G.O.P. Senators, Pulling Away From Trump, Have ‘a Lot Less Fear of Him’

Jennifer Steinhauer, reporting for the New York Times:

Senate Republicans, increasingly unnerved by President Trump’s volatility and unpopularity, are starting to show signs of breaking away from him as they try to forge a more traditional Republican agenda and protect their political fortunes.

Several Republicans have openly questioned Mr. Trump’s decision to fire the F.B.I. director, James B. Comey, and even lawmakers who supported the move have complained privately that it was poorly timed and disruptive to their work. Many were dismayed when Mr. Trump seemed to then threaten Mr. Comey not to leak negative information about him.

As they pursue their own agenda, Republican senators are drafting a health care bill with little White House input, seeking to avoid the public relations pitfalls that befell the House as it passed its own deeply unpopular version. Republicans are also pushing back on the president’s impending budget request — including, notably, a provision that would nearly eliminate funding for the national drug control office amid an opioid epidemic. And many high-ranking Republicans have said they will not support any move by Mr. Trump to withdraw from the North American Free Trade Agreement.

So far, Republicans have refrained from bucking the president en masse, in part to avoid undermining their intense push to put health care and tax bills on his desk this year. And the Republican leadership, including Senator Mitch McConnell of Kentucky, the majority leader, and the House speaker, Paul D. Ryan of Wisconsin, remains behind Mr. Trump.

But with the White House lurching from crisis to crisis, the president is hampering Republicans’ efforts to fulfill his promises.

“All the work that goes into getting big things done is hard enough even in the most tranquil of environments in Washington,” said Kevin Madden, a Republican operative who worked for John A. Boehner when he was the House speaker. “But distractions like these can become a serious obstacle to aligning the interests of Congress.”

When Congress and the White House are controlled by the same party, lawmakers usually try to use the full weight of the presidency to achieve legislative priorities, through a clear and coordinated vision, patience with intransigent lawmakers and message repetition. Mr. Trump’s transient use of his bully pulpit for policy messaging has upended that playbook.

“It does seem like we have an upheaval, a crisis almost every day in Washington that changes the subject,” Senator Susan Collins, Republican of Maine, who has been trying to advance health care legislation, said in a television interview on Thursday night.

The latest subject-changing crisis has been the fallout from Mr. Trump’s sudden dismissal of Mr. Comey, who was leading the F.B.I.’s investigation into contacts between the Trump campaign and Russia. Mr. Trump suggested last week that he might have surreptitiously taped his conversations with Mr. Comey, and on Sunday two Republican senators, Mike Lee of Utah and Lindsey Graham of South Carolina, said the president should turn over any such tapes, if they exist.

* * *

In the days after Mr. Trump’s election victory, the mood was different, as Republicans expressed high hopes that they could move quickly on a conservative agenda that merged with Mr. Trump’s. “We’re going to be an enthusiastic supporter almost all the time,” Mr. McConnell said of Mr. Trump in November.

But Republicans have so far achieved few of their legislative priorities, like repealing the Affordable Care Act or cutting taxes. When Mr. Trump suggested this month that the Senate should change its rules to make it easier for Republicans to push bills through, Mr. McConnell firmly rejected the idea.

Lawmakers are also bucking the president by pushing ahead with bipartisan measures on sanctions against Russia. And this month, Republicans rejected many of the administration’s priorities in a short-term spending measure, including money for a wall along the border with Mexico.

Two Republican senators who face potentially tough re-election fights next year — Dean Heller of Nevada and Jeff Flake of Arizona — have been unabashed in their criticism of Mr. Trump and his administration, which they have clearly begun to view as a drag on their political prospects.

“In Arizona, we grow them independent,” Mr. Flake said, noting the unpopularity in his state of Mr. Trump’s views on the border wall and Nafta. “I expect people want someone who will say, ‘I’m voting with Trump on the good stuff and standing up to him on the not good stuff.’”

Some Republicans, like Mr. Ryan, have preferred to keep the focus firmly on the good stuff. Mr. Ryan has remained in harmony with the president, last month calling him “a driven, hands-on leader, with the potential to become a truly transformational American figure.”

Much more here.

Yes, House Republicans, the heartless health-care vote will define you

E.J. Dionne, Jr., writing in the Washington Post:

We should never forget May 4, 2017.

