San Antonio Express-News: GOP pulls health care bill amid revolt by its rank and fil

WASHINGTON -- On the 64th day of Donald Trump's presidency, the art of the deal didn't work.

Facing a revolt by rank-and-file lawmakers from their party's right and center, Republican leaders Friday were forced to cancel a vote on long-promised legislation repealing the Affordable Care Act, or Obamacare, leaving uncertain, at least for now, the GOP's future plans for health care.

The move spelled the first major tactical and political defeat for Trump, who had presented himself to the nation as a winner, spent weeks trying to woo recalcitrant Republicans and issued an ultimatum the night before: Take a vote, he said, regardless of the outcome, or he would move on, likely to push the Republican tax reform agenda.

It was a tactic straight out of his 1987 best-seller, "The Art of the Deal," one designed to put pressure on adversaries by showing a willingness to walk away. But this time, it was the lawmakers who walked.

It also was a stinging setback for House Speaker Paul Ryan and House Ways and Means Committee Chairman Kevin Brady, a Republican from The Woodlands and one of the central architects of the Obamacare replacement legislation.

Ryan, unshaven and showing the wear of a days-long drama, conceded defeat.

"Obamacare is the law of the land, and it's going to remain the law of the land until it's replaced," he said.

Trump, for his part, suggested that Obamacare might be left to die a natural death, something Republican critics of the 2010 law have long predicted.

"The best thing we can do politically speaking is let Obamacare explode," Trump said. He also invited Democrats, somewhat whimsically, to join in a bipartisan effort to forge "a better health care plan."

Sounding uncharacteristically chastened, Trump also chalked up the defeat as a learning experience. "We learned a lot about loyalty," he said. "We learned a lot about the vote-getting process."

Forced to postpone the bill for the second day running amid frantic negotiations to save it from defeat, Republican leaders faced a wave of internal recrimination over one of the most consequential GOP promises of the 2016 elections: Repeal and replace Obamacare.

While canceling the vote was a humiliation for Republicans, it might have been even worse to force members to publicly support or oppose the bill. That could have exposed Republican moderates to far-right primary challenges, potentially risking GOP control of the chamber.

The turn proved to be a stunning reversal from the heady days of Trump's November election victory, when tea party activists looked forward to repealing Obamacare on "day one" of his presidency.

The failure also feeds a perception that fractious Republicans can't govern and suggests difficulties ahead for other goals, especially tax reform.

Brady, in a final floor speech to rally support, warned his party of the stakes involved.

"Today, we have a choice to make," he said. "Will we answer the president's call to action and pass this legislation to repeal and replace Obamacare? Or, will we allow the law to remain fully in place and deny our constituents the relief they urgently need?"

Democrats, who remained uniformly opposed to rollbacks, said Republicans failed to take into account the political perils of a plan that would leave 24 million more Americans without insurance, even as hard-right lawmakers said it didn't go far enough to repeal Obamacare.

"They've spent eight years in contempt of President Obama and the Affordable Care Act," said Houston Democrat Sheila Jackson Lee. "It really clouded their judgment about which way to go."

In the end, Ryan acknowledged that Republicans could not form a consensus around replacement legislation, caught between conservative critics pressing for total repeal and moderates who wanted to preserve but trim back some of the more popular provisions of Obamacare.

Among the major sticking points were planned GOP cuts to Medicaid, the federal health program for the poor, disabled and elderly, and a passel of Obamacare insurance mandates that Republicans said were too costly.

While Republicans unified against the central tenet of Obamacare -- the "individual mandate" that everyone buy insurance -- they split on what should replace it to ensure sufficiently large risk pools of healthy adults to make the insurance market work.

The central architecture of the GOP bill, called the American Health Care Act, would have replaced the individual mandate with a 30 percent "continuous coverage" penalty, aided by age-based tax credits to buy insurance. Republicans said their plan would reduce the deficit and save $1 trillion dollars in taxes, which Democrats said would disproportionately go to the rich while cutting aid to the poor.

Democrats also fought back against the GOP plan to defund Planned Parenthood, the women's health network that provides abortions.

But the real legislative fistfight was among Republicans themselves.

"Moving from an opposition party to a governing party comes with growing pains," Ryan said. "While we're feeling those growing pains today, we came really close today but came up short."

Ryan, owning the retreat on the GOP bill, said he told Trump it was the best thing to do and that the president agreed.

"I will not sugarcoat this," Ryan said. "This is a disappointing day for us. Doing big things is hard."

With the outcome in severe doubt early in the day, Ryan found himself rushing to the White House to confer with the president, who kept up a full-court press of tweets and phone calls.

Republicans knew full well the stakes for them. Pulling the bill from consideration might not have seemed as ignominious a defeat as losing the vote outright. But both scenarios spelled humiliation for a party that has been railing against the law since Obama signed it seven years ago Thursday.

White House spokesman Sean Spicer said that since 2010, every Republican "from dogcatcher on up" has campaigned on repealing Obamacare, a main reason congressional Republicans and the White House chose to take it up first, before tax reform. He added that the budget savings from repealing the Affordable Care Act could have gone to tax reform.

Depending on how many Democrats would be present, Republicans could afford only 21 or 22 defections. By Trump's estimate, they were still about 10 or 15 short by the end of the day.

Among the possible defectors were two Texans: Reps. Louie Gohmert of Tyler, a Freedom Caucus critic, and Randy Weber of Friendswood, who had tweeted the night before that the bill needed "more vetting."

Gohmert, one of the bill's most outspoken conservative critics, said Republican leaders had oversold their legislation to win votes. "We have been lied to," he said on Fox. "This bill keeps Obamacare in place in perpetuity."

But conservatives, who said the bill fell short of the promise of repealing Obamacare, weren't the only ones standing in the way. A group of moderates, including New Jersey Republican Rodney Frelinghuysen, chairman of the powerful House Appropriations Committee, raised many of the same concerns as Democrats.

Rep. Lloyd Doggett, a San Antonio Democrat who helped write the Affordable Care Act, was scheduled to hold a town hall on health care at 1 p.m. today in San Antonio at La Trinidad United Methodist Church.

Doggett warned after the fate of the legislation became known that Republicans may seek to further sabotage the Affordable Care Act. "This is a victory for the resistance, but the empire will strike back," he said. "Republicans bet on blitzkrieg and lost."

Rep. Will Hurd, R-San Antonio, who had declined to take a public position on the bill, said after it collapsed that he's "hopeful that we can go back to the drawing board and fix our broken health care system. We must get this right."

Rep. Joaquin Castro, D-San Antonio, said afterward that "members of Congress from across the country realized that this bill would hurt their constituents. Millions of people would have lost their coverage, including more than 660,000 Texans."

Now, Castro added, Congress should work in bipartisan fashion to fix problems with the Affordable Care Act.

But with Republican majorities in both chambers of Congress, it is likely that party leaders have not heard the last calls for repeal.

Said Trump: "I never said repeal and replace it in 64 days."

Read this original document at: https://doggett.house.gov/media-center/in-the-news/san-antonio-express-news-gop-pulls-health-care-bill-amid-revolt-its-rank