Even in red states, Republicans feel free to criticize Trump on his taxes and travel

Philip Rucker and Sen Sullivan, reporting in the Washington Post:

Oklahoma may be Trump country, but that did not prevent James Lankford (R), the state’s junior senator, from criticizing President Trump this week by saying he ought to “keep his promise” to release his tax returns.

Nor did Trump’s popularity in Iowa stop Sen. Joni Ernst (R) from telling her constituents there that she is perturbed by the president’s frequent jaunts to his Mar-a-Lago resort in Palm Beach, Fla.

“I do wish he would spend more time in Washington, D.C. That is what we have the White House for,” Ernst said at a town hall meeting Tuesday in Wall Lake, Iowa. She said she has not spoken to Trump about “the Florida issue,” but it “has been bothering not just me, but some other members of our caucus.”

As Republican lawmakers face questions from their constituents back home, some elected leaders have been willing to break with their party’s president. Although they generally support Trump’s agenda on such priorities as a tax overhaul and health care, these Republicans are criticizing the president over his continued refusal to make public his tax returns, as past presidents have, and his costly trips to Florida.

Some of those criticizing Trump are not moderates eager to establish political independence, but rather conservatives from red states who are popular with the voters who propelled Trump into office.

The ease with which a GOP favorite such as Ernst has separated from Trump — she has criticized his Florida travel and his defiance on taxes — underscores the weak grip the president and his political operation have on the Republican Party.

“It is hard to defend in today’s world not releasing your tax returns, and it’s hard to defend playing golf at a seven-star resort when it’s a busy time and people are anxious about problems being addressed,” said Ed Rogers, a GOP operative and lobbyist.

David Carney, a GOP strategist, said finding ways to break with Trump on issues such as tax returns and travel “is a smart strategy” — especially at a moment when Trump opponents are galvanized.

“Back in 2009 and 2010, if Democrats had not been drinking Kool-Aid, saying ‘Obama makes no mistakes,’ and actually called him out on a few things, they would have had a better chance to survive the onslaught in the midterm elections,” Carney said.

White House officials say that although they wish GOP lawmakers would be fully supportive of Trump, it matters more that they back him on policies.

“The president has been pretty clear about where he is on releasing his tax returns,” White House spokeswoman Sarah Huckabee Sanders said. “People knew that before they voted in November, and he still won overwhelmingly. The American people are a lot more concerned about their own taxes than President Trump’s, and that’s what he’s focused on.”

More here.

The number of Americans who think Trump keeps his promises is plummeting

Jenna McGregor, reporting for the Washington Post:

President Trump‘s setbacks on campaign promises such as repealing the Affordable Care Act and his shifting positions on other stances look like they’re catching up with him — bigly.

A new poll from Gallup released early Monday finds that a majority of Americans no longer view Trump as keeping his promises, with poll numbers on that question falling from 62 percent in February to 45 percent in early April, a stunning tumble of 17 percentage points. The drop was seen across every demographic group: women, men, millennials, baby boomers and people with political leanings of all kinds. While numbers sank the furthest among respondents who identified as a Democrat or liberal, independents who said they thought Trump kept his promises fell from 59 percent to 43 percent; even among Republicans, the numbers fell, from 92 percent to 81 percent.

The poll, which was taken between April 5 and April 9, showed that Trump’s ratings fell on all six presidential leadership characteristics that Gallup measures. The percentage who think he is a “strong and decisive leader” also took a big hit, falling from 59 percent to 52 percent. So did the share of people who think he can “bring about changes this country needs,” which fell seven percentage points, too, to 46 percent. Just 36 percent see him as “honest and trustworthy,” compared with 42 percent in February.

On two other measures, whether Trump “cares about the needs of people like you” and “can manage the government effectively,” the president’s numbers also fell, although Gallup noted those declines were not statistically significant.

The ratings dive was most stark when it came to women who think Trump keeps his promises — just 40 percent now say he does, compared with 65 percent in February, a striking 25 percentage-point plunge. In a write-up of the results, Gallup explained that the numbers came after Trump’s defeat over repealing the Affordable Care Act, as supporters have become unhappy he hasn’t done more on taxes and immigration while detractors are upset he hasn’t protected middle- and working-class Americans.

What may be most remarkable is that the poll was performed before Trump dramatically flipped his positions on multiple other stances in the days that followed, as The Post’s Fact Checker column recounted last week. After saying he’d move on to tax reform after the GOP‘s stinging defeat on its health-care bill, Trump said in a Fox Business Network interview on April 11 that he would “do health care first.” And in an interview with the Wall Street Journal, he said guidelines on rewriting the tax code would come only after a new health-care bill passes, although his budget director later said the two were “on parallel tracks.”

* * *

“Strong and decisive leadership” is the only characteristic in the Gallup survey for which a majority of U.S. adults (52 percent) still give Trump positive grades. But even that majority is slim, dropping seven percentage points from February. It followed other polls that have shown a similar trend. For the past three weeks, the Economist/YouGov poll has found that just 50 or 51 percent of U.S. adults said Trump was either a “very strong” or “somewhat strong” leader in a question about leadership qualities, down from 61 percent in the results after his inauguration.

That attribute — a leadership style that’s “strong and decisive” — was said to be extremely important to voters in at least one poll after the last election. A Morning Consult/Politico exit poll from November showed that voters said being a strong leader was the most important characteristic they used when choosing a president, with 36 percent saying it mattered most, compared with just 18 percent who said the same in 2012.