It should forever be marked as the day when the House of Representatives descended to a new level of cruelty, irresponsibility and social meanness.

The lower chamber has always claimed to be “the people’s house.” No more. It should now come to be known by other names: the house of selfishness, the house of suffering, the house of the wealthy, the house of expediency, the house of untreated illness. Perhaps also: the house of Trump.

The Anti-Health-Care Bill passed on Thursday bids to be the most remarkable redistribution of income in congressional history, from the poor and middle class to the very wealthy. An earlier version of the legislation, according to the Congressional Budget Office (CBO), would have thrown 24 million Americans off health insurance. This spiteful abomination is worse.

Republicans from Speaker Paul D. Ryan (Wis.) on down, who complained that insufficient study was given to Obamacare (despite more than a year of debate), rushed this bill through without scrutiny or a CBO score. They thought that having no numbers would make it easier for them to conceal the damage it would do to the American people — and get away with it. But their lies will be exposed.

They promised to improve Obamacare. Instead, they are bringing back the very problems that Obamacare actually fixed. One of the most popular provisions of the Affordable Care Act — supported by 87 percent of Americans in a March CNN/ORC poll — barred insurance companies from discriminating against those with preexisting conditions. This bill guts those protections.

Were you born with a heart defect? You’re out of luck. Did you have an illness in your teens that might come back? Tough. Other victims hidden in the fine print include kids in special ed programs, which could face severe cuts in Medicaid funding.

It gets worse. This bill would cut $880 billion over a decade from Medicaid, which provides health care to about 74 million Americans — the poor, the disabled, the elderly — and another $300 billion that now goes to helping those who cannot afford it buy health insurance. See why it’s the Anti-Health-Care Bill?

Then the Republicans turn right around and plow roughly $595 billion of this money into tax cuts, mostly for the very wealthy. And that’s the real point. The initiators of this bill don’t care a whit about what they do to the health-care system or how their bill will endanger the lives of many Americans, including those of a lot of their own supporters.

“Conservatism is something more than mere solicitude for tidy incomes,” Russell Kirk, one of the founding philosophers of modern conservatism, wrote in 1954. We can now say, 63 years later, that Ryan-style conservatism is only about solicitude for tidy incomes.

“This is who we are,” Ryan told his colleagues this week. “This will define us.”

Yes, it will. So please, Mr. Ryan, have the decency to stop giving those speeches in which you tell us about the depth of your concern about the poor and how you became interested in poverty “at a young age.” No one who would risk throwing so many poor people off health insurance with those enormous Medicaid reductions to score a political victory can claim any real interest in the welfare of the neediest Americans. Stick to tax cuts. At least you have convictions about those.

And then there is President Trump, who has absolutely no idea what’s in this bill and couldn’t care less. He hailed a measure that dumps people off the insurance rolls by saying that “we will have great, great health care for everyone in our nation.” And then he praised the Australian health-care system, which covers everyone and is the antithesis of the bill he had just praised.

For the benefit of this empty man, House Republicans, you just sold your social consciences.

It is said that the Senate will save House Republicans from the consequences of their craven heartlessness. No one should count on this in light of the hatred in the GOP for a law named after Barack Obama; the misguided fantasy that “the market” can cure whatever ails our health care system; the insatiable desire to keep shoveling money to the wealthiest Americans in tax relief; and the eagerness to slash and slash where programs for low-income Americans are concerned. On all these matters, pay heed to Paul Ryan: This is who they are. This defines them.

And the rest of us should never forget it.

Did Republicans just wave bye-bye to their House majority?

Aaron Blake, writing in the Washington Post:

As House Republicans proudly passed their health-care bill on Thursday, Democrats trolled them — hard. They sang “Na na na na, na na na na, hey hey hey, goodbye!” and waved bye-bye at the GOP.

It was a pretty good one, as political gimmicks go. But was it accurate? Are some Republicans signing their own death warrants in the 2018 election?

There is no doubt that votes such as a health-care bill can have long-term and far-reaching electoral implications. Look no further than Democrats and Obamacare. They were arguably still paying the price for that one in the 2016 election.

