How Seriously Should We Have Taken The GOP’s Latest O’Care Repeal Revival?

Evan Vucci/AP
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Alice Ollstein contributed reporting.

On Monday, a handful of House Republicans – encouraged by meetings with the White House – were singing a song of Easter Hallelujah, claiming that the GOP health care bill that two weeks ago had been declared dead was ready to be revived. Forty-eight hours later, a whirlwind of late-night meetings, brokered by the Trump administration’s top brass, between the conference’s opposing wings brought Republicans no closer to an agreement, despite optimism that a deal was imminent and a vote could be scheduled this week.

Republicans, who head out to their April recess this weekend, are playing down the most recent breakdown in talks as just a matter of the fits-and-starts it will take for the GOP to accomplish its long-held goal of dismantling the Affordable Care Act. But given the sloppy negotiating, over-promising and the finger-pointing that ensued, it sure sounds like the recent chatter could have been the bill’s death rattle.

It was a new flash point the sunk the latest round of talks. But the old divisions remain: conservative hardliners seeking to gut the law as much as possible versus moderates who’d like to hold on to its more popular aspects. Many of the same patterns  that helped kill the American Health Care Act last month re-emerged: an expedited timeline, back-channel side deals and a steep learning curve on what happens when you overhaul the health care system. The only difference this time around was that key congressional leadership distanced itself from the intra-party squabbling, suggesting they’d rather let rank-and-file work out the differences among themselves before they take any movement on the bill too seriously.

“Members are coming to the realization that it’s difficult to get a wide group of conservatives around a health care reform,” House GOP deputy whip, Rep. Patrick McHenry (R-NC), told reporters Wednesday.

The misunderstandings and misleading characterizations were aplenty as White House officials, including Vice President Mike Pence and Office of Management and Budget Director Mick Mulvaney, met with the various competing factions.

They started with a Monday afternoon meeting at the White House with a half-dozen moderates who were all previous “yes” votes. The idea that was presented to them – for them to give their greenlight – was allowing states to waive some of the Obamacare Title I reforms if the states could prove they could design programs to increase coverage and lower premiums. The elimination of the Essential Health Benefits in the original bill, a demand of the Freedom Caucus, had spooked moderates and this new proposal was considered a compromise.

One of the meeting’s participants, Trump ally Rep. Chris Collins (R-NY), told reporters afterward that the community ratings – which prevent insurers from hiking up premiums based on health status – were “under discussion” among the ACA mandates from which states could opt out. By Wednesday – after the talks had floundered — he claimed that “we never talked about community ratings.”

“I don’t support that,” Collins said. “It never came up in our discussions on Monday, so I would never want anyone to infer we were told something Monday that changed on Tuesday.”

The House Freedom Caucus had its own meeting with the Trump administration to preview the deal Monday night. Freedom Caucus Chairman Mark Meadows (R-NC) said coming out of it that the conservative hardliners were waiting for legislative text to make a decision on the offering and that they were expecting it, based on signals from the White House, within the next 24 hours, in time for a Tuesday night meeting with the moderates and the leaders of Republican Study Committee, a much larger group of House conservatives.

Throughout Tuesday, neither the White House nor the House Energy and Commerce would say that they were drafting the proposal, and no such text was circulated in Tuesday’s evening’s meeting with the groups.

“Some of those reports were erroneous,” White House Director of Legislative Affairs Marc Short told reporters Wednesday, even as other Republicans, including Rep. Tom MacArthur (R-NJ), the co-chair of the moderate Tuesday Group, had said they had heard from Pence that text was being drafted.

Energy and Commerce Chair Greg Walden (R-OR) also confirmed Thursday that his committee hadn’t yet started the legislative drafting.

Additionally, it had become clear in the hours leading up to Tuesday’s meeting that moderates and Freedom Caucus members were being spun two different deals, with the moderates getting the sense that the barrier for the waivers would be quite high and the conservatives suggesting that they would be handed out like candy.

“States have to provide a better plan for their citizens, if they can do that, then I think that’s worth discussing,” MacArthur told reporters before the meeting.

“As long as my constituents don’t have to abide by the Obamacare regulations and there is a vehicle to make sure that happens, I will have accomplished my task,” Meadows said that same afternoon.

Regardless of what was actually promised to the warring groups, top Republicans are now casting off the idea of waiving community ratings as a “bridge too far.”

“Right now, the offerings have diminished votes, not increased them,” McHenry said Wednesday.

The blame-game, that was already underway in post-mortems of the original bill’s failure, has only intensified since this last go-around. Collins accused the Freedom Caucus Wednesday of “playing Lucy with the football” and said they were “less than genuine in trying to get to yes.”

Meanwhile, Michael Needham, the CEO of outside conservative group Heritage Action, hosted a press phone call where he bashed the moderate Republicans for “intransigence” and argued that they “clearly want to keep Obamacare in place.”

Asked Wednesday if he believed that everyone was at the table negotiation in good faith, Meadows –who has mostly withheld public criticism of the moderates – said coyly, “I can say that the Freedom Caucus is negotiating in good faith and that’s about the only one that I could give a good a opinion on, and of course you will get a different opinion depending on who you talk to.”

House Speaker Paul Ryan (R-WI) has mostly stayed out of the recent round of tussling. He didn’t attend Tuesday night’s meeting – some of his staff, as well as Majority Leader Kevin McCarthy were there instead. Ryan at a Wednesday Q&A defended his hands-off approach.

“What’s happening is what needs to happen, which is members need to start talking with each other about why they think the way they think, so they can get a better understanding of each other’s concerns,” Ryan said. “That’s how you bridge gaps.”

Other Republicans have complained that the latest round of negotiations took place outside the committee structure.

“Many of us on the committees have spent years on these policies, and to just see it kind of being pulled away and put behind the scenes potentially to me is not the wisest course to take,” Rep. Tom Reed (R-NY), a Ways and Means Committee member, said Tuesday, according to the Washington Post.

Few Republicans have said that they’re ready to throw in the towel yet, but some are hinting their patience won’t last forever.

“There does come a time, and I don’t think we’re there yet, where you have to say: ‘Ok, we can’t fix this Hyundai anymore. We better go looking for a new vehicle,'” Rep. Morgan Griffith (R-VA), a Freedom Caucus member who sits on the Energy and Commerce Committee, told reporters Wednesday.

ABOUT THE AUTHOR

Tierney Sneed is a reporter for Talking Points Memo. She previously worked for U.S. News and World Report. She grew up in Florida and attended Georgetown University.

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