More here.

Sorry, Republicans, but most people support single-payer health care

Catherine Rampell, reporting for the Washington Post:

Despite the rise of the tea party and unified Republican control of government, one decidedly anti-free-market idea appears ascendant: single-payer health care.

And it’s no wonder, given that a record-high share of the population receives government-provided health insurance. As a country, we’ve long since acquiesced to the idea that Uncle Sam should give insurance to the elderly, veterans, people with disabilities, poor adults, poor kids, pregnant women and the lower middle class.

Many Americans are asking: Why not the rest of us, too?

A recent survey from the Economist/YouGov found that a majority of Americans support “expanding Medicare to provide health insurance to every American.” Similarly, a poll from Morning Consult/Politico showed that a plurality of voters support “a single payer health care system, where all Americans would get their health insurance from one government plan.”

Divining the longer-term trend in attitudes toward this idea is difficult, as the way survey questions on the topic are asked has changed over time. Views of a health-care system in which all Americans get their insurance from the government single payer vary a lot depending on how you frame the question. Calling it “Medicare for all,” for example, generally elicits much stronger approval, while emphasizing the word “government” tends to depress support.

But at the very least, some survey questions that have remained consistent in recent years show support has been rising back up over the past few years for the broader idea that the federal government bears responsibility for making sure all Americans have health-care coverage.

In a way, stronger public support for single payer is the logical conclusion of recent health-insurance trends.

Since 1987, the share of Americans who receive some sort of public insurance has roughly doubled, to about 4 in 10 as of 2015. That’s not even counting the people who receive subsidies to buy private insurance on the Affordable Care Act exchanges.

The increase in the share of Americans on government insurance is partly due to demographics (baby boomers aging into Medicare) and partly due to deliberate policy changes growing the pool of Americans eligible for government insurance (such as the creation of the Children’s Health Insurance Program and Obamacare’s Medicaid expansion).

Expansions of government coverage have been cheered on by many liberals, but they have also bred suspicion and jealousy.

In both the recent YouGov and Morning Consult polls, for example, the age group most opposed to single payer was the only one that basically already has it: those 65 and up. In other words, single payer for me but not for thee.

That’s not because older Americans hate their experience with Medicare and wouldn’t wish something similar upon their worst enemy. To the contrary, those on Medicare are more satisfied with how the health-care system works for them than people on private insurance are, according to Gallup survey data.

Rather, seniors are probably worried that expanding government coverage to more Americans could put their own generous benefits at risk. That is, they want single-payer enthusiasts to keep your government hands off their Medicare.

Many of those not among the growing pool of public-insurance beneficiaries, on the other hand, have become resentful of the fact that everyone else seems to be getting a big fat government handout. Or so they perceive.

Many of the stories in the booming “blue-state reporter ventures into Trump country” genre have featured Trump supporters with deep hostility toward Obamacare, among other government programs. Some of these Trump supporters are, perhaps puzzlingly, themselves Obamacare beneficiaries, receiving government subsidies for private insurance on the individual exchanges. But often what these Trump voters say they want is not a return to pre-Obamacare days; rather, they want in on the great insurance deal that they think their lazy, less-deserving neighbors are getting.

In fact, that recent YouGov poll found that 40 percent of Trump voters support expanding Medicare to all Americans. Among Republicans overall, the share rises to 46 percent.

More here.

No ‘Death Spiral’: Insurers May Soon Profit From Obamacare Plans, Analysis Finds

Reed Abelson, reporting for the New York Times:

In contrast to the dire pronouncements from President Trump and other Republicans, the demise of the individual insurance market seems greatly exaggerated, according to a new financial analysis released Friday.

The analysis, by Standard & Poor’s, looked at the performance of many Blue Cross plans in nearly three dozen states since President Barack Obama’s health care law took effect three years ago. It shows the insurers significantly reduced their losses last year, are likely to break even this year and that most could profit — albeit some in the single-digits — in 2018. The insurers cover more than five million people in the individual market.

After years in which many insurers lost money, then lost even more in 2015, “we are seeing the first signs in 2016 that this market could be manageable for most health insurers,” the Standard & Poor’s analysts said. The “market is not in a ‘death spiral,’ ” they said.

It is the latest evidence that the existing law has not crippled the market where individuals can buy health coverage, although several insurers have pulled out of some markets, including two in Iowa just this week. They and other industry specialists have cited the uncertainty surrounding the Congressional debate over the law, and the failed effort two weeks ago by House Republicans to bring a bill to the floor for a vote.

The House G.O.P. leadership went home for a two-week recess on Thursday, unable to reach a compromise between conservative and moderate members over the extent of coverage that should be required for the very sick.

If the markets were to falter without a resolution in Congress, the risk of eroding public opinion before the midterm elections next year is bound to increase. The latest monthly Kaiser Health Tracking Poll by the Kaiser Family Foundation showed that more than half of Americans now believe that the president and Republicans own the health care issue and may shoulder the blame for any failings. The survey reported that more than half now support the Obama health care law.

The S.&P. report also buttresses the analysis of the Republican bill by the Congressional Budget Office, which said the markets were relatively stable under the current law, contradicting some Republican assessments of volatility.

“Things are getting better,” Gary Claxton, a vice president at the Kaiser Family Foundation, said of the insurance markets. The foundation has been closely tracking the insurers’ progress.

