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Paul Ryan: House Republicans will continue their push for health-care reform this year

"We're going to be living with Obamacare for the foreseeable future," he said. (Video: The Washington Post, Photo: Oliver Contreras/The Washington Post)

House Speaker Paul D. Ryan told Republican donors Monday 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.

“We are going to keep getting at this thing,” Ryan said three days after intraparty opposition forced him to pull the American Health Care Act after it became clear it did not have enough Republican votes to pass.

On an afternoon call with donors to his Team Ryan political organization, he continued: “We’re not going to just all of a sudden abandon health care and move on to the rest. We are going to move on with rest of our agenda, keep that on track, while we work the health-care problem. . . . It’s just that valuable, that important.”

Ryan (R-Wis.) 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. His remarks indicated that Republicans may be trying to regroup more quickly than Ryan had suggested they would on Friday, when he declared Obamacare “the law of the land” for the foreseeable future.

“When we’re in Florida, I will lay out the path forward on health care and all the rest of the agenda,” Ryan said in the call Monday, according to a recording obtained by The Washington Post. “I will explain how it all still works, and how we’re still moving forward on health care with other ideas and plans. So please make sure that if you can come, you come — it will be good to look at what can feasibly get done and where things currently stand. But know this: We are not giving up.”

What happened to Trump's promise to repeal and replace Obamacare 'on Day 1'? (Video: Peter Stevenson/The Washington Post)

Trump said Friday that he wanted to move on to the rest of his agenda — tax reform, in particular — and that he was content to leave the Affordable Care Act in place and let it “explode.”

“If the Democrats — when it explodes, which it will soon — if they got together with us and got a real health-care bill, I’d be totally open to it, and I think that’s going to happen,” he said.

In addition, White House press secretary Sean Spicer left the door open at Monday’s briefing to further efforts. “We’re at the beginning of a process,” he said. “I don’t think we’ve seen the end of health care.”

Ryan did not take questions on the roughly 10-minute call. Zack Roday, a spokesman for the speaker’s political operation, declined to comment. AshLee Strong, a spokeswoman for the speaker’s office, said Ryan huddled with Trump at the White House on Monday and also met separately about the coming legislative agenda with Vice President Pence, Health and Human Services Secretary Tom Price and Chief of Staff Reince Priebus. “It’s safe to say we’re having these conversations,” she said. “We look forward to talking with our members on Tuesday when we get back.”

Divisions threaten Trump’s hope of winning his next big legislative battle: Taxes

The call Monday came at the most challenging moment of Ryan’s 17-month tenure as speaker: the failure of the American Health Care Act, for which he played the central role in assembling and promoting, throws into doubt the Republican Party’s basic ability to govern even with unified control of the White House and Congress.

Speaking to the donors Monday, Ryan gave an explanation similar to the one he offered reporters on Friday — where he said that “moving from an opposition party to a governing party comes with growing pains.”

But he was more forthright in seeming to lay the blame on the members of the House Freedom Caucus, the hard-right bloc that was a crucial factor in the health-care bill’s demise.

“Basically . . . 90 percent of our members of the conference were there and ready to go and be a governing party and were happy with where we were, and around 10 percent were still in what I would call ‘opposition party mode,’ ” Ryan said on the call. “About 10 percent of our people, a particular bloc, just weren’t there yet, even with the president’s involvement.”

While Freedom Caucus members played a central role in opposing the bill, Ryan did not mention a significant group of moderate Republican who also had qualms about the proposal. The Post has counted at least 25 GOP members not considered aligned with the hard right who had announced they were opposing or leaning against the plan.

In a Sunday interview with ABC’s “This Week,” Freedom Caucus Chairman Mark Meadows (R-N.C.) said he still considered the bill to be “in the negotiation process” and that conservatives and moderates would “come together, hopefully in the coming days, to find consensus.”

But it remained unclear how the GOP health-care push could be salvaged. Trump has turned his sights on the hard right, tweeting Sunday that “Democrats are smiling in D.C. that the Freedom Caucus, with the help of Club For Growth and Heritage, have saved Planned Parenthood & Ocare!”

One Freedom Caucus member, Rep. Ted Poe (R-Tex.), announced Sunday that he was resigning from the group out of disgust for how it handled the issue, raising the prospect that the group could crack up after foiling Trump and Ryan on a front-burner item.

"I think that there was nothing that could be added to the bill that the Freedom Caucus would ever vote yes on," Poe told CNN on Monday. "I got the opinion that there's some members of the Freedom Caucus, they would vote no against the Ten Commandments if they came up for a vote."

There was no indication that there would be any further Freedom Caucus defections — nor evidence that the moderates who abandoned the bill could be wooed back.

Rep. Jim Jordan (R-Ohio), a founder and former chairman of the group, said he had no regrets about killing the bill.

“The lesson here is don’t try to pass a bill that only 17 percent of the country approves of — that’s a problem,” he on MSNBC Monday. “When no one likes the legislation, you have to do it different.”

With AHCA defeat, some Democrats see chance to push for universal coverage

GOP House members who returned to Washington on Monday split on whether the bill had any near-term prospects.

Rep. Barry Loudermilk (R-Ga.) said he had been “slammed” over the weekend by constituents angry that the bill had failed: “We maybe make a few tweaks and change it, but I still think it’s valid. Bring it up. We worked too hard on this.”

But Rep. Chris Collins (R-N.Y.) said he did not believe the fundamental politics of the issue had changed or that his colleagues could stomach another internecine battle.

“It’s an open wound right now — ask the Freedom Caucus,” Collins said. “I’m guessing we’ve all moved on, because it’s not going to do any good to open the wound again.”

Ryan acknowledged on the call that he leads a deeply divided conference that is threatening to descend into open infighting. By pulling the bill Friday, Ryan said, he moved to “let a little pressure off the system, let some nerves cool a little bit and then get back talking with each other while we work on this issue and all the other issues.”

"Ninety percent of our conference was very, very upset with about 10 percent, and I didn't want things being done and said that people would regret," he said. "So I sent folks home for the weekend to just kind of soak in what had happened, appreciate the situation and start over and get back to work again."

Nonetheless, tensions remained evident. Rep. Austin Scott (R-Ga.) rose in a closed-door meeting of House Republicans Thursday night to lambaste Meadows and the Freedom Caucus, only to be talked down by colleagues wary of sparking an intraparty shouting match.

But Scott let loose in a tweet Saturday: "Mark Meadows betrayed Trump and America and supported Pelosi and Dems to protect Obamacare."

And then there are the tensions between Ryan and Trump, a fraught relationship dating back to the presidential campaign that was once again cast into doubt Saturday when Trump asked his 27 million Twitter followers to tune in to the Fox News show of Jeanine Pirro — who proceeded to call for Ryan’s removal as speaker.

In a Fox News interview Sunday, Priebus said the tweet and Pirro’s call were “coincidental” and that Trump was “helping out a friend” by promoting Pirro’s show.

Ryan did not mention the episode in the call Monday, but he said he had spoken to Trump “four or five times this weekend . . . and we see it the same way: We’re completely united on how we move forward and where we go from here and how we need this effort moving.”

"In a strange way, this really merged our teams — our team in the House with the president's team — even more closely," he said at another point in the call. "I think the White House, the president in particular, has a much, much clearer understanding of just the dynamic that we have in the House Republican Conference. And so that, if anything, is very helpful that he really now appreciates the challenges we have of governing and of becoming a governing party."

Philip Rucker contributed to this report.

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