Fingers point over health bill’s demise
Ryan, Priebus get some of blame, but most falls on divisions in GOP
WASHINGTON — After House Republicans abandoned their health care overhaul effort Friday, President Donald Trump retreated to the White House, where he repeatedly asked advisers who was to blame for the failure, according to three people briefed on his recent discussions.
The repeal and replace of former President Barack Obama’s Patient Protection and Affordable Care Act has long been sought by Republicans and was a major campaign issue for Trump in last year’s presidential election.
House Speaker Paul Ryan spearheaded the effort to drum up support for the GOP bill, and White House Chief of Staff Reince Priebus coordinated the initial legislative strategy on the repeal of Obama’s health care law. Although some blame for Friday’s bill failure was cast their way, sources said Republican Party rifts were mostly to blame.
In an interview with The New York Times on Friday, Trump insisted that the administration was “rocking.”
The problem, he suggested, was divisions among Republicans.
There are “a lot of players, a lot of players with a very different mindset,” Trump sai d . “You have liberals, even within the Republican Party. You have the conservative players.”
Late Friday, the president told one adviser that the bill’s failure was a minor bump in the road and that the White House would recover.
Trump was hands-on in negotiating for the bill with members of the far-right Freedom Caucus, even if some members of that group, who spoke on condition of anonymity, said he didn’t have the greatest grasp on health care policy or legislative procedure.
The president’s chief strategist, Stephen Bannon, described what happened Friday as a flat-out failure that could inflict serious damage on Trump’s presidency — even if Bannon believes that Congress, not Trump, deserves much of the blame, according to people familiar with White House
discussions.
Bannon and the president’s legislative affairs director, Marc Short, had pushed Trump to insist that the House hold a public vote on the health care bill, as a way to identify, shame and pressure lawmakers who opposed it and were seen as trying to kill the last, best chance to unravel the 2010 health care law.
One Republican aide on Capitol Hill who was involved in the last-minute negotiations said Bannon and Short were seeking to compile an enemies list of the lawmakers who opposed the bill. But Ryan repeatedly counseled the president to avoid seeking vengeance — at least until lawmakers pass spending bills and a debt-ceiling increase that’s needed to keep the government running.
At midday Friday, Ryan went to the White House and personally told Trump that there weren’t enough votes in the House to pass the bill. Later, Ryan recommended that the bill be pulled from consideration, and Trump agreed.
The president and his team lamented outsourcing so much of the early bill-drafting to Ryan, and one aide compared their predicament to a developer who has staked everything on obtaining a piece of property without first conducting a thorough inspection.
The bill would have erased much of Obama’s health care law, eliminating its requirement that people buy insurance coverage, ending its Medicaid expansion and trimming federal assistance to help people pay medical bills.
Nonpartisan congressional analysts concluding that the GOP bill would cause 24 million people to lose health insurance in a decade and drive up costs for poorer and older people. Opposition to the bill included doctors, hospitals, consumer groups and the AARP.
Despite the president’s public displays of unity with the speaker, Trump’s team was privately stunned by Ryan’s inability to win over Republicans, according to two West Wing aides. The president, they said, is taking a fresh look at Ryan and his abilities.
Trump told allies Wednesday night that if he did not push for the bill himself, it would not pass. Several, speaking on condition of anonymity, expressed astonishment that the president had not realized that much earlier.
Until last week, Trump’s team was deeply divided over whether he should commit to hard sell the bill that they viewed as fundamentally flawed, and Vice President Mike Pence pointedly advised the president to label the effort “Ryancare,” not “Trumpcare,”
according to aides.
Trump brushed aside those concerns and embraced the conventional role as leader of his party. He has one speed when he decides to shift to sales mode, aides said, and he had trouble modulating his tone, using superlatives like “wonderful” to describe the bill that his aides described as anything but.
Several Trump associates had already laid groundwork to blame the House speaker, who butted heads with Trump repeatedly before Trump was elected president, sources said.
“I think Paul Ryan did a major disservice to President Trump. I think the president was extremely courageous in taking on health care and trusted others to come through with a program he could sign off on,” Chris Ruddy, chief executive officer of Newsmax and a longtime friend of Trump’s, said in an interview earlier this month. “The president had confidence Paul Ryan would come up with a good plan, and to me, it is disappointing.”
Some Republicans rose to Ryan’s defense.
“It’s sometimes easier to do things with a smaller majority, because you all realize you’ve got to stick together or you won’t get anything done,” said Rep. Mike Simpson, R-Idaho. “When you get a bigger majority, you have factions. And then the challenge is dealing with the different factions.”
Trump ally Rep. Chris Collins, R-N.Y., said he didn’t think the loss of the health care bill would affect Ryan, saying “everyone in our conference, whether you’re voting yes or no, does know he put his heart and soul into this. I am certainly not blaming Paul Ryan in the least.”
After pulling the bill Friday, Trump publicly blamed its demise on the Democrats, the party that’s out of power and largely leaderless.
Earlier Trump had rejected their offers to negotiate on a bipartisan package to address shortcomings in the Affordable Care Act while preserving its core protections for poor and working-class patients.
“I think the real losers are Nancy Pelosi and Chuck Schumer,” Trump said Friday, referring to the Democratic leaders of the House and Senate. “Because now they own it. They 100 percent own it.”
Several aides advised him that that argument was nonsensical, according to a person with knowledge of the interaction.
Former Speaker Newt Gingrich, a Trump supporter, said Friday, with a chuckle, that he was “getting some deja vu right now.”
“Do you think Donald J. Trump goes home tonight, shrugs and says, ‘This is what winning looks like’?” Gingrich added. “No! But this is where the Republican Party is right now, and it’s been this way for years.”
On Saturday, Pence spoke as if the push to repeal and replace Obama’s health care law will continue. He told a group of small-business operators in West Virginia that “we will end the Obamacare nightmare and give the American people the world-class health care that they deserve.”
He acknowledged that “Congress just wasn’t ready. … We’re back to the drawing board.”
Earlier Saturday, Trump put on his best face on the matter.
“ObamaCare will explode, and we will all get together and piece together a great healthcare plan for the people. Do not worry!” he said on Twitter, putting some words in all-capital letters.