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Trump embraces conservatives as their interests align on healthcare

House Speaker Paul Ryan has touted an estimate that the Republican plan for replacing Obamacare would reduce premiums 10 percent. But there’s more to know about that claim. (Getty Images)

 

March 15, 2017

President Trump’s desire to see the American Health Care Act survive in the House has, for now, aligned his interests with the conservatives who say they won’t support the bill until it does more to roll back Obamacare. But the White House’s alliance with congressional conservatives may not extend to upcoming legislative battles, when Trump’s preference for ends over means may redirect his focus on any given issue.

An increasingly bitter debate among Republicans in the House and Senate over healthcare reform has pitted members of the conservative House Freedom Caucus and a handful of senators — including Sens. Rand Paul, Tom Cotton and Mike Lee — against House leadership, which initially fought for the AHCA as written.

After conservatives quickly labeled the legislation “Obamacare-lite” and “Obamacare 2.0,” the White House launched an aggressive effort to collect input from the conservative lawmakers and organizers who were prepared to sink Trump’s Obamacare reform plan. Many of those who have spoken privately with Trump say he indicated he was open to changing the AHCA.

Jason Pye, director of legislative affairs for the conservative FreedomWorks, was among a handful of conservative leaders who met privately with Vice President Mike Pence on Friday to air their concerns about the AHCA. During that meeting, he said he got the sense that the White House is “open to negotiations on Obamacare repeal and replace,” an impression shared by others who have spoken behind closed doors with Trump or Pence over the past week.

While Trump has professed his commitment to conservative ideals during his relatively short political career, Pye said Trump’s embrace of the House Freedom Caucus and the grassroots groups that support it can also be attributed to his results-oriented focus in the case of healthcare reform.

“I think it’s a combination of both,” Pye said. “I think in their hearts, they know the conservatives’ concerns are legitimate, but they also are seeking to get the bill through the House … They realize [the conservatives] are right philosophically, and they understand that this is the art of the deal.”

“This scenario we’re in now, where the president is going to have to negotiate with House conservatives, is going to play out again and again on key issues,” said Mark Serrano, a Republican strategist. “Immigration will be another one where a plan is introduced, House conservatives claim it’s dead on arrival, the media overreacts to that pronouncement from House conservatives, and then the dealmaking begins.”

Trump’s ascension to the top of the Republican Party last year met early resistance from some conservatives, who feared the thrice-married former Democratic donor could not be trusted to uphold conservative values.

And some of his proposals, such as a massive infrastructure spending package, already have small-government advocates on Capitol Hill feeling uneasy. That means Trump may have to look beyond the Freedom Caucus in the future to shepherd his other legislative priorities through the House.

“The president is far more wedded to making good deals than he is to ideology,” Serrano said.

While conservatives in the House will be key to passing much of Trump’s legislative agenda, Serrano noted, the near-opposite could be true in the upper chamber.

“Here’s what’s interesting: in the Senate, I think the president may actually find more success in cutting deals with Democrats who are up for reelection in 2018 in states that the president won in 2016,” he said.

Trump has pinned his hopes for Obamacare reform to the legislation Speaker Paul Ryan introduced early last week, which likely will require some repairs demanded by conservatives before heading to the floor for a vote.

Two sources with the House Freedom Caucus told the Washington Examiner that conservative members hoped leadership would allow them to introduce amendments to the healthcare bill through an open process.

One Freedom Caucus source said members “expect to see leadership being more willing to work with conservatives” now that the Congressional Budget Office has assigned such unflattering predictions to the legislation. The source said members are still weighing a number of different amendments “or even potentially introducing a bunch of changes as one amendment.”

Members of the House Rules Committee will make a decision about whether to allow changes to the healthcare package after it passes through the Budget Committee, a Rules Committee aide told the Washington Examiner.

White House press secretary Sean Spicer confirmed Tuesday that Trump’s team was working with House leadership on a manager’s amendment to the AHCA, which would give Republicans the opportunity to make adjustments that could satisfy the White House and holdout lawmakers without opening the legislation up to a potentially messy and protracted fight over individual amendments.

Pye said GOP leadership likely recognized that the AHCA was not going to survive without undergoing some changes.

“Look, they have to,” Pye told the Washington Examiner of leadership’s decision to allow an amendment. “At the end of the day, the concerns raised by conservatives in Congress — those concerns are going to have to be addressed.”