GOP Health Care Bill Is Critical First Test For Trump

WASHINGTON (AP) — As conservatives revolt over Republican health care legislation, Donald Trump faces a crucial first test of his presidency: Can he translate his bully pulpit and popularity with conservative voters into a legislative win?

For Trump, it is a new arena five rocky weeks into his presidency. Thus far his accomplishments have been carried out mostly via executive authority or appointments ratified by the Senate, often overshadowed by self-inflicted distraction.

Now the Washington newcomer finds himself in the more complex realm of legislative deal-making, as GOP leaders push forward their long-promised plan to undo former President Barack Obama's health care law and replace it with a conservative blueprint that shrinks the federal role and reduces assistance to help voters buy coverage.

With the plan under attack from conservatives as well as medical groups and the AARP on Wednesday, congressional Republican leaders made clear they will rely on Trump to corral restive lawmakers and bring them in line.

A lot of them haven't experienced what it's like "with Air Force One landing in their district," Rep. Greg Walden, R-Ore., chairman of the Energy and Commerce Committee, said Wednesday before his panel met to begin voting on the legislation. "I think when the president of the United States, who campaigned on repeal and replace, says this is the repeal-and-replace bill ... I think the dynamic changes."

In their early outreach, Trump and Vice President Mike Pence met Wednesday with conservative leaders who have raised objections about the bill. But the activists emerged from the White House with some optimism.

"He heard our concerns, our very serious concerns with the House draft bill," said Club for Growth President David McIntosh. "I'm encouraged that the president indicated they're pushing to make changes in the bill."

Trump also vowed during the meeting to travel to states he won in November and hold big rallies to put unsupportive senators on the spot, according to one meeting participant who spoke on condition of anonymity to disclose details of the private discussion.

And the president acknowledged the repeal and replace effort could fail, the person said. If that happens, Trump argued, Obamacare will continue sputtering and Americans will blame Democrats.

Trump has kept an arm's length from legislative maneuvering on Capitol Hill thus far, sending mixed signals that have led to repeated bouts of confusion about what exactly he supports. Yet with more than 26 million Twitter followers, he can sway GOP lawmakers with a tweet. Before the president was even sworn in, Republicans backed off plans to gut an independent ethics office after he objected over Twitter.

On Tuesday, Republican House members who are part of the GOP vote-counting team met with the president at the White House, with several saying later they were pleasantly surprised by the president's level of engagement on the health bill. He made clear he is fully behind the plan and willing to engage with individual lawmakers to get them on board. Hours after the meeting wrapped up Trump made good on that commitment with a tweet aimed at Sen. Rand Paul, R-Ky., an outspoken critic of the House health legislation.

"I feel sure that my friend @RandPaul will come along with the new and great health care program because he knows Obamacare is a disaster!" the president wrote.

"He said he's 100 percent behind it, he's going to be very engaged, he's going to dedicate as much time as he can possibly do to it," said Rep. Markwayne Mullin, R-Okla., who was in Tuesday's meeting with Trump.

"The White House and the president have the largest pulpit in the world," said Rep. Tom Reed, R-N.Y., another lawmaker in Tuesday's meeting. "And to have that spotlight on you as a member, you better be able to explain your position and you better be able to explain why you're supporting Obamacare and not working with us to repeal it."

Also Wednesday Trump dined with Texas Sen. Ted Cruz, a onetime GOP presidential rival and conservative luminary, his wife, Heidi, and their two daughters. Cruz said it was "principally a social dinner but I'm sure the conversation will turn to the repeal of Obamacare." Cruz said he has serious concerns about the House bill as drafted and doesn't think it could get through the Senate, but hopes to work with the administration to improve it.

Trump's team is deploying three former House conservatives — Pence, budget chief Mick Mulvaney and Health Secretary Tom Price — to persuade some of the most skeptical members of the GOP caucus, including members of the Republican Study Committee and the Freedom Caucus.

Pence hit the airwaves on Wednesday with local television interviews in swing states Michigan, Wisconsin, Ohio, Pennsylvania, North Carolina and Florida. Mulvaney went so far as to invite members of the House Freedom Caucus to join him for a night at the White House bowling lane next week.

Even some holdouts acknowledged that such pressure could make a difference.

"I would be the first to admit that calls from the president will certainly influence members and to suggest otherwise would be to ignore politics," said Rep. Mark Meadows of North Carolina, chairman of the Freedom Caucus, whose members have been speaking out against the bill.

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Associated Press writer Julie Bykowicz contributed to this report.