Take it to the bank, GOP leaders are all but declaring: The House will vote to repeal and replace by the end of this month.
Their confidence, coming after months of dead ends and false starts, is fueled by the belief that President Donald Trump has their back — even if some conservatives currently don’t.
At a closed-door meeting with Republicans on Thursday, Speaker Paul Ryan said he plans for the House to hold a vote on the leadership’s Obamacare alternative in three weeks, sources in the room told POLITICO. The White House and the Senate support the House GOP leadership’s effort, Ryan added — comments many in the room took as a warning for the far right to get in line.
On Friday, Vice President Mike Pence and newly installed Health and Human Services Secretary Tom Price will join Ryan in his hometown of Janesville, Wisconsin, to pitch their health care agenda. It’s the clearest display of unity yet between the White House and GOP leadership on an Obamacare replacement strategy.
Price, meanwhile, has been summoning to his office conservative agitators who oppose Ryan’s draft proposal. While Price didn’t try to strong-arm them into standing down, the meetings themselves send a signal that the White House is in Ryan’s corner.
“We’re all working off the same piece of paper, the same plan,” Ryan said at a Thursday news conference when asked about conservative opposition. “We are in sync — the House, the Senate and the Trump administration, because this law is collapsing.”
Privately, senior Republican lawmakers and staff are more blunt. They say they have no problem steamrolling conservatives by daring them to vote against an Obamacare repeal that their constituents have demanded for years.
“Conservatives are going to be in a box,” said one senior Republican lawmaker. Trump, the source predicted, eventually will “go out front and … tell the conservatives … they’re either for this or for keeping Obamacare.”
That moment hasn’t arrived yet, though, and conservatives haven’t been shy about voicing their objections to Ryan’s plan — including to administration officials. Several House Freedom Caucus and Republican Study Committee members have joined Senate firebrands Rand Paul, Ted Cruz and Mike Lee in blasting a draft Ryan plan as “Obamacare-lite.”
The White House has responded by dispatching Price, a former House member with sterling conservative credentials, to quell the uprising and try to sell conservatives on the repeal plan. Price once ran the conservative Republican Study Committee himself. And he wrote an Obamacare replacement plan that closely mirrors Ryan’s — and that had broad support among members on the far right, including Freedom Caucus Chairman Mark Meadows of North Carolina.
Price in the coming weeks is expected to meet with Republicans opposed to the leadership plan. He summoned study committee Chairman Mark Walker on Wednesday after the North Carolina Republican said he would vote against a draft of the House bill. The statement had surprised leadership and irked some of his fellow study committee members: California Rep. Tom McClintock. in a private RSC meeting, called it “Freedom Caucus crap,” referring to the in-your-face tactics employed by the smaller, more aggressive group. McClintock resigned from the Freedom Caucus in 2015.
Price also met Wednesday with Meadows, Jim Jordan of Ohio and Morgan Griffith of Virginia. POLITICO reported the night before that Meadows’ wife had sent a mass email to Republicans in North Carolina, urging them to call the White House and Congress to oppose what she derisively dubbed “Ryancare.”
Price’s outreach seems to have engendered goodwill. Freedom Caucus leaders declined an invitation from Paul to engage in a high-profile act of political theater on Thursday to protest what conservatives see as a secretive process used to craft the GOP health care legislation. Paul wanted the group to join him in trying to barge through security into a Capitol meeting room where GOP leaders were rumored to have stashed the latest draft of the health care plan.
Some Freedom Caucus members insist that, as far as they know, the White House hasn’t endorsed Ryan’s bill. They say they’ve never been told by administration officials that Trump backs the proposal.
“There have been stories in the media that somehow the White House and Ryan’s office are in agreement on health care,” said Rep. Raul Labrador (R-Idaho), a Freedom Caucus member. “We have not heard that [Trump] backed it or he doesn’t.”
Other conservatives, however, believe the White House is moving in Ryan’s direction. In a brief interview outside the House chamber Wednesday evening, Walker said it’s clear from his meetings with senior administration officials that Ryan’s plan is “the way that they’re headed.”
Numerous sources told POLITICO that Price and other White House staff have defended the use of refundable tax credits — a big sore point for far-right members that are part of Ryan’s plan — during several meetings with conservatives.
Paul, one of the most vocal opponents of the House GOP plan, said he sparred with Price over the tax credits during a recent conversation.
“The only thing we have a disagreement on is refundable tax credits,” Paul said of his conversations with Price, though he also knocked Ryan’s proposal to pay for part of the replacement by curbing an employer deduction for health care. “We’re not real excited about a new tax on health insurance.”
With the Energy and Commerce Committee expected to take up the first portion of the GOP leadership bill next week, a path to the end of the first phase of the Obamacare fight — passing the bill in the House — is starting to emerge. The Senate, however, is another story.
The upper chamber is tensely divided over how to handle the Medicaid expansion under Obamacare; any rollback is bound to create winners and losers among states. Majority Leader Mitch McConnell of Kentucky told Ryan he needs the House bill within three weeks to move a measure through his own chamber before senators get bogged down in other issues.
The White House wasn’t always behind Ryan’s plan; the speaker had to sell it. Price’s involvement — which was delayed by his confirmation fight — has certainly helped.
Since early February, conservatives have been making their case to the White House that they should simply move a repeal bill and get to the details of replacement later. For weeks, White House officials did nothing to counter the conservative backlash: Two senior administration aides attended a February conservative retreat where Freedom Caucus leaders and Walker devised their plan to push for an immediate repeal vote.
Last week, conservatives decided to make a push against Ryan’s bill via a media blitz, an effort devised partly to try to get Trump’s attention.
Some conservatives are still hoping they can win a few changes. During his meeting with Price, Walker said he asked the secretary to consider tying tax credits to a person’s income level as well as a quicker end to Obamacare’s expansion of Medicaid. He also expressed concerns about the cost of the replacement package, as he worries it will cost the government just as much as Obamacare did.
Walker added that he hopes to get to yes.
“We want to get behind the House plan, but we just want to make sure, to quote Secretary Price, that these dials are turned in the right direction,” he said. “We want to make sure we’re not putting the middle class in a situation where they’re carrying the weight of this.”
By: Rachael Bade, Kyle Cheney and John Bresnahan