In Health Care Push, Trump Couldn't Master Art of Consensus

WASHINGTON (AP) — President Donald Trump thought he had a deal.

He’d been greeted with a standing ovation — one of his favorite measures of success — when he entered the Roosevelt Room on Thursday to meet with members of the hard-line House Freedom Caucus.

After seven years of promises, the president said Republicans had reached a crucial moment to repeal and replace the “Obamacare” health care law. They had the right bill in front of them and a president who could get them across the finish line, he argued.

“Have you read ‘The Art of the Deal?’ You need to read, ‘The Art of the Deal,'” Rep. Paul Gosar, R-Ariz., said of the president’s message to lawmakers.

But Trump’s guide to closing a deal in the boardroom turned out not to provide a roadmap to passing a bill. Less than 24 hours later, the Trump-backed health care law would collapse in a shocking failure for a new president on his first attempt to legislate. The final push to round up the votes, as told by administration officials, congressional aides and others familiar with the president’s thinking, demonstrates Trump’s difficulty in navigating competing factions in his own party.

Although the White House referred to Trump as a “the closer,” every time the president attempted to make concessions to conservatives, it alienated more moderate members.

In relatively short order, the president encountered the complexity of legislating and found he could not master the art of building consensus.


“No deal,” Rep. Mark Meadows, the House Freedom Caucus chairman, said hours after the standing ovation for Trump on Thursday.

The concessions Trump offered to the conservatives weren’t enough, much to the frustration of the White House.

To Trump, health care had been more of a necessary agenda item than a passion project. Still, he had signed on to House Speaker Paul Ryan’s plan and promised to work the phones to help rack up votes. Throughout the process, Trump wanted a vote on the bill that would force House members to make clear which side they were on.

“There’s going to be no waiting and no more excuses by anybody,” Trump told Rep. Steve Scalise of Louisiana and the Republican House vote-counting team in early March.

The White House thought it had a natural ally in Meadows and the conservative members of his group. On Wednesday, the night before the House planned to vote, Trump agreed to eliminate the essential services requirements, the part of the law that mandated insurers cover a slate of popular services, such as maternity and mental health care. The move cost him moderate Republicans.

But by Thursday afternoon, about 25 members of the caucus were still in opposition, forcing Ryan to postpone the vote a day in hopes of salvaging the bill.

“We really had it. It was pretty much there, within grasp,” Trump later told reporters, expressing disappointment in the group.


Trump, meanwhile, seemed preoccupied with other matters. As negotiations went down to the wire Thursday, Trump was busy welcoming a group of truckers he’d invited to the White House with their big rigs. It was a stunning split screen, with the president hamming it up in the cab of a truck, as news broke that the vote had been postponed.

It wasn’t the first time Trump had seemed to be disconnected from the fight. People familiar with Trump’s approach described him as more focused on getting to a deal than bogged down in the details of the policy.

Outside groups formed to push his policy agenda ran no ads to promote the bill. And in speeches this week, Trump had started to sound ready to move on to an agenda item that he hopes will be more gratifying: tax reform.

“We want a very big tax cut, but cannot do that until we keep our promise to repeal and replace the disaster known as ‘Obamacare,'” he told a rally in Louisville, Kentucky, earlier this week.


Meadows told reporters on Thursday night that he remained optimistic that a deal could be reached. He disputed criticism that he was moving the goal posts on a deal.

By nightfall, Trump’s team had had enough.

The president dispatched his top deputies to Capitol Hill and demanded a make-or-break vote. The president, said budget director Mick Mulvaney, was done negotiating. Aides warned that Trump would walk away from the table, leaving “Obamacare” in place if the vote failed.

During the meeting, White House officials tried to get individual members of the Freedom Caucus to say how they would vote, a play to isolate and identify the holdouts. They began with Rep. Mo Brooks of Alabama, but were quickly rebuffed by Meadows, who said he spoke for the caucus.

Trump’s ultimatum did little to persuade.

By Friday morning, an angry president was lashing out on Twitter, writing “this is finally your chance for a great plan!” in a message that called out the members of the Freedom Caucus. “The irony is that the Freedom Caucus, which is very pro-life and against Planned Parenthood, allows P.P. to continue if they stop this plan!”

As the bill’s chances were sinking on Friday, Gosar pinned the blame on Trump’s team. “I don’t think the president bluffs at all, but I think he follows a pattern. He trusts the people that are around him. I don’t know that the people around him, and the people he trusts, actually did him a service,” Gosar said.


The House vote was scheduled for 3:30 p.m. Friday, but the writing was already on the wall.

Lacking the votes, Ryan left the Capitol shortly after noon and rode down Pennsylvania Avenue to the White House to make the case for the last time that that the vote should be pulled.

Trump and several White House advisers had pushed for a vote on the bill regardless. They wanted to make clear which House Republicans had opposed him on the key legislation.

Over a lunch of chicken and Brussel sprouts, Trump and Ryan, joined by Treasury Secretary Steven Mnuchin, discussed the prospects for tax reform, a topic that allowed the president to begin planning for future legislative battles.

Ryan and Trump emerged from the meeting with an agreement to pull the bill, rather than risk a humiliating, and possibly sizable, defeat.

Trump almost immediately began dialing reporters from The Washington Post and The New York Times to explain the decision.

He blamed the collapse on Democrats.


Associated Press writer Erica Werner contributed to this report.


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