Although it took longer than expected, the insurers appear to be starting to understand how the new individual market works, said Deep Banerjee, an S.&P. credit analyst who helped write the report. The companies have aggressively increased their prices, so they are now largely covering their medical costs, Mr. Banerjee said. They have also significantly narrowed their networks to include fewer doctors and hospitals as a way to lower those costs.

In 2016, the number of companies whose medical costs exceeded their premiums fell by half, to nine of the 32 Blue Cross companies included in the S.&P. analysis. The improvement signaled the potential for profit margins to increase. A few plans, notably Florida Blue, are already profitable. The report released on Friday did not include Anthem’s for-profit Blue Cross plans, which span 14 states.

Mr. Banerjee warned that the market is still fragile, and he said insurers needed more time to figure out how to make the business work. While the market is very much alive, he said, it is “still in critical care. It still needs time to improve.”

Much more here.

Affordable Care Act Gains Majority Approval for First Time

Via Gallup:

Fifty-five percent of Americans now support the Affordable Care Act (ACA), a major turnaround from five months ago when 42% approved and 53% disapproved. This is the first time a majority of Americans have approved of the healthcare law, also known as Obamacare, since Gallup first asked about it in this format in November 2012.

Since the ACA’s passage without a single Republican vote in its favor, the law has been a significant political issue in each of the past four national elections. Republicans’ opposition to the ACA helped them win control of the House in 2010, control of the Senate in 2014 and the presidency last year. However, Republicans’ plan to repeal and replace the healthcare law foundered last month, as House leaders’ replacement bill ran into stiff opposition within the party.

Republicans, Democrats and independents are all more likely to approve of the ACA now than in November, a few days after Donald Trump’s victory in the presidential election left Republicans in control of the legislative and executive branches. Independents have led the way in this shift toward approval, increasing by 17 percentage points compared with 10-point changes for both Republicans and Democrats. When including “leaners” (independents who lean toward either the Republican or Democratic Party) in the totals for both major party groups, Democratic approval has increased by 16 points, compared with eight points for Republicans.

More here.

Democrats have a new and surprising weapon on Capitol Hill: Power

Kelsey Snell, reporting for the Washington Post:

Democrats in Congress have a new and surprising tool at their disposal in the era of one-party Republican rule in President Trump’s Washington: power.

It turns out that Republicans need the minority party to help them avoid a government shutdown at the end of April, when the current spending deal to fund the government expires. And Democrats have decided, for now at least, that they will use their leverage to reassert themselves and ensure the continued funding of their top priorities — by negotiating with Republicans.

“I think we have a lot of leverage here,” said Sen. Chris Van Hollen (D-Md.). Republicans “are going to need our help putting together the budget, and that help means we can avoid some of the outrageous Trump proposals and advance some of our own proposals.”

The fact that Republicans need Democrats to vote for a temporary spending measure to avoid a shutdown gives Democrats leverage to force the GOP to abandon plans to attack funding for environmental programs and Planned Parenthood. And it also allows Democrats to block Trump’s top priority — the wall along the U.S.-Mexico border — which the president seeks to factor in to this latest round of budget negotiations.

It comes at a time when Republicans on Capitol Hill are badly divided and President Trump’s ambitious agenda — a health-care overhaul, his 2018 budget blueprint, a tax proposal and an infrastructure program — has yet to get off the ground.

Since the failure of the House GOP’s health-care plan, Trump has signaled he may work with Democrats to achieve major goals. Coupled with the negotiations over the spending measure, such a statement could foreshadow a major and unexpected power shift in Washington in which the minority party has far more influence in upcoming legislative fights than was initially expected.

“I think most of our caucus wants to work with them,” said Senate Minority Leader Charles E. Schumer (D-N.Y.) in a recent interview, referring to the GOP. “But it requires working in a compromise way.”

But cooperation with their GOP counterparts — and possibly even with Trump — is a risky move for congressional Democrats, who are being pressured by the more liberal wing of their party to obstruct the GOP and Trump at all costs. Part of that energy is playing out in the Senate over the nomination of Judge Neil Gorsuch to the Supreme Court, as Democrats have vowed to block his confirmation, potentially leading to an explosive fight next week to change Senate rules.

Hill Democrats are betting voters will view any attempt to compromise on spending as further evidence that the fractured GOP is unable to govern. If the talks fail and a shutdown approaches, voters might then blame Republicans for failing to keep the government open despite their control of the House, Senate and White House, several Democratic aides reasoned.

There is a sense among many Democrats that bipartisanship isn’t necessarily toxic, even in an environment in which ardent liberals continue to protest at town hall meetings. House Minority Leader Nancy Pelosi (D-Calif.) and other Democrats think voters see Democrats taking steps to defend existing policies — such as battling the American Health Care Act or blocking funding for a border wall — and understand the big picture.

More here.

GOP Lawmakers Now Admit Years of Obamacare Repeal Votes Were a Sham

Lee Fang, writing for The Intercept:

IT IS HARD to overestimate the role of the Affordable Care Act in the Republican resurgence.

Over the last seven years, the GOP has won successive elections by highlighting problems with Obamacare, airing more than $235 million in negative ads slamming the law, and staging more than 50 high-profile repeal votes. In 2016 every major Republican presidential candidate, including Donald Trumpcampaigned on a pledge to quickly get rid of it.