And it’s pretty clear that the Affordable Care Act did cost specific members their seats. A study from Brendan Nyhan, Seth Masket, the Monkey Cage’s John Sides and others in 2012 found that, in the 2010 midterm elections — the first one after Obamacare’s passage and the one in which the GOP took over the House — Democrats who supported Obamacare did 5.8 points worse than Democrats in similar districts who opposed it.

They calculated that if every Democrat in a tough district voted against the bill, Democrats could have saved 25 seats and probably their majority:

Could support for health-care reform have cost the Democratic Party not only votes but seats? We simulate the Democratic seat share in the House of Representatives in a counterfactual scenario in which all Democrats in competitive districts opposed health-care reform. In this scenario, Democrats would have retained an average of an additional 25 seats and would have had a 62 percent chance of winning enough races to maintain majority control of the House.

That 25 number, by the way, happens to be the exact number of seats Democrats need to regain the House majority in 2018.

(A separate study from Masket and Steven Greene in 2011 determined that 13 Democrats who voted for the bill pretty clearly lost their seats because of it — a number that today would wipe out just more than half of Republicans’ House majority.)

And there are clearly some Republicans who may have jeopardized themselves Thursday. According to Stephen Wolf of Daily Kos Elections, 24 House Republicans who voted for the bill come from districts where President Trump didn’t get a majority of the vote, and 14 come from districts that went for Democrat Hillary Clinton. Those are two-dozen districts where this vote can quickly be thrown in the GOP members’ faces. And, again, Democrats need 25 seats.

(Philip Bump has much more detail on who voted how.)

What’s more, the GOP’s health-care bill certainly seems unpopular enough to really do some damage to them politically. We only have polling of the previous version of the bill, which was abandoned when it faced defeat in March. But polls then showed very strong opposition.

A CBS News poll showed Americans opposed it 62 percent to 29 percent.

Much more here.

100 Days of Noise From Donald Trump

Via the Editorial Board of the New York Times:

It was fitting that President Trump closed out his first 100 days in another bumbling attack on Obamacare, trying and failing to jam a bill through the House this week that had no chance of passing the Senate, just to create the illusion of action.

The sorry saga of health care under this president bears all the Trumpian hallmarks that Americans are learning to expect: the dishonest campaign promise (“health care for everyone”); the clownish attempts to write a bill; the miniaturization of Paul Ryan (remember that guy?); the rivalrous White House confederation of Bannonite anarchists and glittering cosmopolites; the dearth of nonwhites and nonmales at the table; the absence of any strategy and of any vision beyond “winning.”

All that’s needed to complete the Trump pattern is the insultingly obvious effort by the president’s kin to cash in. A health care summit meeting at the Trump International Hotel in Washington, maybe.

If only this administration could simply play as comedy, as pratfalls and double takes. Unfortunately, the saga of health care also reveals the capacity of Mr. Trump to do harm, through incompetence and indifference, if not effective action. Rather than build on the foundation of the Affordable Care Act, and take credit for a strengthened system, Mr. Trump is causing the prospect of nationally affordable care to recede through malign neglect.

Governing, so far, has turned out to be more than Mr. Trump can manage. He didn’t know very much coming into the job of president, including how little he knew, and the extent of his own ignorance has come as a continual surprise to him. “Nobody knew that health care could be so complicated,” he famously marveled the first time he was preparing to fail at passing legislation. He expressed the same wonder of discovery at the complexity of North Korea.

In private life, Mr. Trump was accustomed to negotiations based on the simple reality that everyone involved shared the same objective: profit. He has struggled to bargain with legislators, who want to satisfy many constituencies and have conflicting notions of the national interest. In that sense, legislative deals require far more art than commercial ones, and for that reason, Mr. Trump has found himself in over his head. This week, after congressional Democrats called his bluff, threatening a government shutdown rather than acceding to his bluster, he slunk away from a demand that Congress start paying for his wasteful border wall — you know, the one Mexico has refused to pay for.

“I thought it would be easier,” Mr. Trump admitted about his job to Reuters this week.

Does he show any signs of learning on the job? In fact, yes. He has backed off dangerous pledges like tearing up the Iran nuclear deal and accusing China of manipulating its currency. He replaced his first national security adviser — the cartoonish Michael Flynn, who turned out to have been on not only the Russian payroll but also the Turkish one — with the formidable Lt. Gen. H. R. McMaster.

