Despite last week’s bitter sniping, the White House has spent a significant amount of time this week meeting with conservative and moderate Republicans about a GOP health care replacement plan, heightening speculation that the American Health Care Act (AHCA), rumored dead, may be resurrected.
Which raises the question: What on earth is Donald Trump planning with health care?
On Sunday, the president spent five hours golfing with Senator Rand Paul, a physician and chief critic of the AHCA, and Director of the Office of Management and Budget Mick Mulvaney.
Trump tweeted before the meeting that “talks on repealing and replacing Obamacare are, and have been, going on, and will continue until such time as a deal is hopefully struck.” Real progress was made during Sunday’s golf outing, sources say. Paul pitched the president on ways he could lower costs for patients without the help of Congress, and Trump was very receptive. After the meeting, which included lunch, Paul called it a “great day” and said he was “very optimistic” that “the sides are getting closer and closer together” on an Obamacare repeal plan.
This outing was surprising, given its striking contrast with last week’s acrimony. After the AHCA failed, Trump exploded on Twitter, calling for his supporters to primary the House Freedom Caucus in 2018. On Saturday, White House social media Director Dan Scavino Jr. called out Congressman Justin Amash personally, tweeting: “Donald Trump is bringing auto plants & jobs back to Michigan. [Amash] is a big liability. #TrumpTrain, defeat him in primary.” For his part, Amash has not been squeamish about explaining his reasons for opposing Trump’s agenda on social media.
After Paul’s golf outing with Trump, Vice President Pence met with the House Freedom Caucus on Monday, and proposed small changes to the bill that would allow states the flexibility to opt out of regulations through a waiver process and another idea that would let insurers opt out of community health ratings. Caucus Chairman Mark Meadows later said he was “intrigued” by the ideas put forward by the White House, but sounded a note of caution that he would need to see legislative text first.
Also on Monday, Pence, Mulvaney, White House chief of staff Reince Priebus, and Energy and Commerce Committee Chairman Greg Walden met with the House Freedom Caucus’ chief opposition, the moderate Tuesday Group, and discussed similar small changes to the bill.
That’s a lot of meetings. Yet the question remains: what is going on here? Is the White House looking to strike a bargain – and if so, with whom?
House GOP leadership is still adamant that the changes conservatives wish to see – changes that are supported by the White House and would lower costs for Americans like allowing trade across state lines and arranging groups by association rather than employment – will not pass muster in the Senate.
This is a favorite tactic of House leadership when they don’t want to pass a bill. After all, once a politician says something about “Senate rules” and “reconciliation,” people’s eyes start to glaze over. Throw in “Senate parliamentarian” and they’ve definitely tuned out.
But that doesn’t mean these excuses make any sense. Anything included in a reconciliation bill has to have an impact on the budget, and, as noted by the courts and CBO, Obamacare’s coverage regulations and subsidies have a sizable impact on the budget. And while the unelected Senate parliamentarian advises, she doesn’t have the final say over what happens in the Senate, and can be overruled by a Senate vote.
The path on health care is there, if Republicans want to take it. Fortunately, it seems the White House really is interested in resolving some of Obamacare’s issues this year, and is looking for a compromise bill that offers something for both sides. Whether they’ll be able to find that compromise is another question entirely.