Trump Demands Health Care Vote Today
Conservatives hold out hope for free-market reforms.
President Trump is finished with negotiating and is demanding lawmakers get down to business and vote on House Speaker Paul Ryan’s Obamacare-replacement package today.
Trump is dropping the hammer because after days of jawboning and arm-twisting, the much-anticipated vote in the House of Representatives yesterday never came. Of course, the only reason GOP leadership would delay the endlessly hyped vote was if they lacked the votes to pass the measure in the House.
Rep. Mark Meadows (R-N.C.), who chairs the House Freedom Caucus, has said he remains optimistic that a deal can be reached.
Other Republican lawmakers say there is no reason for House leadership to cut off negotiations so early in the process. They note that the passage of Obamacare itself took many months, even when Democrats dominated both houses of Congress.
“It is our leadership team that has set an arbitrary deadline — we are happy to keep working with the White House and the leadership team but we don’t think the arbitrary deadline of [Thursday] really means anything,” said Rep. Justin Amash (R-Mich.) who opposes the package in its current form.
Rep. Trent Franks (R-Ariz.) was also unmoved. “I always think if there’s any chance whatsoever that we can make the bill better then we should never stop negotiations,” he said. “Now there is a time that those negotiations should stop, but let that not be arbitrary, let that be on the timetable itself.”
White House Press Secretary Sean Spicer helped to ratchet up the pressure yesterday afternoon when he said the Trump administration feels no need to have a “plan B” in place. Trump warned Republican House members earlier in the week that they could lose their seats in the 2018 election if they don’t play ball.
Trump’s Office of Management and Budget (OMB) director Mick Mulvaney laid down the law last night, saying it’s now or never, according to various media reports.
If there is no vote on the health care bill today, the president will drop the issue and move on to border security, tax reform, trade and other issues Trump considers important, Mulvaney reportedly told Republican lawmakers during pressure-cooker negotiations.
Should the bill fail to be approved, Trump would regard it as “people in Congress breaking their promises to their constituents to repeal and replace Obamacare even with a Republican president in the White House,” NBC News reported, citing an anonymous source.
Needless to say, the strategy could backfire. If the House doesn’t do what he wants, Trump, who hasn’t enjoyed the traditional so-called honeymoon new presidents typically enjoy, could see his approval numbers plummet while he antagonizes GOP lawmakers he needs for the rest of his policy agenda. And just because the president has a bully pulpit, he can’t necessarily bend Congress to his will, especially on issues like fresh trade restrictions which many conservatives treat as heretical.
Meanwhile, House leadership is backing Trump up.
“For seven and a half years [sic], we have been promising to repeal and replace this broken law because it is collapsing and failing families,” Ryan told reporters last night. (Yesterday was only the seventh anniversary of President Obama signing his Affordable Care Act into law.)
“And tomorrow we are proceeding.”
Deputy Majority Whip Tom Cole (R-Okla.) opined that the president’s ultimatum is “credible” and said he expected the legislation would pass the House Friday, adding he wasn’t concerned about how the Senate might respond.
“I think it was time to have pencils down — time to move forward,” House Energy and Commerce Committee chairman Greg Walden (R-Ore.), who has been managing the legislation, said Thursday evening.
At time of writing, it seems unlikely Ryan has the votes he needs but that could change as the contentious vote draws nearer.
Conservatives have reportedly been holding the line on their key demands. They want to kill Obamacare’s ban on refusing to cover pre-existing conditions, the requirement allowing children to remain on their parents’ insurance to age 26, and the so-called Essential Benefits Package (ESP) which forces insured persons to purchase maternal care coverage. The White House is firmly opposed to getting rid of the pre-existing conditions provision and the guarantee of coverage to age 26 but wants to give states the ability to drop ESPs. As a deal-sweetener, the legislation championed by Ryan was altered to retain a 0.9 percent Medicare tax on high income earners, the proceeds from which would go to states.
At Conservative Review, Daniel Horowitz remains optimistic that conservatives will carry the day because they are bargaining from a position of strength.
In a strongly-worded column, he wrote yesterday that “everything the GOP establishment has said until now about the policy, politics, and process of repealing Obamacare has been an outright lie.”
“They never intended to repeal Obamacare. In fact, their health care bill is more insolvent than Obamacare. Now we know definitively that their excuses about process hurdles to real repeal were all lies, too. They have no leverage to demand that conservatives accept anything less than the only solvent version of the GOP platform on health care — and that is full repeal of Obamacare.” [italics in original]
It’s been clear for a long time that the Republican establishment has no intention of repealing Obamacare.
“Those of us who have followed the health care debate since 2010 have long known that the key GOP members, staffers, consultants, and lobbyists involved in health care have accepted the entire premise of Obamacare all along,” Horowitz added.
Members of the GOP establishment have been tipping their hand for quite a while.
For seven years after Obamacare passed Congress, they passed symbolic repeal legislation over and over again but never seriously pressed actual repeal. There was excuse after excuse. When Sen. Ted Cruz (R-Texas) and a handful of other senators tried to defund Obamacare for real, they balked and vilified Cruz. When, more recently, messaging guru Frank Luntz went wobbly, telling them to soften their language regarding repeal, they tripped over each in the rush to repeat his mantra that the law should be “repaired.” Earlier this month House Speaker Paul Ryan explained that there were “three phases of repeal and replace,” paying undue deference to Senate rules which everybody knows can be changed by a simple majority vote in that chamber. He was stringing conservatives along.
These people don’t want to dismantle Obamacare. They want to pretend to dismantle it, while keeping its core structure intact. Having control over one-sixth of the nation’s economy is a powerful aphrodisiac for politicians regardless of party. It gives them an issue to run on again and again. Denouncing Obamacare and then spending decades fixing it is their idea of political best practices.
When the House votes today, if it votes, we’ll get a sense of whether the Republican establishment still has the upper hand in the health care debate.