by David M. Drucker · March 14, 2017
Powerful conservative groups wary of alienating President Trump are blaming their opposition to his healthcare initiative on House Speaker Paul Ryan, R-Wis.
The American Health Care Act, though authored by Ryan, with input from House and Senate Republicans, was crafted with an eye toward satisfying Trump’s liberal inclinations on healthcare policy.
The president promised to repeal Obamacare on the campaign trail.
But he has publicly supported government-run healthcare in the past and vowed to replace the Affordable Care Act with a plan that maintains its high coverage levels and generous benefits, but at lower cost and absent its onerous regulations.
That process led to a bill that is too liberal for Washington’s high-profile conservative activist groups, the Republican Party’s self-styled ideological enforcers.
And, Trump and his lieutenants have signaled that they’re only open to modest changes, bolstering Ryan’s case to conservative opponents of the bill that it’s now or never if they want to fulfill their years-long goal of repealing Obamacare.
Instead of rebuking Trump, conservative groups are dissing the AHCA as “Ryancare” and training all of their fire at the speaker, in a bid to curry favor with the president and protect their relationships with him in future negotiations.
“I really look forward to the president’s engagement on this,” Michael A. Needham, CEO of Heritage Action for America, said Monday during a conference call with reporters.
That engagement has been well underway for a while now.
Indeed, it began with Trump’s secretary of health and human services, Tom Price, collaborating with Ryan and other Republican leaders on the outcome of the AHCA. Price, who served in Congress until he joined the administration, was an influential healthcare policymaker in the House Republican Conference.
It has continued with White House meetings with Trump and his aides, as he seeks to whip enough votes for the GOP health care bill to push it through Congress.
The major conservative groups, like Needham’s Heritage Action for America; Club for Growth; and Americans for Prosperity, were granted one of those meetings last week. They walked away impressed and said they’re willing to give Trump a chance to deliver.
“We said, if you say you’re negotiating, we’ll work with you because we want to get a bill done,” said a conservative operative who participated in the meeting with Trump and the conservative advocacy groups.
The groups plan to continue aggressive public opposition to the AHCA to keep the pressure on Trump to agree to as many conservative reforms as they can get to improve the bill. Privately, however, they’re in different places.
Heritage Action appears to be the most hardline, insisting on a bill that fully repeals Obamacare and resets healthcare delivery and spending back to pre-Affordable Care Act levels. That’s what Needham told reporters his organization wants during Monday’s conference call.
By contrast, Club for Growth and Americans for Prosperity are making specific policy asks of the president, and they appear ready to support the legislation if they get what they want.
The main sticking points for these and other groups revolves around aspects of the Medicaid overhaul portion of the AHCA, how the tax credits to help purchase insurance are handled, plus a couple of other items.
The groups’ policy objections to the bill and demands for changes are consistent with how they have behaved over the years in opposing Republican leadership-driven proposals in Congress.
What is unusual is their conciliatory approach at the outset. Some of these groups seem more interested in getting to “yes” with Trump than they have been over the years with Republican congressional leaders.
“We don’t want to prejudice the negotiations by saying what’s acceptable or not acceptable,” said a second conservative operative said.