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GOP dreams of repealing Obamacare collapse as Trump relents, halting vote on House bill

Ryan Meets With Trump Over Health Care
House Speaker Paul D. Ryan leaves the White House on Friday after meeting with President Trump on the House healthcare bill. (Jim Lo Scalzo / European Pressphoto Agency)
(Lisa Mascaro)

President Trump, elected on a promise to use his deal-making prowess to get Washington working, blinked Friday in the face of defeat, agreeing to halt a House vote on a GOP healthcare overhaul amid crumbling Republican support.

The move came just hours after the White House insisted the vote would go forward regardless of the outcome, and followed Trump’s extraordinary ultimatum Thursday night, when he told rebellious lawmakers that if they didn’t vote for the bill, he would move on to other priorities.

To avoid an embarrassing vote, Trump asked House Speaker Paul D. Ryan to abandon the effort.

The collapse of the bill — legislation that managed to displease both Republican conservatives and centrists — dashed the party’s immediate hopes of fulfilling a longtime campaign promise to repeal and replace President Obama’s signature healthcare law, also called Obamacare.

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Trump made a hard, last-minute push for the GOP bill. His spokesman said Friday that the president “left everything on the field.”

In an Oval Office appearance after the vote was pulled, Trump described it as a “very interesting experience.” He praised his fellow Republicans and deflected blame on Democrats — who opposed the bill. He also said he’d learned something about “loyalty,” apparently referring to the GOP defections.

Trump predicted the country would eventually need to revisit the issue, saying, “We will end up with a truly great healthcare bill in the future after this mess that is Obamacare explodes.”

Both Trump and Ryan, however, said the Republican Party had no plan to revive the repeal-and-replace effort anytime soon, so the current healthcare law will remain in place.

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The defeat exposed Trump’s limits as negotiator in chief and raised doubts about his administration’s ability to achieve the rest of its conservative agenda, including tax cuts, deregulation and trade reform.

The fallout was also a setback for Ryan. Critics say the legislation was crafted too quickly and without enough input from other lawmakers or consultation with industry and interest groups.

“Hopefully there will be a lesson learned that let’s work together to write the bill instead of writing it in private,” said Rep. Louie Gohmert (R-Texas).

The failure will only complicate the odd-couple partnership between Ryan and Trump. The president may think twice next time about relying on the speaker to lead legislative campaigns. Though Trump signaled his continued support Friday for Ryan to remain in his post, and many lawmakers were standing by his side, finger-pointing over what went wrong is bound to linger.

Ryan could have afforded to lose no more than about 21 Republican votes to reach the 216 needed for passage. Defections were estimated at one point to be 30 or more.

The conservative House Freedom Caucus wanted Trump and Ryan to go further and faster in unwinding Obamacare rules and taxes. Centrist Republicans were worried the GOP plan would leave too many Americans without health insurance.

“Moving from an opposition party to a governing party comes with growing pains and, well, we’re feeling those growing pains today,” Ryan said. “We came up short.”

The GOP defeat marked a victory for a broad coalition of patient advocates, physician groups and hospitals, which had mounted an intense and sustained campaign to highlight the damage they said the bill would do to patients’ medical care.

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Congressional offices reported a huge influx of calls urging a “no” vote on the bill.

“This is a clear statement that the policies in the bill were fatally flawed and should never again see the light of day,” said Robert Doherty, senior vice president of the American College of Physicians.

It remains unclear what political price Republicans may pay for their failure to advance a repeal bill despite controlling the White House and both chambers of Congress. Many GOP activists will be angry if the party abruptly drops an issue it has campaigned on for years.

At the same time, public support for Obamacare has been rising amid the threat to repeal it, and opinion polls showed strong concern over the GOP plan.

The turmoil over the bill also served as a reminder of the GOP’s ongoing internal strife, which can allow small groups of rank-and-file Republicans to determine the party’s direction.

“There’s bitterness within our conference,” said Rep. Chris Collins (R-N.Y.). “It’s going to take time to heal.”

Rep. Steve Womack (R-Ark.) said he hoped the defeat would eventually bring the party closer together.

“This is a tough situation for us to handle right now; there’s no question it’s a loss for leadership,” he said. “Sometimes these things, if you give them time to marinate, we’ll have an opportunity to bring us back together, and regroup, and get our mojo again.”

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Democrats stood firmly against the Republican bill, which GOP leaders had hoped to pass on Obamacare’s seventh anniversary this week. Democrats warned of the harm to ordinary Americans — many in areas Trump won — who would lose access to healthcare.

Under the Republican plan, about 24 million more Americans would be expected to join the ranks of the uninsured during the first decade, according to the nonpartisan Congressional Budget Office.

House Minority Leader Nancy Pelosi (D-San Francisco), who helped Obama pass the Affordable Care Act, called the failure of the Republican effort a “victory for the American people.”

The House bill would have dramatically scaled back the healthcare safety net that Obamacare expanded, slashing federal spending and removing key coverage guarantees.

It would have effectively reversed the insurance coverage gains that the country has notched over the last several years, and doubled the number of uninsured by 2026.

States would have lost nearly $900 billion in federal funding for their Medicaid health insurance programs for the poor.

As the bill approached a final vote, opposition grew. GOP leaders were forced to abandon a Thursday vote after conservatives, led by the House Freedom Caucus, argued the bill did not go far enough in gutting Obamacare — particularly its mandates that health policies provide specific benefits. They wanted insurers to be allowed to offer skimpier plans that cost less.

Meanwhile, centrist Republicans worried the bill would have left too many constituents without healthcare.

Trump’s inability to close the deal with the holdouts exposed his newness to the legislative process and his slim hold on the deeper policy nuances needed to bring lawmakers to his side.

The president largely played the role of a bustling figurehead — inviting lawmakers to the White House, trying to win their support — rather than an in-the-weeds horse-trader able to round up votes.

For example, Friday morning Trump tweeted criticism of the Freedom Caucus for not taking the deal even though it would have cut funds for Planned Parenthood. But abortion, in this case, wasn’t driving their opposition.

For a while, negotiations with the rebellious factions were relatively congenial. But that changed late Thursday after Trump’s budget chief told House Republicans during a private meeting in the Capitol basement that the president was “done negotiating” and expected lawmakers to fulfill their campaign promises to end Obamacare, according to those in the room.

The dramatic moment startled Republicans — and cut both ways.

Some lawmakers who panned the bill left the meeting frustrated by Trump’s tough talk, while others became emotional — “there were tears,” said Rep. Barry Loudermilk (R-Ga.) — over their moment to achieve their longtime goal of ending Obamacare.

“I wish you could have seen the passion in that room,” said Republican Rep. Brian Mast (R-Fla.).

Times staff writers Brian Bennett and Michael A. Memoli contributed to this report.

A side-by-side comparison of Obamacare and the GOP’s replacement plan »

Trump threatens to leave Obamacare in place if GOP bill fails »

lisa.mascaro@latimes.com | @LisaMascaro

noam.levey@latimes.com | @noamlevey

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