The renewed push by House Republicans to pass legislation replacing parts of the Affordable Care Act might just be a game of political hot potato, with no one sure who will end up holding the object when the legislative music stops.
A month ago, when Speaker Paul D. Ryan (R-Wis.) first pulled the bill from a planned vote, the blame fell squarely on the shoulders of the House Freedom Caucus, the group of almost three dozen hard-line conservatives who were largely opposed because Ryan’s proposal did not go far enough to eliminate the Obama administration’s landmark health-care bill.
Ryan and other leaders made clear that they blamed the conservative caucus with thinly veiled criticism, and in the days that followed President Trump eviscerated the group in a series of tweets that left no doubt where he believed the blame fell.
On Wednesday, however, after a few changes to the legislation that modestly tilted the bill more to the right, the Freedom Caucus issued a forceful endorsement of the new package. Outside allies issued declarations that the bill’s fate now fell entirely on the shoulders of moderate Republicans.
It was a whiplash moment for a group that has previously based its existence largely on opposition in the pursuit of purity — and it set off alarm bells among other Republicans.
“A lot of them were taking a lot of heat for the failure of the bill, and they didn’t like it. It’s an exercise in blame-shifting,” said Rep. Charlie Dent (R-Pa.), a leading member of the Tuesday Group, the collection of more than 50 moderate Republicans.
At this point Ryan’s leadership team still does not have enough votes to bring the new legislation to the House floor for a vote, and it’s unclear whether enough Tuesday Group members will support it, particularly given the continued effort to appease conservatives in the emerging legislation.
In this new alignment, the thinking goes, another failure to repeal what Republicans derisively call “Obamacare” will be because the other caucus got cold feet and not the Freedom Caucus. Or, if the bill narrowly passes the House, it may well meet its demise in the Senate, where a bloc of Republicans have the votes to defeat the measure unless their demands are met to protect their constituents who rely on the ACA’s Medicaid expansion.
Dent was the most blunt in accusing the conservatives of buckling under pressure and looking for another scapegoat, but there were quite a few other moderates who privately cheered his accusation.
This belief is that, even though they faced no political blowback at home over the 18-day spring recess, members of the Freedom Caucus found themselves as the face of defeat. And while they did not mind that image during President Barack Obama’s final years in office, it’s a much more difficult thing to be known as the group that upended its own party’s administration.
The arch conservatives reject the idea that they gave in to the presidential pressure. “We went back to our districts and received widespread support for our position,” Rep. Justin Amash (R-Mich.), one of the most strident Freedom Caucus members, told reporters Wednesday, even as he declined to say if he will support the new bill. “That was not a concern, if anything I came back with a renewed spirit to keep up the fight.”
Yet in the same breath, Amash acknowledged that he saw the new details, negotiated by the chairmen of the Freedom Caucus and Tuesday Group, as only slightly better than what the hard-line caucus rejected in late March.
“We want full repeal of Obamacare. This bill is not even close to full repeal of Obamacare. I’m not sure it’s half repeal,” Amash said. “So this is a marginal improvement over what we have today, and if that’s what we can get right now, then that’s what the House Freedom Caucus is going for.”
The simple math is, when Ryan pulled the bill last month, both the Freedom Caucus and Tuesday Group shared the blame. According to a Washington Post whip count of public statements, 36 Republicans were open in their opposition to the legislation. Another 15 Republicans were leaning against the legislation.
Of those 51 opponents, about 30 were members of the Freedom Caucus, while many of the others were in the Tuesday Group. Ryan could only spare 20 votes from his side of the aisle — no Democrat will vote for a bill repealing the ACA — so he had no path to passing the legislation.
What infuriated GOP leaders, as well as Trump, was that in last month’s negotiations, they made several tweaks to the bill that were designed to bring on conservative support. There was even an inclusion of a provision that would have eliminated requirements for insurers to cover key areas, including maternity care and preexisting conditions.
That move drove Republicans in swing districts away from the bill. “Many of us ran on the platform of making sure that the pre-existing-condition issue remained as is, and I certainly ran on that,” said Rep. Leonard Lance (R-N.J.), whose district swung from being a solidly Republican suburban stronghold to one that Trump narrowly lost last year.
Last month, even as the bill tilted in their direction, Freedom Caucus members still objected, but this week the group decided to get behind the effort. The compromise gives states the ability to opt out of the “essential health benefits” requirements.
The conservatives are now the ones trying to sound as if they’re flexible, abandoning their search for the most pure bill. “That doesn’t mean that this is the legislation we would have liked to have seen,” Amash said.
And now it’s up to the moderates to decide if they can support this bill. Rep. Mario Diaz-Balart (R), whose South Florida district Trump narrowly won, could not decide how he planned to vote as he saw the legislation move to the right.
“It seems that way, yeah,” Diaz-Balart said. “This is an issue that I need to make sure that I get right “