But since his risible assertion of “American carnage” in the streets during his Inaugural Address, Mr. Trump has continually fomented fear and bullied vulnerable groups, particularly unauthorized immigrants. He has shown no interest in reaching beyond the minority of Americans who elected him, one reason his approval ratings are the lowest on record for a president at this point in his term.

And what of his central campaign pledge, to make America great again, presumably by creating vast numbers of jobs for those who helped elect him? This may prove the emptiest of his promises. The giant infrastructure program, which would indeed yield jobs, is nowhere to be seen. In its place are proposed tax cuts to benefit mainly the wealthy and photo-op executive orders to deregulate energy businesses that, even if sustained by the courts — a long shot — will merely enrich the likes of the Koch brothers.

Yet if his ratings are dismal, the other measure Mr. Trump has always lived by — his revenue — is booming, as he uses the presidency to promote his properties. His determination to leverage his office to expand his commercial empire is the only objective to which Americans, after 100 days, can be confident this president will stay true.

Health Law Repeal Will Miss Trump’s 100-Day Target Date

Thomas Kaplan and Robert Pear, reporting for the New York Times:

An 11th-hour White House push to give President Trump a major legislative victory in his first 100 days in office broke down late Thursday as House Republican leaders failed to round up enough votes for their bill to repeal the Affordable Care Act.

Some White House officials had hoped for a vote on Friday on a measure to prove that Mr. Trump was making good on his promise to undo the sweeping health law — President Barack Obama’s signature domestic achievement — in his first 100 days in office.

But seesawing commitments and the reservations from numerous lawmakers throughout Thursday laid bare the difficulty that Republican leaders faced in trying to push through a repeal bill. While revisions to their bill won over conservative hard-liners in the Freedom Caucus this week, those same changes threatened to drive away other members, even some who supported the first version.

A senior House aide said late Thursday that there would not be a vote on the health bill this week. At least 18 House Republicans oppose the latest version of the bill, the American Health Care Act, and leaders can lose no more than 22 to win passage if all members vote.

“We’re going to try and measure three times and saw once,” Representative Pete Sessions, Republican of Texas and the chairman of the House Rules Committee, said late Thursday. “A lot of people around this town have tried their best to try and rush it, rush it, rush it.”

He urged patience, saying the health bill “will find its time.”

The lost opportunity was perhaps the biggest blow to the future prospects of Reince Priebus, Mr. Trump’s chief of staff, who has a long relationship with Speaker Paul D. Ryan of Wisconsin. Mr. Priebus had pushed aggressively for the House to schedule a vote this week, according to several people who spoke with him within the West Wing and on Capitol Hill.

Earlier on Thursday, Mr. Ryan appeared to shy away from pushing for a fast vote. “We’re going to go when we have the votes,” he said, adding that Republicans would not be constrained by “some artificial deadline.”

House Democrats, sensing an advantage, pressured Republicans to once again back away from the bill, just as they did a month ago in an embarrassing defeat for Mr. Trump and Mr. Ryan. Democratic leaders threatened to withhold votes from a stopgap spending measure to keep the government open past Friday if Republicans insisted on trying to jam the health care bill through the House on Friday or Saturday, which is Mr. Trump’s 100th day as president.

The House Democratic leader, Nancy Pelosi of California, said Mr. Trump was “really making fools of the members of Congress of his own party” by asking them to support a health bill that is unpopular with the public.

“If they vote on it, the minute they cast that vote, they put doo-doo on their shoe,” she said.

Republican leaders in both chambers plan to pass the stopgap measure to give lawmakers another week to work out a spending package to fund the government for the remainder of the fiscal year, which ends Sept. 30.

The longer-term spending deal is expected to provide more funding for the military and for border security, although Mr. Trump backed off his demand that lawmakers provide money for the wall he wants to build along the border with Mexico.

Mr. Ryan brushed off the threat from Democrats. “I would be shocked that they would want to see a government shutdown,” he said.

But Mr. Trump was not so dismissive. He unleashed a torrent of Twitter posts on Thursday accusing Democrats of wanting to shut down the government. The posts accused Democrats of putting the needs of health insurance companies, Puerto Rico and undocumented immigrants over the military, visitors to national parks and coal miners — claims that Democrats called absurd.