Now in total control of Congress and the White House, some GOP legislators are saying that the political assault on Obamacare was an exercise in cynical politics, and that an outright repeal was never on the table.

“We have Republicans who do not want to repeal Obamacare,” said Rep. Mo Brooks, R-Ala., on Sirius XM Patriot on Wednesday.

“They may have campaigned that way, they may have voted that way a couple of years ago when it didn’t make any difference,” Brooks continued. “But now that it makes a difference, there seems to not be the majority support that we need to pass legislation that we passed 50 or 60 times over five or six years.”

* * *

Likewise, Rep. Pat Meehan, R-Pa., one of the lawmakers who came into power by riding the anti-ACA Tea Party wave in 2010, and who once elected pledged to “repeal, defund, delay, and dismantle Obamacare,” recently conceded in a candid interview with the Delaware County Daily Times that previous repeal efforts were a sham.

Asked if the years of votes against the ACA were simply “ceremonial,” since Republicans knew that any serious repeal bill would be vetoed by President Barack Obama, Meehan responded “yes.”

“I don’t think anyone would quarrel with the idea that they were largely position votes,” Meehan continued. “They were as political as they were anything else because there was a recognition that those were unlikely to be moved.”

Republicans expected Hillary Clinton to win the election last year, and had not planned for being in a position to actually pass a repeal effort this year, said Meehan. But after Trump’s victory, the GOP leadership thought something had to be done on their campaign promises, and that’s why they attempted to move forward with the American Health Care Act.

More here.

A new dynamic may be emerging in the House: A right and left flank within the GOP willing to buck leadership

Paul Kane, reporting for the Washington Post:

President Trump and House Speaker Paul D. Ryan made it a binary choice: You’re either for their health-care legislation or you’re for “Obamacare.”

From Reps. Trent Franks (R-Ariz.) to Rodney Frelinghuysen (R-N.J.), spanning the party’s ideological spectrum, the answer came back Friday: No, it’s much more complex. It was filled with several different options and possible routes ahead, and dozens of Republicans agreed with their sentiment.

That left Republicans well short of the votes they needed to fulfill a seven-year promise to destroy the 2010 Affordable Care Act once they were fully in charge, delivering a stinging defeat to both Ryan and Trump.

It also suggested a new dynamic in which both the right and left flanks of the Republican conference are emboldened to challenge leadership. And that could make each future negotiation more difficult as the issue matrix gets more complicated and the pockets of internal GOP resistance continue to grow, not shrink, in the new era of Trump’s Republican-controlled Washington.

Some parts of these botched negotiations looked a lot like the recent past. Franks and his House Freedom Caucus cronies played the role of obstructionists who will buck party leaders no matter if it’s John A. Boehner, Ryan’s predecessor, or now Trump, as well. These ideologues gobbled up tons of attention, resulting in much care from Trump, Vice President Pence and top West Wing advisers.

By lunchtime Friday, Franks still would not commit to publicly supporting the bill — even though he admitted it was far better than current law. “Of course it is, yeah, it’s a lot better than Obamacare, of course it is. There’s not even any comparison,” Franks said a few hours before the legislation went down in flames.

Franks remained upset that conservative proposals were left out of the bill because they would have violated Senate budget rules, meaning that the proposal to replace the ACA was nowhere near to his liking.

“That still is like putting dirt in ice cream,” he said.

Other parts of the negotiation, however, were new and quite different from the previous six years of Republican control of the House. Nothing capped this off more than the stunning announcement Friday morning from Frelinghuysen, just three months into his hold on the coveted Appropriations Committee gavel, that bucked leadership.

“Unfortunately, the legislation before the House today is currently unacceptable as it would place significant new costs and barriers to care on my constituents,” he said in a statement.

A 22-year veteran whose family traces its establishment lineage to the Continental Congress, Frelinghuysen won his chairmanship uncontested with the blessing of Ryan and the leadership team. He’s not someone who rocks the boat — he supported impeachment articles against President Bill Clinton — but his pronouncement Friday sent a jolt through the Capitol.

He also joined a long list of influential centrists who rejected the proposal on policy grounds, not out of fear politically. Frelinghuysen has received more than 60 percent of the vote in all but one election.

If anyone should back Ryan — he’s a new committee chairman, he’s safe back home — it would have been Frelinghuysen. Instead, he sent a message to a few dozen other Republicans who have more troubling districts that they, too, should break from the president and the speaker.

More here.

Donald, This I Will Tell You

Maureen Dowd, writing in the New York Times:

Dear Donald,

We’ve known each other a long time, so I think I can be blunt.

You know how you said at campaign rallies that you did not like being identified as a politician?

Don’t worry. No one will ever mistake you for a politician.

After this past week, they won’t even mistake you for a top-notch negotiator.

I was born here. The first image in my memory bank is the Capitol, all lit up at night. And my primary observation about Washington is this: Unless you’re careful, you end up turning into what you started out scorning.

And you, Donald, are getting a reputation as a sucker. And worse, a sucker who is a tool of the D.C. establishment.

Your whole campaign was mocking your rivals and the D.C. elite, jawing about how Americans had turned into losers, with our bad deals and open borders and the Obamacare “disaster.”

And you were going to fly in on your gilded plane and fix all that in a snap.

You mused that a good role model would be Ronald Reagan. As you saw it, Reagan was a big, good-looking guy with a famous pompadour; he had also been a Democrat and an entertainer. But Reagan had one key quality that you don’t have: He knew what he didn’t know.

