers were standing by his side, fingerpoin­ting over what went wrong is bound to linger.

Ryan could have afforded to lose no more than about 21 Republican votes to reach the 216 needed for passage. Defections were estimated at one point to be 30 or more.

The conservati­ve House Freedom Caucus wanted Trump and Ryan to go further and faster in unwinding Obamacare rules and taxes. Centrist Republican­s were worried the GOP plan would leave too many Americans without health insurance.

“Moving from an opposition party to a governing party comes with growing pains and, well, we’re feeling those growing pains today,” Ryan said.

The GOP defeat marked a victory for a broad coalition of patient advocates, physician groups and hospitals that had mounted an intense campaign to highlight the damage they said the bill would do to patients’ medical care.

Congressio­nal offices reported a huge influx of calls urging a “no” vote.

“This is a clear statement that the policies in the bill were fatally flawed and should never again see the light of day,” said Robert Doherty, senior vice president of the American College of Physicians.

The turmoil over the bill also served as a reminder of the GOP’s ongoing internal strife, which can allow small groups of rank-and-file Republican­s to determine the party’s direction.

“There’s bitterness within our conference,” said Rep. Chris Collins, R-N.Y. “It’s going to take time to heal.”

Democrats stood firmly against the Republican bill, which GOP leaders had hoped to pass on Obamacare’s seventh anniversar­y this week. Democrats warned of the harm to ordinary Americans — many in areas Trump won — who would lose access to health care.

Under the Republican plan, some 24 million more Americans were expected to join the ranks of the uninsured during the first decade, according to the nonpartisa­n Congressio­nal Budget Office.

House Minority Leader Nancy Pelosi, D-Calif., who helped Obama pass the Affordable Care Act, called the failure of the Republican effort a “victory for the American people.”

States would have lost nearly $900 billion in federal funding for their Medicaid health insurance programs for the poor.

Centrist Republican­s worried the bill would have left too many constituen­ts without health care.

Trump’s inability to quickly close the deal with the holdouts exposed his newness to the legislativ­e process and his slim hold on the deeper policy nuances needed to bring lawmakers to his side.

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