GOP blame game starts, with plenty to share

Some point to Ryan, Trump or hard-lin­ers — but all will have their work cut out for them

The Washington Post Sunday - - FRONT PAGE - BY SEAN SUL­LI­VAN, MIKE DEBONIS, JOHN WAG­NER AND DAVID WEIGEL

Let the blame game be­gin. Repub­li­cans’ fail­ure to over­haul the U.S. health-care in­dus­try has ush­ered in a round of in­ter­nal fin­ger-point­ing that threat­ens to deepen the very rifts that doomed the deal — and carve new ones that are likely to com­pli­cate the GOP’s abil­ity to func­tion in the Trump era.

Re­crim­i­na­tions have been un­der­way for weeks, but they in­ten­si­fied Satur­day and cast a new spot­light on the break­down that led Speaker Paul D. Ryan (RW is.) to pull the Amer­i­can Health Care Act from the House floor Fri­day af­ter­noon, after it be­came clear to him and Pres­i­dent Trump that they did not have enough Repub­li­can votes to pass it.

Some top Repub­li­cans in­ter­viewed Satur­day sin­gled out Ryan for blame, ar­gu­ing that he did not suf­fi­ciently rep­re­sent the views of con­ser­va­tive law­mak­ers

or in­ter­est groups, who had pressed for a fuller re­peal of the law. But some blamed Trump or his aides for not smooth­ing out the dif­fer­ences, a sen­ti­ment that has been stronger pri­vately than in pub­lic. Still oth­ers found fault with var­i­ous GOP fac­tions and in­ter­est groups, on the right and in the mid­dle, who op­posed the bill.

All of this puts pres­sure on Trump, Ryan, the hard-right House Free­dom Cau­cus and the mod­er­ate Repub­li­cans who voted against the bill to shore up their re­la­tion­ships and show the na­tion that they can achieve real suc­cesses to­gether.

“Paul Ryan is a re­ally smart pol­icy guy, and we saw that on dis­play,” Club for Growth Pres­i­dent David McIn­tosh said in an in­ter­view Satur­day. “But he lacks the leg­isla­tive skills to put to­gether a coali­tion to get the bill through.” The Club for Growth cir­cu­lated a memo Satur­day ar­gu­ing that “con­ser­va­tives saved Repub­li­cans from vot­ing for their own ver­sion of Oba­macare.”

Other Repub­li­cans ar­gued that groups such as the Club for Growth and the hard-right House Free­dom Cau­cus are at fault for stub­bornly op­pos­ing the bill and con­tin­u­ally de­mand­ing a more ag­gres­sive at­tack on the Af­ford­able Care Act.

“Quite frankly, I think we had a group of peo­ple that are tra­di­tion­ally ‘no’ on ev­ery­thing. And they vote as a bloc. And so you’ve got to pen­e­trate that bloc. And so we’ve got fig­ure out how to do that,” said Rep. Mike Coff­man (R-Colo.).

“I some­times won­der with some of my col­leagues, though, if they wrote the bill them­selves, whether they could get to yes, you know?” said Rep. Bill Huizenga (R-Mich.). “Be­cause it’s about pro­tect­ing their brand or pro­tect­ing their vot­ing record or pro­tect­ing their pu­rity with an out­side group.”

The bill also had its fair share of crit­ics from the more mod­er­ate wing of the party — which has led some to con­clude it’s not about Ryan or Trump but the hard-torec­on­cile na­ture of the GOP right now.

“This is not a fail­ure of lead­er­ship; it’s a fail­ure of fol­low-ship,” said Rep. Tom Cole (R-Okla.), a fre­quent de­fender of both Ryan and Trump.

That still puts the bur­den on Ryan to fig­ure out how to man­age a new dy­namic within his con­fer­ence, with right and left flanks will­ing to buck him.

‘We’re a no’

The dis­cord started weeks ago but reached a crit­i­cal point Thurs­day night, when the mem­bers of the Free­dom Cau­cus sat in the Capi­tol be­fore Ryan, White House chief strate­gist Stephen K. Ban­non and bud­get di­rec­tor Mick Mul­vaney, who had helped found the group of Repub­li­can hard­lin­ers two years ago.