You both resembled Macy’s Thanksgiving Day balloons, floating above the nitty-gritty and focusing on a few big thoughts. But President Reagan was confident enough to accept that he needed experts below, deftly maneuvering the strings.

You’re just careering around on your own, crashing into buildings and losing altitude, growling at the cameras and spewing nasty conspiracy theories, instead of offering a sunny smile, bipartisanship, optimism and professionalism.

You promised to get the best people around you in the White House, the best of the best. In fact, “best” is one of your favorite words.

Instead, you dragged that motley skeleton crew into the White House and let them create a feuding, leaking, belligerent, conspiratorial, sycophantic atmosphere. Instead of a smooth, classy operator like James Baker, you have a Manichaean anarchist in Steve Bannon.

You knew the Republicans were full of hot air. They haven’t had to pass anything in a long time, and they have no aptitude for governing. To paraphrase an old Barney Frank line, asking the Republicans to govern is like asking Frank to judge the Miss America contest — “If your heart’s not in it, you don’t do a very good job.”

You knew that Paul Ryan’s vaunted reputation as a policy wonk was fake news. Republicans have been running on repealing and replacing Obamacare for years and they never even bothered to come up with a valid alternative.

And neither did you, despite all your promises to replace Obamacare with “something terrific” because you wanted everyone to be covered.

Instead, you sold the D.O.A. bill the Irish undertaker gave you as though it were a luxury condo, ignoring the fact that it was a cruel flimflam, a huge tax cut for the rich disguised as a health care bill. You were so concerned with the “win” that you forgot your “forgotten” Americans, the older, poorer people in rural areas who would be hurt by the bill.

As The Times’s chief Washington correspondent Carl Hulse put it, the G.O.P. falls into clover with a lock on the White House and both houses of Congress, and what’s the first thing it does? Slip on a banana peel. Incompetence Inc.

“They tried to sweeten the deal at the end by offering a more expensive bill with fewer health benefits, but alas, it wasn’t enough!” former Obama speechwriter Jon Favreau slyly tweeted.

Despite the best efforts of Bannon to act as though the whole fiasco was a clever way to bury Ryan — a man he disdains as “the embodiment of the ‘globalist-corporatist’ Republican elite,” as Gabriel Sherman put it in New York magazine — it won’t work.

And you can jump on the phone with The Times’s Maggie Haberman and The Washington Post’s Robert Costa — ignoring that you’ve labeled them the “fake media” — and act like you’re in control. You can say that people should have waited for “Phase 2” and “Phase 3” — whatever they would have been — and that Obamacare is going to explode and that the Democrats are going to get the blame. But it doesn’t work that way. You own it now.

More here.

Republicans Land a Punch on Health Care, to Their Own Face

Jennifer Steinhauer, reporting for the New York Times:

At the end of the long day, the alliance of conservative ideologues who once shut down the government over President Barack Obama’s health care law could not find the will to repeal it.

Since the Tea Party wave of 2010 that swept House Republicans into power, a raucous, intransigent and loosely aligned group of lawmakers known as the Freedom Caucus — most from heavily Republican districts — has often landed a punch to its own party’s face.

Friday’s defeat of the Republican leadership’s bill to repeal the Affordable Care Act was a return to form, handing an immense defeat to President Trump and embarrassing Speaker Paul D. Ryan in his own House. It also challenged the veracity of their long-held claims that a Republican president was all they needed to get big things accomplished.

The most important question for Republicans now is whether the members of the Freedom Caucus will find themselves newly emboldened in ways that may bring the new president more defeats — or whether Mr. Ryan will do what former Speaker John A. Boehner could not, and find a way to shred their influence for good.

“If you are defined by your opposition to leadership, it’s hard to be part of a governing coalition,” said Alex Conant, a onetime aide to Senator Marco Rubio, the Florida Republican who was once a Tea Party star. “Their opposition to Trump’s health care bill should surprise nobody who’s paid attention for the last six years. Even the world’s best negotiator can’t make a deal with someone who never compromises.”

But the Freedom Caucus has never been about compromise. In 2011, it picked a huge, costly fight over Planned Parenthood. In 2013, it orchestrated a government shutdown over funding for the health care law. Then, in its most striking move, it deposed Mr. Boehner in 2015. The common thread: It has continuously been an adversary of legislation itself.

But after years of opposing power — both in the White House, which was occupied by a Democrat, and in the leadership of their own party — the conservatives were offered a chance to negotiate directly with the president and his budget director, a former Freedom Caucus member, over the bill to replace the Affordable Care Act. The members pushed and pushed Mr. Trump to the far right edges of policy, just as they have done for years on other bills. But they still could not get to “yes,” and therefore became part owners of the expansive health law they were trying to undo.

“They made the perfect the enemy of the good,” said Representative Roger Marshall, Republican of Kansas. “I don’t know how they can go back home and tell people they voted to keep Obamacare, voted to keep funding Planned Parenthood.”

Indeed, members of the Freedom Caucus — which is supported by outside conservative groups — have often claimed the mantle of pure conservatism, but their tactics have been seen by many in their party as uniformly counterproductive.

Time after time, they undermined Republican leaders’ efforts to secure wins for the conservative cause by overreaching and demanding the impossible.

They have anointed Representative Mark Meadows of North Carolina as their leader and principal spokesman. But they occasionally get help from three senators sympathetic to their cause: Ted Cruz of Texas, Rand Paul of Kentucky and Mike Lee of Utah.