The latest House plan to repeal and replace the health law would include an amendment drafted by Representative Tom MacArthur, Republican of New Jersey and a leader of a centrist bloc of lawmakers called the Tuesday Group.

Mr. MacArthur’s amendment would allow states to opt out of certain provisions of the Affordable Care Act, including one that requires insurers to provide a minimum set of health benefits and another that prohibits insurers from charging higher premiums based on a person’s health status.

Republicans say the federal mandates drive up costs, but Democrats say they provide important protections for consumers.

Under Mr. MacArthur’s amendment, states could obtain waivers letting them redefine the “essential health benefits,” which now include maternity care, emergency services, mental health care and drug addiction treatment.

More here.

Public pans Republicans’ latest approach to replacing Affordable Care Act

Amy Goldstein and Scott Clement, reporting for the Washington Post:

In strategy and substance, the American public disagrees with the course that President Trump and congressional Republicans are pursuing to replace the Affordable Care Act with conservative policies, according to a new Washington Post-ABC News poll.

Large majorities oppose the ideas at the heart of the most recent GOP negotiations to forge a plan that could pass in the House. These would allow states to choose whether to keep the ACA’s insurance protection for people with preexisting medical problems and its guarantee of specific health benefits.

Public sentiment is particularly lopsided in favor of an aspect of the current health-care law that blocks insurers from charging more or denying coverage to customers with medical conditions. Roughly 8 in 10 Democrats, 7 in 10 independents and even a slight majority of Republicans say that should continue to be a national mandate, rather than an option for states to retain or drop.

* * *

“All states should be required to do the same thing,” said Bayonni Handy-Baker of Killeen, Texas, who supports nationwide requirements on both preexisting conditions and minimum benefits for insurance plans. As the 25 year-old Army veteran and political independent reasoned, “when you have people picking and choosing what to cover, you have this system of holes and disruption and disorder.”

Beyond their criticism of GOP proposals for devolving health policy to the states, many Americans appear leery in general about a major overhaul to the health-care law often called Obamacare, with 61 percent preferring to “keep and try to improve” it, compared with 37 percent who say they want to “repeal and replace” it. Roughly three-quarters of Republicans prefer repealing and replacing the ACA, but more than 6 in 10 independents and nearly 9 in 10 Democrats favor working within its framework.

Much more here.

Republicans Agree on No Shutdown, but Not on How to Avoid One

Carl Hulse, reporting for the New York Times:

After their already shaky start, it is hard to imagine Republicans would want to top off a chaotic first 100 days of unified government control with a disruptive federal government shutdown.

But that astounding scenario remains a live possibility this week as lawmakers and the Trump White House have so far been unable to agree on a plan to fund the government beyond Friday despite months of staring at the hard April 28 deadline. It is an unsettling but not unfamiliar position for congressional Republicans who have forced government closures in the past and know well that they will be assigned the brunt of the blame if federal agencies are shuttered yet again.

Should a shutdown occur, this one would have a defining new wrinkle. The politically charged spending fights that closed the government during the Clinton and Obama administrations were the product of clashes between congressional Republicans and a Democratic White House in a sharply divided Washington. Today, Republicans control both ends of Pennsylvania Avenue, and allowing the federal government to go dark on their watch might be hard to explain.

“Our Republican colleagues know that since they control, you know, the House, the Senate and the White House, that a shutdown would fall on their shoulders, and they don’t want it,” said Senator Chuck Schumer of New York, the Democratic leader.

Republican leaders from President Trump on down insist they are determined to avoid a shutdown and will be successful in doing so. Failure would put a bizarre exclamation point on the symbolic 100-day marker that the administration coincidentally will reach Saturday.

“No one wants a shutdown,” Sean Spicer, the White House spokesman, told reporters on Friday. “We want to keep it going.”

* * *

The spending drama is the first Trump-era clash in which minority Democrats have real leverage, and they intend to use it to stop the White House and congressional conservatives from pushing through spending that Democrats oppose, such as money for a wall on the southern border.

Lawmakers, who have been negotiating for weeks to try to reach a compromise, say they were steadily progressing until the White House in recent days began taking a more aggressive posture, insisting that Mr. Trump wanted a least a down payment on the construction of a border wall that was central to his successful presidential campaign.

