A spec­trum of dis­sen­sion in GOP

The span of ide­olo­gies re­fus­ing to fa­vor the health-care bill is sur­pris­ingly com­plex.

The Washington Post Sunday - - FRONT PAGE - @PKCapi­tol PAUL KANE paul.kane@wash­post.com

Pres­i­dent Trump and House Speaker Paul D. Ryan made it a bi­nary choice: You’re ei­ther for their health-care leg­is­la­tion or you’re for “Oba­macare.”

From Reps. Trent Franks (RAriz.) to Rod­ney Frel­inghuy­sen (RN.J.), span­ning the party’s ide­o­log­i­cal spec­trum, the an­swer came back Fri­day: No, it’s much more com­plex. It was filled with sev­eral dif­fer­ent op­tions and pos­si­ble routes ahead, and dozens of Repub­li­cans agreed with their sen­ti­ment.

That left Repub­li­cans well short of the votes they needed to ful­fill a seven-year prom­ise to de­stroy the 2010 Af­ford­able Care Act once they were fully in charge, de­liv­er­ing a sting­ing de­feat to both Ryan and Trump.

It also sug­gested a new dy­namic in which both the right and left flanks of the Repub­li­can con­fer­ence are em­bold­ened to chal­lenge lead­er­ship. And that could make each fu­ture ne­go­ti­a­tion more dif­fi­cult as the is­sue ma­trix gets more com­pli­cated and the pock­ets of in­ter­nal GOP re­sis­tance con­tinue to grow, not shrink, in the new era of Trump’s Repub­li­can-con­trolled Wash­ing­ton.

Some parts of th­ese botched ne­go­ti­a­tions looked a lot like the re­cent past. Franks and his House Free­dom Cau­cus cronies played the role of ob­struc­tion­ists who will buck party lead­ers no mat­ter if it’s John A. Boehner, Ryan’s pre­de­ces­sor, or now Trump, as well. Th­ese ide­o­logues gob­bled up tons of at­ten­tion, re­sult­ing in much care from Trump, Vice Pres­i­dent Pence and top ad­vis­ers.

By lunchtime Fri­day, Franks still would not com­mit to pub­licly sup­port­ing the bill — even though he ad­mit­ted it was far bet­ter than cur­rent law. “Of course it is, yeah, it’s a lot bet­ter than Oba­macare, of course it is. There’s not even any com­par­i­son,” Franks said a few hours be­fore the leg­is­la­tion went down in flames.

Franks re­mained up­set that con­ser­va­tive pro­pos­als were left out of the bill be­cause they would have vi­o­lated Se­nate bud­get rules, mean­ing that the pro­posal to re­place the ACA was nowhere near to his lik­ing.

“That still is like putting dirt in ice cream,” he said.

Other parts of the ne­go­ti­a­tion, how­ever, were new and quite dif­fer­ent from the pre­vi­ous six years of Repub­li­can con­trol of the House. Noth­ing capped this off more than the stun­ning an­nounce­ment Fri­day morn­ing from Frel­inghuy­sen, just three months into his hold on the cov­eted Ap­pro­pri­a­tions Com­mit­tee gavel, that bucked lead­er­ship.

“Un­for­tu­nately, the leg­is­la­tion be­fore the House to­day is cur­rently un­ac­cept­able as it would place sig­nif­i­cant new costs and bar­ri­ers to care on my con­stituents,” he said in a state­ment.

A 22-year vet­eran whose fam­ily traces its es­tab­lish­ment lin­eage to the Con­ti­nen­tal Congress, Frel­inghuy­sen won his chair­man­ship un­con­tested with the bless­ing of Ryan and the lead­er­ship team. He’s not some­one who rocks the boat — he sup­ported im­peach­ment ar­ti­cles against Pres­i­dent Bill Clin­ton — but his pro­nounce­ment Fri­day sent a jolt through the Capi­tol.

He also joined a long list of in­flu­en­tial cen­trists who re­jected the pro­posal on pol­icy grounds, not out of fear po­lit­i­cally. Frel­inghuy­sen has re­ceived more than 60 per­cent of the vote in all but one elec­tion.

If any­one should back Ryan — he’s a new com­mit­tee chair­man, he’s safe back home — it would have been Frel­inghuy­sen. In­stead, he sent a mes­sage to a few dozen other Repub­li­cans who have more trou­bling dis­tricts that they, too, should break from the pres­i­dent and the speaker.