At critical times, House conservatives have forced their party to make deals with Representative Nancy Pelosi of California, the Democratic leader — an idea anathema to most Republicans, who would seethe.

This time, by negotiating with Mr. Trump on the complex issue of health care, a measure whose complexity he did not seem to fully grasp, they moved an already contentious bill further and further to the right, eliminating too many benefits to keep moderate and other conservative members on board. Even Mr. Trump was said to be taken aback by their attempts to remove things Republicans have long promised to keep, like health insurance benefits for children up to 26 years old.

More here.

Trump’s First Legislative Effort Fails as G.O.P. Pulls Bill to Repeal Obamacare

Via The New York Times:

House Republican leaders, facing a revolt among conservatives and moderates in their ranks, pulled legislation to repeal the Affordable Care Act from consideration on the House floor Friday afternoon in a humiliating defeat for President Trump on the first legislative showdown of his presidency.

Paul D. Ryan, the House speaker, rushed to the White House shortly after noon to tell Mr. Trump he did not have the votes for a repeal bill that had been promised for seven years — since the day President Barack Obama signed his landmark health care act into law.

Mr. Trump, in a telephone interview moments after the bill was pulled, blamed Democrats and predicted that they would seek a deal within a year after, he asserted, “Obamacare explodes” because of higher premiums. The president said he did not fault Mr. Ryan and said that he was pleased to move past his first legislative fight. He maintained that he was merely going along with the House bill.

But the effort to win passage was hardly kept secret. Vice President Mike Pence and Tom Price, the health secretary, rushed to Capitol Hill for a late appeal to House conservatives, but their pleas fell on deaf ears.

“You can’t pretend and say this is a win for us,” said Representative Mark Walker, Republican of North Carolina, who conceded it was a “good moment” for Democrats.

“Probably that champagne that wasn’t popped back in November may be utilized this evening,” he said.

At 3:30 p.m., Mr. Ryan called Republicans into a closed-door meeting to deliver the news that the bill would be pulled, with no plans to try again. The meeting lasted five minutes.

“We’re going to go home and spend time with our families and time with our constituents, and one day I hope we can eventually repeal,” said Representative Chuck Fleischmann, Republican of Tennessee.

The Republican bill would have replaced the Affordable Care Act, known informally as Obamacare, which mandated that almost everyone have health insurance, with a system of age-based tax credits to purchase health insurance plans.

But it never won over conservatives who wanted a far more thorough eradication of the Affordable Care Act. Nor did it have the backing of more moderate Republicans who were anxiously aware of the Congressional Budget Office’s assessment that the bill would leave 24 million more Americans without insurance.

With the House’s most hard-line conservatives holding fast against it, the bill’s support collapsed Friday after more rank-and-file Republicans came out in opposition, including Representatives Rodney Frelinghuysen of New Jersey, the soft-spoken chairman of the House Appropriations Committee, and Barbara Comstock of Virginia, whose suburban Washington district went handily for the Democrat nominee, Hillary Clinton, in November.

“Seven years after enactment of Obamacare, I wanted to support legislation that made positive changes to rescue health care in America,” Mr. Frelinghuysen wrote in a statement. “Unfortunately, the legislation before the House today is currently unacceptable as it would place significant new costs and barriers to care on my constituents in New Jersey.”

In the end, Republican leaders doomed the bill by agreeing to eliminate federal standards for the minimum benefits that must be provided by certain health insurance policies.

“This provision is so cartoonishly malicious that I can picture someone twirling their mustache as they drafted it in their secret capitol lair last night,” said Representative Jim McGovern, Democrat of Massachusetts. “This backroom deal will kill the requirement for insurance companies to offer essential health benefits such as emergency services, maternity care, mental health care, substance addiction treatment, pediatric services, prescription drugs and many other basic essential services.”

Defeat of the bill could be a catalyst if it forces Republicans and Democrats to work together to improve the Affordable Care Act, which virtually every member of Congress believes needs repair. Democrats have been saying for weeks that they want to work with Republicans on such changes, but first, they said, Republicans had to abandon their drive to repeal the law.

Much more here.

‘We just pulled it,’ Trump says of health bill

Via The Washington Post:

House Republican leaders abruptly pulled a Republican rewrite of the nation’s health-care system from consideration on Friday, a dramatic acknowledgment that they are so far unable to repeal the Affordable Care Act.

“We just pulled it,” President Trump told the Washington Post in a telephone interview.

The decision came a day after Trump delivered an ultimatum to lawmakers — and represented multiple failures for the new president and House Speaker Paul D. Ryan (R-Wis.).

The decision means the Affordable Care Act remains in place, at least for now, and a major GOP campaign promise goes unfulfilled. It also casts doubt on the GOP’s ability to govern and to advance other high-stakes agenda items, including tax reform and infrastructure spending. Ryan is still without a signature achievement as speaker — and the defeat undermines Trump’s image as a skilled dealmaker willing to strike compromises to push his agenda forward.

“I don’t blame Paul,” Trump said, referring to Ryan.

Rep. Bradley Byrne (R-Ala.), who planned to vote for the legislation, said that Friday would have been the “first big vote in the presidency of Donald Trump. I think it’s a statement, not just about him and the administration, but about the Republican Party and where we’re headed.”

