GOP Struggles to Salvage Health Care Reform

Meadows trying to get 30 to 40 members to switch from ‘no’ to ‘yes’

Rep. Mark Meadows, R-N.C., chairman of the House Freedom Caucus, is interviewed in Rayburn Building after he and other members of the HFC met at the White House with President Trump, March 23, 2017. (Tom Williams/CQ Roll Call)
Rep. Mark Meadows, R-N.C., chairman of the House Freedom Caucus, is interviewed in Rayburn Building after he and other members of the HFC met at the White House with President Trump, March 23, 2017. (Tom Williams/CQ Roll Call)
Posted March 23, 2017 at 6:28pm

Republicans struggled to work out a deal to salvage the troubled health care reform legislation ahead of a House Republican Conference meeting Thursday evening.

Negotiations over how to repeal and replace the 2010 health care law were moving along two parallel tracks: conservatives in the Freedom Caucus were dealing with President Donald Trump and his staff, and moderates in the Tuesday Group were talking to Speaker Paul D. Ryan and his leadership team.

Freedom Caucus Chairman Mark Meadows told reporters at 4 p.m. that he was getting ready to call Tuesday Group co-chair Tom MacArthur of New Jersey to try to find common ground between the two factions.

“We are trying to get another 30 to 40 votes that are currently in the ‘no’ category to ‘yes,’” the North Carolina Republican said.

Freedom Caucus members met with Ryan, GOP leaders and White House officials for nearly two hours Thursday evening. As the meeting broke up without a deal, members moved from Ryan’s second floor office to the basement of the Capitol for the GOP conference meeting.

A few hours earlier Meadows had expressed hope a deal could come together by the 7 p.m. House Republican Conference meeting. That meeting would be the first time since Trump’s visit to the conference on Tuesday morning that all the GOP members would meet to discuss the state of play.

One topic of conversation likely will be the updated CBO report concerning the bill, made public Thursday afternoon. The CBO reported that the measure would reduce deficits by $150 billion over a decade, considerably less than the original estimate of $337 billion. Its estimate that 24 million people uninsured by 2026 remained unchanged.

Meadows’ goal to get a deal on further changes by 7 p.m. appears to be a moving target. “We’re committed to stay as long as it takes to get this done,” he said. “Whether the vote is tonight tomorrow or five days from here the president will get a victory.”

Ryan remained quiet, twice postponing his weekly press briefing from 11:30 a.m. to 3:30 p.m., and then to a time to be announced later.

The day started with both sides looking to the Freedom Caucus’s 11:30 a.m. meeting with Trump at the White House as where a deal could emerged, but the conservative caucus returned to the Capitol around 1:30 p.m. empty handed.

The Freedom Caucus then huddled in an Oversight Committee room in the Rayburn House Office building for 2 1/2 hours to discuss their next move. Meadows emerged from the meeting continuing to talk up the president’s role as a dealmaker, although they still had not struck one.

“Let me be clear: We would not be where we are even considering this if it had not been for President Trump’s personal involvement,” Meadows said.

The “this” Meadows was referring to was unclear and he declined to elaborate much to reporters other than to say “some of the text and some of the things we’re being asked to consider at this point are not in enough of a form to make a good informed decision on.”

The language moves negotiations in the right direction but is still “ambiguous” in terms of whether it would lower health insurance premiums, Meadows said.

It appeared the Freedom Caucus emerged from their afternoon meeting having settled on their latest asks but Meadows also declined to identify those to reporters.

“We’ve communicated that very effectively with the president and his staff,” he said.

The day however has offered some hints of where the negotiations were headed.

One the table early in the day was repeal of the so-called essential health benefits, one part of the current law that the Freedom Caucus cites as driving up health insurance costs. GOP leaders had previously resisted inclusion of the provision, citing noncompliance with the Senate’s budget reconciliation rules that they’re planning to use to push the measure through the upper chamber without threat of a Democratic filibuster.

Freedom Caucus members left the White House having discussed some other ideas but lacking an additional offer. “There were no new concessions,” Michigan Republican Rep. Justin Amash told reporters, saying repeal of essential health benefits alone is “a nonstarter.”

Amash said Freedom Caucus members also want to roll back community ratings that prevent insurance companies from discriminating based on age or gender, and making them set prices based on “community.” He signaled there were other insurance mandates they were looking to repeal but didn’t name them, but it appears conservatives are not pushing for repeal of all aspects of Title I.

White House Press Secretary Sean Spicer confirmed in his daily briefing that Trump and the roughly 30 Freedom Caucus members he met with did not reach a deal. Spicer called the session a “positive” step toward a shared goal of driving down health care costs.

Trump is expected to meet later Thursday with members of the moderate Tuesday Group, as his quest to get the bill over the finish line in the House continues, Spicer said.

Republicans, especially conservatives, are continuing to drive home the narrative that the president is the one calling the shots, while being careful not to specifically criticize Ryan and House GOP leaders.

“It’s ultimately the president that is going to decide ‘yes’ or ‘no’ on what happens here,” Meadows said after the White House meeting.

Meadows noted he spoke to Ryan earlier in the day — apparently before the White House meeting though he didn’t specify — acknowledged the speaker’s concerns, noting that he’s trying to work to ensure moderate members also remain on board.

While the Freedom Caucus appears largely united, Meadows said he’s not holding anyone to a specific position.

“I happen to be chairman of the Freedom Caucus but I am not their conscience, nor do I represent their districts,” he said. “We’ve got 40, plus or minus, members that make up their own minds in how they can best serve their constituents.”

Erin Mershon, Joe Williams, Rema Rahman, John T. Bennett and Bridget Bowman contributed to this report.