In some cor­ners, Repub­li­cans saw the past week as a defin­ing mo­ment when law­mak­ers went from the hy­po­thet­i­cal ex­er­cise of pre­vi­ous fis­cal pro­pos­als, which they knew the White House of Pres­i­dent Barack Obama would block, into the world of live am­mu­ni­tion in which th­ese pro­pos­als could be­come law.

That grav­ity, among mod­er­ates and some main­stream con­ser­va­tives as they saw Trump agree to con­ces­sions to the Free­dom Cau­cus, al­tered votes. “Some­times you’re play­ing Fan­tasy Foot­ball and some­times you’re in the real game,” said Rep. Joe Bar­ton (R-Tex.), a Free­dom Cau­cus mem­ber whom Trump had won over to sup­port the bill.

By the time Ryan ar­rived at the White House, de­liv­er­ing the bad news about the whip count for the vote, those Repub­li­cans were do­ing just that. Rep. Bar­bara Com­stock (R-Va.), who brought Ryan into her subur­ban dis­trict out­side Wash­ing­ton, broke against the bill, fol­lowed by Rep. David Joyce (R-Ohio).

Joyce’s dis­trict, a mix of sub­urbs and work­ing-class towns east of Cleve­land, ac­tu­ally went for Trump by more than 11 per­cent­age points, as Joyce was re­elected by a 25-per­cent­age-point mar­gin. In the past, his biggest po­lit­i­cal fear has been a pri­mary chal­lenge from the right, yet the slight hint of Trump-fu­eled chal­lengers to those op­posed to the bill did not sway Joyce.

Ohio Gov. John Ka­sich (R) had ac­cepted ex­panded Med­i­caid fund­ing as part of in­creas­ing in­sur­ance cov­er­age through the ACA. Ryan’s Amer­i­can Health Care Act would phase out the Med­i­caid cov­er­age.

Joyce made a sim­ple, bi­nary choice about Oba­macare: “The Amer­i­can Health Care Act was not a bet­ter so­lu­tion.”

This new com­bi­na­tion, with Ryan’s right and left flanks will­ing to buck him and the new pres­i­dent, presents deep con­cern for the long-term ef­fort to take up the more com­pli­cated ef­fort to over­haul the cor­po­rate and in­di­vid­ual tax codes.

Be­fore they can even get there, how­ever, Ryan faces an April 28 dead­line to come up with a fund­ing stream for the fed­eral agency bud­gets through the end of the fis­cal year. In pre­vi­ous fed­eral spend­ing fights, the Free­dom Cau­cus has re­fused to lend a hand un­less pol­icy riders were at­tached. Democrats, who have been re­lied on in the past to back­fill those lost con­ser­va­tive votes, have sig­naled they will not do so this time if the leg­is­la­tion in­cludes fund­ing for con­tro­ver­sial mea­sures such as Trump’s re­quest for fund­ing to build a bor­der wall.

That messy task falls to Frel­inghuy­sen’s com­mit­tee — and it will be­come much more dif­fi­cult for the new chair­man to ask for loy­alty votes on his leg­is­la­tion just a few weeks after he walked away from Ryan on the AHCA. Democrats be­lieve this at­tempt, and fail­ure, has left Repub­li­cans po­lit­i­cally in charge of health care from now on. They can’t com­plain about some­thing if they can’t come up with their own fix.

“If it passes, they have to an­swer for it,” House Mi­nor­ity Leader Nancy Pelosi (D-Calif.) told re­porters early Fri­day. “If it doesn’t pass, they have to an­swer for that as well.”

Some Repub­li­cans re­jected that, but oth­ers took a more holis­tic view. Pass­ing the Ryan leg­is­la­tion would have only led to a very messy fight in the Se­nate, set­ting up what might have been an even more con­tentious fight later in the spring be­tween the two dif­fer­ent pieces of leg­is­la­tion.

Said Rep. Mark Amodei (RNev.), who op­posed the leg­is­la­tion: “Even if it passes to­day, it’s like — I wanna pick th­ese words very care­fully — the ado­les­cent dance school will still con­tinue in full view.”


Rep. Trent Franks (R-Ariz.) stands in the Capi­tol’s Stat­u­ary Hall on Fri­day, be­fore the health-care bill was pulled from the House floor. Franks re­mained up­set at the bill’s lack of con­ser­va­tive pro­pos­als.

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