“So much about political power is about perception. And if the perception is that you can’t get your first big initiative done, then that hurts the perceptions down the road about your ability to get other big things done,” Byrne said in an interview before the decision.

The decision came hours after Ryan visited the White House to warn Trump that despite days of intense negotiations and sales pitches to skeptical members, the legislation lacked the votes to pass.

Trump had personally lobbied 120 lawmakers, either in person or on the phone, White House press secretary Sean Spicer reminded reporters on Friday. The president had “left everything on the field,” Spicer said.

Spicer said that no matter what happens, the White House did not think that defeat would slow other parts of Trump’s agenda including tax reform and immigration reform.

Vice President Pence, White House Chief of Staff Reince Priebus and Health and Human Services Secretary Tom Price also made a last-ditch attempt to win over members of the hard-line House Freedom Caucus, huddling with them at midday at the Capitol Hill Club, a GOP social hall next door to the headquarters of the Republican National Committee. All three exited the meeting quickly without taking questions.

In one stunning defection Friday, House Appropriations Committee Chairman Rodney Frelinghuysen (R-N.J.) announced at midday that the health care bill is “currently unacceptable” and that changes made late Thursday to placate conservatives “raise serious coverage and cost issues.”

Another moderate, Rep. David Joyce (R-Ohio) — who had met with Trump on Wednesday night — said he would vote against the bill. So did Rep. Barbara Comstock (R-Va.), a longtime Ryan friend and ally who represents a competitive Northern Virginia congressional district.

Rep. Paul Gosar (R-Ariz.), a Freedom Caucus member, was one of six Republicans who voted against a procedural resolution bringing the bill to the floor on Friday morning.

“You know what? I came here to do health care right,” said Gosar, a dentist. “This is one chance we that can get one-sixth of our GDP done right. It starts with here.”

At the heart of the argument made by GOP leaders to skeptical members: Keeping the Affordable Care Act is a worse outcome than passing a potentially flawed replacement.

“You want to score a touchdown, but sometimes, on the fourth down, you kick a field goal,” said Rep. Joe Barton (R-Tex.), the longest-serving member of Congress in the Freedom Caucus. “The choice is yes or no. I’m not going to vote no and keep Obamacare. That’d be a stupid damn vote.”

At the White House on Friday morning, Trump projected confidence as he answered shouted questions following an announcement of a presidential permit for the Keystone XL pipeline, a revived project that the president said would create jobs.

Asked by a reporter what he would do if the bill fails, Trump — seated at his Oval Office desk — shrugged and said: “We’ll see what happens.”

Trump also said he didn’t feel the process had been rushed and that Ryan should remain as speaker if the bill fails.

On Twitter, Trump said that “After seven horrible years of ObamaCare (skyrocketing premiums & deductibles, bad healthcare), this is finally your chance for a great plan!”

With 237 House Republicans, party leaders can afford only 21 or 22 defections, depending on how many Democrats are present on Friday. If the measure fails, it would be a defeat for Trump in his first effort to help pass major legislation. An unsuccessful vote could also jeopardize other items on his wish list, including a tax overhaul and infrastructure spending.

No matter what happens in the House, the ultimate fate of the legislation hinges on the Senate, where new uncertainty emerged about the timing of a vote despite earlier guidance that Senate Majority Leader Mitch McConnell (R-Ky.) planned to push for a vote next week.

The Congressional Budget Office warned senators on Friday that recalculating the rewritten House bill could take a week or more to produce, said several officials familiar with the discussions, who were not authorized to speak publicly about the matter.

That was expected to upend McConnell’s plan to finish their work and send the legislation to the White House for Trump’s signature before a two-week Easter recess, according to three people briefed on the matter.

Senate budget rules require that party leaders provide an official estimate of how much the legislation would cost and how it would change the deficit before scheduling a vote.

McConnell’s aides didn’t immediately return requests for comment.

Republicans have a 52-to-48 advantage in the Senate, but at least a dozen Republicans are on the fence about the legislation, because many of them want to maintain some of the current law’s more generous spending components.

When formal debate on the bill began on Friday morning, top leaders used a procedural vote to gauge last-minute support. House Majority Whip Steve Scalise (R-La.) was seen conferring with Rep. Christopher Smith (R-N.J.), a key holdout. House Ways and Means Committee Chairman Kevin Brady (R-Tex.) sat in the row behind them cajoling Rep. Patrick Meehan (R-Pa.), another moderate who has yet to announce what he plans to do.

Rep. Mark Meadows (R-N.C.), who chairs the Freedom Caucus, did not respond to requests for comment on Friday about his plans.

Rep. Ken Buck (R-Colo), a caucus member who said before the election that minor losses in the House Republican ranks would increase conservative clout, said he remained undecided.

“I’m examining life experiences,” he said. Asked to explain what he meant, he said he was joking.

Rep. Peter King (R-N.Y.), a moderate who had expressed qualms as recently as Tuesday, when he was singled out by Trump inside a private meeting of House Republicans, said he had all but decided to vote for the bill.

“I’m not one they should worry about,” he said.

More here.

A postponed health-care vote, a big GOP embarrassment and no good options ahead

Dan Balz, reporting for the Washington Post:

Thursday was supposed to be a glorious anniversary for President Trump and the Republicans. Seven years after President Barack Obama signed the Affordable Care Act, Republicans were poised to take the first concrete step toward repealing and replacing that law. Instead, Thursday produced an embarrassing setback that left the way forward far from certain.

