Obamacare replacement dropped, a stunning defeat for Donald Trump
WASHINGTON — Faced with an intransigent group of conservative Republicans, House Speaker Paul Ryan abandoned GOP dreams today of replacing Obamacare, a stunning defeat for Ryan and President Donald Trump.
As moderate House Republicans such as Rep. Steve Stivers of Upper Arlington blamed about 30 GOP conservatives known as the Freedom Caucus for scuttling the bill, House GOP leaders faced the grim reality that they will not keep their seven-year promise to repeal the 2010 Affordable Care Act — at least for now.
And the early defeat for the "Art of the Deal" president — who told Ryan to pull the bill — could impact the rest of Trump's agenda, such as a promised revamp of the tax system.
"I will not sugarcoat this," said Ryan, R-Wisconsin. "This is a disappointing day for us. Doing big things is hard."
But in a hint of his frustration with GOP conservatives such as Rep. Jim Jordan of Urbana, Ryan said "ultimately this all kind of comes down to a choice: Are all of us willing to give a little to get something done? Are we willing to say yes to the good, to the very good, even if it's not the perfect?"
Without mentioning specific lawmakers, Stivers said the "Freedom Caucus is doing us a favor by playing hard to get. Now we get to go make friends with and talk to Democrats and say what do they need to help us fix Obamacare, fix the tax code and move America forward?"
"I think we lost an opportunity here to reach out to moderate Democrats and say what can we do to get your votes and I believe that is and should be something we try to do and start to do," said Stivers, chairman of the House GOP's campaign arm. "Because in some cases, their votes are easier to get then some of the members of our Freedom Caucus."
"All of these conservative policies weren't enough for some conservatives," said Rep. Pat Tiberi, R-Genoa Township, "I was with the president yesterday and he was perplexed that some of them were making the perfect the enemy of the good."
Even though Republicans control the House by a margin of 237 to 193 Democrats, Ryan needed the support of Jordan and his conservative allies to pass the bill. But it quickly became apparent that while Jordan wanted to scrap Obamacare, the Urbana Republican sharply opposed the GOP alternative as well.
In addition, as Ryan appeased the conservatives with concessions, he began losing the votes of moderate Republicans such as Rep. David Joyce of Russell Township. At one point, a GOP source said, as many as 47 Republicans opposed the bill — some two dozen more than the number to sink the bill.
Although Jordan said afterward that Obamacare "is a disaster and repealing it remains one of my top priorities," Ryan made it clear that the 2010 law will remain in effect, impervious to GOP efforts to scrap it.
"There is a bloc of 'no' votes that we had; that is why this didn't pass," Ryan said. "They were a sufficient number of members that prevented it from passing and they didn't change their votes."
The decision to pull the bill capped a dramatic week in which Trump repeatedly tried to woo conservatives, bringing them repeatedly to the White House. Vice President Mike Pence was a near-constant presence on Capitol Hill. On Thursday, Trump issued an ultimatum: The House would vote Friday and if the bill failed, he was done with health care.
But on Friday, after an unplanned visit from Ryan where the speaker told the president that they didn't have the votes, Trump told Ryan to pull the plug. Ryan told GOP lawmakers during a meeting in the bowels of the Capitol where arriving members were greeted by the Rolling Stones classic "You Can't Always Get What You Want."
"Because of the lack of votes today in the House, Obamacare is going to be the law of the land," Tiberi said. "I think for conservatives it's not a good day when (House Democratic Leader) Nancy Pelosi calls it a victory."
Rep. Joyce Beatty, D-Jefferson Township, said that despite fighting the law for the past seven years, Republicans "could not close the deal," which, she said would "have taken health care away from 24 million Americans and given an unnecessary tax cut to the super wealthy. The American people spoke out — health care should be a right for all, not just the privileged few."
Since passage of Obamacare, Republicans have complained the law did nothing to control the rise in premiums in the individual insurance market while burdening taxpayers with hundreds of billions of dollars to expand eligibility to Medicaid, the federal-state program that provides health coverage to the low-income and disabled.
One of the major demands by conservatives was to eliminate an Obamacare provision that requires private insurers in the individual market to provide a minimum package of benefits, including ambulance services, hospitalization, maternity and newborn care, preventive care, and treatment for mental health and substance abuse.
Conservatives have argued that such a mandate drives up the cost of health care and prevents insurance companies from offering a wider range of policies in the individual market. Defenders of the mandate say it prevents insurance companies from offering middle-income people policies that provide skimpy coverage.
As a compromise, Ryan has suggested allowing the states — not the federal government — to establish a minimum package of benefits.
This article first appeared on the Columbus Dispatch's website on March 24, 2017.