Health Care

House GOP Mulls Another Try at Obamacare Repeal

“House Republicans are considering making another run next week at passing the health-care bill they abruptly pulled from the floor in an embarrassing setback to their efforts to repeal Obamacare,” Bloomberg reports.

“Two Republican lawmakers say that leaders are discussing holding a vote, even staying into the weekend if necessary, but it’s unclear what changes would be made to the GOP’s health bill.”

“Members of the conservative House Freedom Caucus, who helped derail the bill, have been talking with some Republican moderate holdouts in an effort to identify changes that could bring them on board with the measure.”

Republicans Stick with Trump Despite Health Bill Failure

A new CBS News poll finds President Trump’s overall job approval is at 40%, underpinned by continuing strong support from Republicans who don’t appear to blame him for the failed health care bill.

“Republicans surveyed pointed to an unpopular bill — or the Democrats — as the reason the Republican health care effort to repeal and replace Obamacare failed in Congress, not the president’s approach to meeting one his hallmark campaign promises.”

GOP Leaders Say Obamacare Repeal Is Back on Agenda

“House Republican leaders and the White House, under extreme pressure from conservative activists, have restarted negotiations on legislation to repeal the Affordable Care Act, with House leaders declaring that Democrats were celebrating the law’s survival prematurely,” the New York Times reports.

Said Speaker Paul Ryan (R-WI): “We’re not going to retrench into our corners or put up dividing lines.”

David Nather: “Their comments confirmed that this is mostly an exercise in showing their supporters that they’re not giving up — and maybe giving conservative or moderate holdouts some time to reconsider their position.”

What Do Republicans Do Now?

New York Times: “As they come to terms with their humiliating failure to undo the Affordable Care Act, Republicans eyeing next year’s congressional campaign are grappling with a new dilemma: Do they risk depressing their conservative base by abandoning the repeal effort or anger a broader set of voters by reviving a deeply unpopular bill even closer to the midterm elections?”

“The question is particularly acute in the House, where the Republican majority could be at risk in 2018 if the party’s voters are demoralized, and Democratic activists, energized by the chance to send a message to President Trump, stream to the polls.”

“Sifting through the wreckage of a disastrous week, Republican strategists and elected officials were divided over the best way forward.”

Ryan Will Introduce Another Health Care Bill

House Speaker Paul Ryan told Republican donors “that he intends to continue pushing for an overhaul of the nation’s health-care system by working ‘on two tracks’ as he also pursues other elements of President Trump’s agenda,” the Washington Post reports.

Said Ryan: “We are going to keep getting at this thing.”

“Ryan did not disclose details of what the next iteration of health-care reform might look like, but he suggested that a plan was being developed in time to brief the donors at a retreat scheduled for Thursday and Friday in Florida.”

Trump Violated His Own Playbook

“As members of the House Freedom Caucus plotted to seize control of Donald Trump’s health care bill earlier this month, they discovered a key weakness in the President’s strategy. In a memo circulated to members of the conservative group, a top adviser to Sen. Rand Paul of Kentucky pointed out that Trump had made an uncharacteristic error: The President had violated his own rules in The Art of the Deal,” CNN reports.

“Quoting from a passage of the book in which Trump urged readers never to seem too eager to cut a deal, the memo concluded Republican leaders appeared to have done just that: ‘The Speaker needs a deal right now, more than the Freedom Caucus. So does the White House.'”

“Recognizing the immense leverage they enjoyed, members of the Freedom Caucus and other conservatives like Paul would stubbornly maintain their opposition to the House GOP bill to repeal and replace Obamacare. The lawmakers continued to press for concessions from Trump and House Speaker Paul Ryan, creating an impasse in negotiations that helped lead to the legislation’s dramatic defeat on Friday.”

From Repeal to Neglect?

David Nather: “Trumpcare may be dead, but that doesn’t mean Obamacare is safe. The next thing to watch is whether the law actually does fall apart, not because of the design flaws, but because the Trump administration has no incentive to prevent a collapse.”