Legislative sausage-making is never pretty, but what has been happening all week with the signature legislative priority of the GOP seems beyond the norms. Faced with possible defeat on the floor, House Republican leaders postponed a scheduled vote until Friday, hoping that another day of negotiations could produce what seven years of talking have failed to produce, which is a consensus bill that all factions of the party can support.

The difficulties Republicans are confronting are entirely of their own making. For seven years, Republican politicians have made one overriding bargain with their conservative constituency, which was that they would repeal Obamacare as their first order of business if they ever had the power to do so. Now that they have the power, they still haven’t found a way to make good on that promise.

The other reality that has become clearer as Republicans have struggled to turn a campaign promise into a satisfactory piece of legislation is that, even if they eventually put a bill on Trump’s desk, they still could be buying themselves political problems in the months and years ahead. That is perhaps a second-order problem right now, given the goal of getting something through the House. But as Obama and the Democrats learned, changing the health-care system is fraught, no matter which direction the changes go.

Failure to live up to the pledge to, at the very least, significantly scale back Obamacare is obviously the worst of all possible outcomes. Such a defeat would put the lie to the claim that the Republicans, now with full control of the executive and legislative branches, were ready to govern as a conservative party. Failure also would undermine the idea of the president as the dealmaker in chief, for he has thrown himself into the battle with notable energy and determination, putting his own prestige on the line.

Republicans have postponed votes on critical legislation before, bedeviled by opposition from the hardcore conservative faction. They’ve overcome those setbacks and could do so with health care. The president and Republican leaders are far from conceding defeat and will redouble efforts to cobble together the necessary votes in the House.

But at a minimum, Trump’s reputation as the closer in chief has taken a hit — and on the first big test of his presidency. The greater damage has been to the reputation of House Speaker Paul D. Ryan (R-Wis.) as the savvy intellectual godfather of a new conservative agenda around which his party could rally. This legislation, if eventually passed, may come to be known as Trumpcare, but for now it can more fairly be called Ryancare.

More here.

Healthcare quote of the day

I don’t know whether [Trump] will ultimately succeed or fail [on healthcare], but I will tell you that President Trump is so transactional, who knows what transactions he will be willing to make to pass this.

So far he’s acting like a rookie. It’s really been amateur hour. He seems to think that a charm offensive or a threat will work — that saying “I can do this for you” or “I can do this against you” will work. That’s not the way it works. You have to build real consensus, and you have to gain a real knowledge of the policy — and the president hasn’t done either of those things.

Nancy Pelosi, quoted in the New York Times.

As Trump takes ownership of GOP health bill, support for it drops

Greg Sargent, reporting for the Washington Post:

THE MORNING PLUM:

The fate of the GOP health plan appears to hang in the balance, with GOP leaders still struggling to find the votes to pass it in the House. There is widespread disagreement both about the bill and its prospects for passage. But one thing appears to be widely agreed upon: President Trump has now “taken ownership” of this bill.

Yet Trump’s ownership of the GOP plan is not having the desired effect. It doesn’t appear to be moving many Republicans — indeed, GOP critics of it appear to be hardening in their opposition — and a new poll out this morning finds that support for it is dropping.

Trump’s ownership of the bill is being widely praised by some Republicans. “He’s all in,” gushed Sen. Roger Wicker (R-Miss.). “It was the right thing for the president to take ownership of it,” enthused Rep. Patrick McHenry (R-N.C.). Meanwhile, other Republicans report that Trump has made an aggressive pitch to them for the bill, arguing that they will face a voter backlash in 2018 if they don’t deliver on their promise to repeal and replace the Affordable Care Act.

But NBC News reports that House Republicans are moving away from the bill:

Yesterday morning, we wrote that 17 House Republicans opposed or leaned strongly against the GOP health-care plan that’s scheduled for a vote Thursday. Then President Trump visited Capitol Hill and appeared to threaten GOP lawmakers …

After that visit, the number of Republicans opposing or leaning strongly against the legislation grew to 27, per NBC News’ count — when Trump and GOP leaders can’t afford more than 21 defections.

As the NBC First Read crew observes, it’s “clear that Trump’s arm-twisting hasn’t paid dividends — at least not yet.”

Meanwhile, a new Politico/Morning Consult poll finds that support for the bill has dropped six points among American voters nationwide, and more voters approve of Obamacare than of the GOP replacement:

Since the Congressional Budget Office released its cost estimate of the Obamacare alternative last week, showing steep coverage losses, the legislation’s approval rating has dipped six points, from 46 percent to 40 percent. Obamacare’s approval rating, on the other hand, sits at 46 percent, as it did in February.

Meanwhile, disapproval of the GOP bill has ticked up two points, for a total net swing against the bill of eight points. What’s more, the new Morning Consult poll shows that only 1 in 5 voters thinks it will decrease their health-care costs, while a plurality of 39 percent think they will increase. And note this:

Fifty-three percent of voters said they were less likely to support the legislation when taking into account the CBO estimate that it would lead to 24 million fewer people having health insurance in the next decade. And 59 percent of voters, including almost half of Republicans (49 percent), said they were less likely to support the bill because the CBO projects it could increase average premiums by 15 to 20 percent in its first two years after becoming law.

Majorities tilt against the legislation when told it would result in millions without coverage and would drive up costs, as the Congressional Budget Office has concluded.

More here.