With the bill — and the rest of Trump’s leg­isla­tive agenda — hang­ing in the bal­ance, Ryan polled the room: Would they sup­port the bill after changes that would par­tially, but not en­tirely, meet their de­mands?

Rep. Mark Mead­ows (R-N.C.), the group’s chair­man, spoke up: “I speak for the group. We’re a bloc. And we’re a no.”

The meet­ing sealed the fate of the AHCA, which would be pulled from House con­sid­er­a­tion less than 24 hours later, and brought to a head months of sim­mer­ing frus­tra­tions be­tween each of the par­ties — the Free­dom Cau­cus, the House GOP lead­er­ship and the Trump ad­min­is­tra­tion.

Free­dom Cau­cus mem­bers bris­tled at many of the talk­ing points Ryan used as he blitzed con­ser­va­tive ra­dio and tele­vi­sion shows to project Repub­li­can unity on health care. One that par­tic­u­larly grated, ac­cord­ing to sev­eral mem­bers of the group, was his re­peated claim that Repub­li­cans had “run on” the health-care plan in 2016, be­cause it was sketched out in Ryan’s “A Bet­ter Way” pol­icy agenda.

While some cau­cus mem­bers par­tic­i­pated in lis­ten­ing ses­sions about health care, the pol­icy pro­vi­sions that ul­ti­mately were in­cluded in the plan were writ­ten largely by Health and Hu­man Ser­vices Sec­re­tary Tom Price, then the House Bud­get Com­mit­tee chair­man, as well as Ryan’s own pol­icy staff and Ways and Means Com­mit­tee Chair­man Kevin Brady (R-Tex.). The plan in­cluded pro­vi­sions that many hard-lin­ers con­sid­ered un­ac­cept­able — such as the in­clu­sion of a re­fund­able tax credit, some­thing they saw as a new fed­eral en­ti­tle­ment.

Michael A. Need­ham, the pres­i­dent of Her­itage Ac­tion for Amer­ica, a group that op­posed the bill, said that a “blame game” is a distraction from the need to forge a bet­ter re­place­ment.

“The prob­lem with this bill wasn’t that it would be sound health pol­icy if only it wiped away one set of ben­e­fit man­dates,” said Need­ham. “It was that it was not de­signed from the ground up to cir­cum­vent Oba­macare’s reg­u­la­tory ar­chi­tec­ture. We would be very ea­ger to be in­volved in craft­ing leg­is­la­tion that achieves that ob­jec­tive while nav­i­gat­ing the rel­e­vant pro­ce­dural hur­dles.”

House lead­ers in­sisted that they were con­strained by the spe­cial bud­get pro­ce­dures they needed to fol­low to get the bill through the Se­nate with­out Demo­cratic sup­port. That prompted pol­icy trade-offs that left some con­ser­va­tives fum­ing. And the lead­ers faulted the Free­dom Cau­cus hard­lin­ers — and out­side groups en­cour­ag­ing them — for ig­nor­ing that real­ity and con­stantly shift­ing their de­mands.

The sense that the bill was sim­ply bad pol­icy was shared by many of the cen­trist Repub­li­cans who op­posed it — as well as the Democrats who united against it.

Sec­ond-string back­ing

Since the de­feat, Trump and Ryan have de­clined to say any­thing in­di­cat­ing that they blame each other. That has not stopped some Repub­li­cans from mus­ing that Trump’s less-than-fullthroated sup­port for Ryan and the bill along the way helped em­bolden crit­ics to be­lieve he was on their side.

While Trump sup­ported the bill and sought to build sup­port for it, he also sent con­fus­ing sig­nals sug­gest­ing that he might be open to changes. It was Ryan who in­tro­duced it, cham­pi­oned the de­tails and served as chief sales­man. He also took most of the pub­lic heat from crit­ics.