“When President Trump tweets that ‘Obamacare will explode,’ and House Speaker Paul Ryan says it can’t be fixed, they’re not sending signals that they’re looking for success. The reality is that insurers will need incentives to stay in the market and not impose another round of rate hikes. Instead, we could get a meltdown followed by an endless round of finger-pointing: Trump and Ryan would blame the Democrats for a poorly designed law, and Democrats would blame them for rooting for failure.”

The New York Times has more on the decisions ahead.

Meadows Hailed as a Hero Back Home

“House insurgent Mark Meadows embarrassed the White House and forced his fellow Republicans to turn tail on a seven-year pledge to tear down Obamacare,” Politico reports.

“His constituents are throwing him a party.”

“In these small rural towns that double as ground zero for the type of populist, anti-establishment politics that thrust Donald Trump into the presidency and gave Republicans control of Washington, Meadows remains a hero. He demanded full repeal of Obamacare, more than the failed House bill would have attempted. And his star only shines brighter here after he cost House Republicans their first big win on health care — and their first big win as the governing party.”

Why the GOP Pushed Health Care So Quickly

Washington Post: “Why were Republicans rushing to vote on a health-care plan that they’d barely finished drafting, that budget scorekeepers hadn’t had a chance to fully evaluate, and that, insofar as people did know about it, was widely despised?”

“In part, it’s because their plan was so unpopular and because it got more unpopular the more people learned about it. But it’s also because only by rushing to reshape a full sixth of the American economy without knowing exactly how they would be reshaping it would Republicans be able to use health care to pave the way for the rest of their agenda, including tax reform. In other words, the GOP didn’t want to let a detail like tens of millions of people losing their health insurance get in the way of two tax cuts for the rich.”

The Art of the Blame

CNN: “Speaking soon after accepting defeat, Trump didn’t shoulder the responsibility himself, nor did he pin the blame on House GOP leadership or any of the warring Republican factions’ whose competing demands ultimately sunk any chance of a consensus bill. Instead, he blamed Democrats and vowed to let Obamacare ‘explode.’

Said Trump: “We had no Democrat support. We had no votes from the Democrats. They weren’t going to give us a single vote, so it’s a very very difficult thing to do. I think the losers are Nancy Pelosi and Chuck Schumer because now they own Obamacare. 100% own it.”

“The words flew in the face of Trump’s intense and personal engagement in lobbying members of Congress to support the House bill, efforts the White House touted in recent days as they hinted at Trump’s negotiating expertise.”

You Can’t Blame the Democrats

A Wall Street Journal editorial rips the Republican leadership:

“House Republicans pulled their health-care bill shortly before a vote on Friday, and for once the media dirge is right about a GOP defeat. This is a major blow to the Trump Presidency, the GOP majority in Congress, and especially to the cause of reforming and limiting government. The damage is all the more acute because it was self-inflicted. President Trump was right to say on Friday that Democrats provided no help, but Democrats were never going to vote to repeal President Obama’s most important legislation. And that’s no excuse. Republicans have campaigned for more than seven years on repealing and replacing Obamacare, and they finally have a President ready to sign it. In the clutch they choked.”

What Trump Didn’t Like About the Health Care Bill

Politico: “For weeks Trump had seemed disinterested and disengaged from the specifics of the health care fight, both behind closed doors with his aides and at public rallies. Trump ‘just wanted to get something he could sign,’ said one adviser who talks to him frequently. ‘He was over it.’ He would often interrupt conversations on the law to talk about other issues, advisers and aides said.”

“In one phone call with Ryan earlier this month, Trump told the House speaker that he had a problem with the bill. It wasn’t over Medicaid expansion, maternity coverage, deductibles or insurance premiums. Rather, it was that he didn’t like the word ‘buckets’ — which Ryan had been using to describe the parts of their plan. ‘I don’t like that word buckets. You throw trash in buckets. I don’t like that word,’ Trump said, according to two people familiar with the call. Trump preferred ‘phases.’ Ryan agreed and adopted the term.”