WASHINGTON — 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 on Friday in a major defeat for President Donald Trump on the first legislative showdown of his presidency.
“We’re going to be living with Obamacare for the foreseeable future,” House Speaker Paul Ryan conceded.
The failure of the Republicans’ three-month blitz to repeal President Barack Obama’s signature domestic achievement exposed deep divisions in the Republican Party that the election of a Republican president could not mask. It cast a long shadow over the ambitious agenda that Trump and Republican leaders had promised to enact once their party assumed power at both ends of Pennsylvania Avenue.
And it was the biggest defeat of Trump’s presidency, which has suffered many. His travel ban has been blocked by the courts. Allegations of questionable ties to the Russian government forced out his national security adviser, Michael Flynn. Tensions with key allies such as Germany, Britain and Australia are high, and Trump’s approval ratings are at historic lows.
Republican leaders were willing to tolerate Trump’s foibles with the promise that he would sign into law their conservative agenda. The collective defeat of the health care effort could strain that tolerance.
Trump, in a phone interview moments after the bill was pulled, tried to put the most flattering light on it. “The best thing that could happen is exactly what happened — watch,” he said.
“Obamacare unfortunately will explode,” Trump said later. “It’s going to have a very bad year.” At some point, he said, after another round of big premium increases, “Democrats will come to us and say, ‘Look, let’s get together and get a great health care bill or plan that’s really great for the people of our country.’”
Trump expressed weariness with the effort, though its failure took a fraction of the time that Democrats devoted to enacting the Affordable Care Act in 2009 and 2010. “It’s enough already,” the president said.
A major reason for the bill’s demise was the opposition of members of the conservative House Freedom Caucus, which wanted more aggressive steps to lower insurance costs and to dismantle federal regulation of insurance products.
In a day of high drama, Ryan rushed to the White House shortly after noon on Friday to tell Trump he did not have the votes for a repeal bill that had been promised for seven years — since Obama signed the landmark health care law. During a 3pm phone call, the two men decided to withdraw the bill rather than watch its defeat on the House floor.
Trump later told journalists in the Oval Office that Republicans were 10 to 15 votes short of what they needed to pass the repeal bill.
The effort to win passage had been relentless, and hardly hidden. Vice-President Mike Pence and Tom Price, the health secretary, visited Capitol Hill on Friday 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 Rep. Mark Walker of North Carolina, chairman of the conservative Republican Study Committee, who conceded it was a “good moment” for Democrats.
“Probably that champagne that wasn’t popped back in November may be utilised this evening,” Walker said.
At 3:30pm on Friday, Ryan called Republicans into a closed-door meeting to deliver the news that the bill would be withdrawn, with no plans to try again. The meeting lasted five minutes. One of the architects of the House bill, Rep. Greg Walden, R-Ore., and chairman of the Energy and Commerce Committee, put it bluntly: “This bill’s done.”
“We are going to focus on other issues at this point,” he said.
The Republican bill would have repealed tax penalties for people without health insurance, rolled back federal insurance standards, reduced subsidies for the purchase of private insurance and set new limits on spending for Medicaid, the federal-state program that covers more than 70 million low-income people. The bill would have repealed hundreds of billions of dollars in taxes imposed by the Affordable Care Act and would also have cut off federal funds to Planned Parenthood for one year.
With the House’s most hard-line conservatives holding fast against the bill, support for the legislation collapsed on Friday after more and more Republicans came out in opposition. They included Reps. Rodney Frelinghuysen of New Jersey, the soft-spoken chairman of the House Appropriations Committee, and Barbara Comstock of Virginia, whose suburban Washington district went for the Democratic presidential 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,” Frelinghuysen said. “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.”
The bill died after Republican leaders, in a bid for conservative support, agreed to eliminate federal standards for the minimum benefits that must be provided by certain health insurance policies.
“It’s so cartoonishly malicious that I can picture someone twirling their moustache as they drafted it in their secret Capitol lair last night,” said Rep. Jim McGovern, D-Mass. “Republicans are killing the requirements that insurance plans cover essential health benefits” such as emergency services, maternity care, mental health care, substance abuse treatment and prescription drugs.
Trump blamed Democrats for the bill’s defeat, and they proudly accepted responsibility.
“Let’s just, for a moment, breathe a sigh of relief for the American people that the Affordable Care Act was not repealed,” said Rep. Nancy Pelosi of California, the House Democratic leader.