Still, Repub­li­cans have been less will­ing to crit­i­cize Trump pub­licly. One top Repub­li­can who spoke on the con­di­tion of anonymity to speak can­didly likened the dy­namic to a foot­ball game in which Ryan was the strug­gling start­ing quar­ter­back, and fans were chant­ing for Trump to come off bench to re­lieve him. When Trump did en­gage, the Repub­li­can said, “What­ever good he did was am­pli­fied, be­cause it makes a bad start look bet­ter.”

And like a sec­ond-string player, Trump took less grief for the even­tual loss.

A se­nior White House of­fi­cial said Satur­day that the biggest les­son learned is that Trump and his aides must drive the process from the be­gin­ning. It was a mis­take to come on board with the House plan rather than present Trump’s own ini­tia­tive, this of­fi­cial said.

The of­fi­cial, who spoke on the con­di­tion of anonymity to speak can­didly about White House strat­egy, said that when he is ready, Trump will of­fer his own plan on tax re­form in a bid to have more con­trol over the process.

“We’ve got to line up com­mit­ments ear­lier,” the of­fi­cial said. “Of course we’re go­ing to look at th­ese things.”

The White House also was caught off guard by the re­sponse of law­mak­ers who had re­peat­edly voted to re­peal the Af­ford­able Care Act. Trump aides never ex­pected so many law­mak­ers in this cat­e­gory to de­cline to sup­port this bill.

Some White House staffers and Trump ad­vis­ers have pinned blame for the de­ba­cle on White House Chief of Staff Reince Priebus, who is close to Ryan and who en­cour­aged Trump to em­brace the House bill, ac­cord­ing to sev­eral Trump as­so­ciates, not all of whom say the crit­i­cism is fair.

For many Repub­li­cans, it was a prob­lem of tim­ing. They felt House GOP lead­ers rushed ahead in craft­ing the bill to re­peal and re­place the ACA, need­lessly try­ing to hold a fi­nal vote on Thurs­day, the law’s sev­enth an­niver­sary.

“Re­ally, are we in the Hall­mark card busi­ness?” asked Rep. Mark Amodei (R-Nev.) hours be­fore the bill was of­fi­cially pulled Fri­day. Amodei held both Ryan and Trump cul­pa­ble for the mess.

Trump and some Repub­li­cans have sought to blame Democrats for not join­ing their ef­fort — a claim Democrats say is out­ra­geous. And they have em­braced an­other po­ten­tial path for­ward on health-care re­form, pre­dict­ing that the cur­rent laws will col­lapse un­der their own weight and that some Democrats fi­nally will join their calls for re­peal.

“Oba­maCare will ex­plode and we will all get to­gether and piece to­gether a great health­care plan for THE PEO­PLE. Do not worry!” Trump tweeted Satur­day.

“I don’t think one party is go­ing to be able to fix this by them­selves,” said Sen. Lind­sey O. Gra­ham (R-S.C.) at a town hall meet­ing a few hours later. “So here’s what I think should hap­pen next: I think the pres­i­dent should reach out to Democrats.”

But the Repub­li­can fail­ure has only em­bold­ened Democrats to de­fend the ACA.

“If they would de­nounce re­peal . . . then we’ll work with them on im­prov­ing it and mak­ing it bet­ter,” said Se­nate Mi­nor­ity Leader Charles E. Schumer (D-N.Y.). “They can’t con­tinue to want to re­peal.”

As they quickly filed out of a meet­ing Fri­day where GOP lead­ers of­fi­cially an­nounced the bill was doomed, many with de­jected fa­cial ex­pres­sions, Repub­li­can House mem­bers said it was on them to work out their dif­fer­ences dur­ing this pe­riod of one-party con­trol — and ac­knowl­edged it would not be easy.

“This is a learn­ing ex­pe­ri­ence. I want to learn from this ex­pe­ri­ence. I hope my col­leagues will learn from this ex­pe­ri­ence,” said Rep. Gar­land “Andy” Barr (R-Ky.).

MELINA MARA/THE WASH­ING­TON POST

Tourists pass the of­fice of House Speaker Paul D. Ryan on Fri­day be­fore a vote on the bill was shelved.

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