President Trump signed on to a pair of changes to the House Republican health plan and declared “100 percent” backing for it Friday, moving to consolidate support among GOP lawmakers in hopes of moving it through the House next week.
In a meeting with members of the conservative Republican Study Committee, Trump endorsed two provisions affecting Medicaid, the federal health program for the poor and disabled that would see $880 billion in cuts over the next decade under the current GOP plan.
Well there are conservatives and then there are conservatives — like the Freedom Caucus. The latter’s leaders say nothing has changed, and they still oppose the America Health Care Act. The group tweeted, “The House Freedom Caucus still opposes the GOP replacement bill in its current form.”
Even if some of the Freedom Caucus members cave, provided they get anything of consequence (e.g., speed up repeal of Medicaid expansion), the bill will become more unpalatable to the moderate Republicans in the House, some of whom are already nervous about their votes in committee.
Moreover, the “no” votes in the Senate are piling up, now including Sen. Susan Collins (R-Maine). Four Republicans who initially opposed the bill because the original Medicaid provisions were too harsh — Sens. Rob Portman (Ohio), Shelley Moore Capito (W.Va.), Cory Gardner (Colo.) and Lisa Murkowski (Alaska) — will find the bill even more unpalatable with conservatives’ sped-up Medicaid rollback. And then there are all the hard-line GOP senators who oppose this. The Senate’s near-certain rejection of the House bill is further reason for House moderates to vote no. A yes vote would leave them holding the bag for a health-care bill so bad not even Portman, Sen. Ted Cruz (R-Tex.), etc. would vote for it.
Because the bill is so obviously contrary to the interests of Trump’s base and so likely to fail in one or both houses, there is speculation this is some brilliant trick by Trump and Stephen K. Bannon to back the bill. While Trump now is publicly supporting the bill and trying to woo Republicans, we can imagine — since he changes his mind on everything — that the bill stalls and he declares, “Not even a great dealmaker like me could push Paul Ryan over the goal line.” He might add, “What kind of leader puts something together without getting everyone on board first?”
Maybe this was the plan, or maybe, as is their custom, no one in the White House inner circle is strong enough on details to see how objectionable the bill is or to count noses in the House to figure it might fail. Trump keeps insisting the bill is consistent with his address to Congress — and he might really think so. But he’s never said in any detail what he wants and he will never admit the bill hurts his supporters.
Where does that leave us? Ryan desperately wants the bill to pass the House to get the weight off his shoulders and be able to blame the Senate. Democrats would love a straight up-or-down vote, getting as many Republicans on record as voting for an unpopular bill. The TV ads for 2018 write themselves.
A good number of moderate Republicans in the House don’t want to vote for this (for the very same reason Democrats want a recorded vote) — but frankly, aside from the Freedom Caucus, they would have a hard time passing something that takes away Medicaid benefits or hurts people in their own state (in other words, they cannot really support any GOP bill). The Freedom Caucus Republicans won’t vote for it knowing their Senate fellow hard-liners won’t vote for it. In sum, maybe Ryan pulls out 216 votes, but after that, the prospects for passing something Republicans can call “repealing Obamacare” look dim.