“Elections have consequences,” Mick Mulvaney, the former House conservative who is now the head of the Office of Management and Budget, told The Associated Press in an interview. He offered Democrats a deal: The administration would support continued subsidies for millions of people receiving health insurance through the Affordable Care Act in exchange for Democrats agreeing to the initial wall funding.

Mr. Schumer called that proposal a nonstarter. Other Democrats suggested they saw no reason to accept that offer because Republicans are separately but simultaneously trying to unravel the health care program. They also believe that if White House refusal to fund the subsidies caused a collapse of the health insurance market, Republicans would get the political blame for that upheaval, as well.

More here.

Ryan promises to keep government open — and makes no promises on health care

Kelsey Snell, writing in the Washington Post:

House leaders told GOP lawmakers Saturday that they plan to devote their energy in the coming week to keeping the federal government open, conspicuously avoiding an immediate commitment to take up health care despite pledges to do so by conservatives and the White House.

House Speaker Paul D. Ryan (R-Wis.), speaking on a conference call with GOP members Saturday afternoon, offered no specific plan on how or when lawmakers might see details of a new proposal to revise the Affordable Care Act, which White House officials suggested might receive a vote by Wednesday.

Ryan also made clear that his top priority was to pass a stopgap spending bill to keep government open past April 28, an objective that requires Democratic support. “Wherever we land will be a product the president can and will support.” Ryan said, according to a senior GOP aide on the call.

Less clear was whether even a narrow focus on spending would allow Republicans to avoid a showdown with President Trump, whose top aides have in recent days that any spending bill must include funding for a border wall. Such a demand would almost certainly prompt Democrats, whose support is needed to pass the budget bill in the Senate, to vote no.

Senate Minority Leader Charles E. Schumer (D-N.Y.) said leaders in Congress could reach a spending agreement, but only if the White House stays out of the negotiations.

“I want to come up with an agreement,” Schumer said Tuesday on a conference call with reporters. “Our Republican colleagues know that since they control, you know, the House, the Senate and the White House, that a shutdown would fall on their shoulders, and they don’t want it.”

On the flip side, there was no guarantee that Trump would sign a spending plan without funding for the wall, several aides said.

The Ryan call comes as GOP leaders find themselves trapped between proving that they can complete basic tasks of governing such as funding the government, while also meeting the demands of Trump, who is looking for a legislative win ahead of his 100th day in office next Saturday.

Trump and his top aides have been calling on Congress to take dramatic action in the coming week: vote on health care, take up tax reform and demand that Democrats agree to a stopgap spending measure that includes funding for a wall along the U.S.-Mexico border.

Ryan’s comments suggested that he and other House Republicans are pushing back on that pressure. He said, for instance, that the House will vote on a health-care bill when Republicans are sure they have the support to pass it, according to several GOP aides on the call — suggesting that he does not believe that to be the case currently, despite renewed negotiations between House conservatives, moderates and the White House.

The direction of the border wall fight was less certain. Ryan and other Republican leaders have suggested that it is more important to protect a spending deal with Democrats, who have vowed to oppose spending on the wall. The speaker assured members on the call that the spending talks were still promising and ongoing, but close Trump aides continued to insist in public that the spending bill should include money for the wall.

“I think it goes without saying that the president has been pretty straightforward about his desire and the need for a border wall,” Homeland Security Secretary John F. Kelly said in an interview with CNN’s Jake Tapper scheduled to run Sunday morning. “So I would suspect, he’ll do the right thing for sure, but I would suspect he will be insistent on the funding.”

The comment is likely to further threaten bipartisan budget talks, which were jostled after Trump’s budget director, Mick Mulvaney, was the first suggested that Trump would demand border wall funding in the upcoming spending bill.

“This president should be allowed to have his highest priorities funded even though the Democrats rightly have a seat at the table because of the Senate rules,” Mulvaney said Friday in an interview with Bloomberg Live. “You cannot expect a president who just won election to give up very easily on his highest priority.”

Mulvaney repeated his expectation that the spending talks will include border spending at several events throughout the week, causing a flurry of confusion among congressional aides who say the spending bill must remain free of major controversies if it is to pass.

More here.

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.