Donald Trump suffered a major legislative reversal on Friday as Republicans were forced to pull their repeal of the Affordable Care Act from the House floor.
After weeks of contentious negotiations over the American Health Care Act (AHCA), Republicans had to admit defeat as they could not gain sufficient support from their own side for the plan to overhaul US health insurance.
Speaking afterward in the Oval Office, Trump blamed Democrats for the failure of a bill to repeal the signature achievement of Barack Obama. “If [Democrats] got together with us, and got us a real healthcare bill, I’d be totally OK with that. The losers are Nancy Pelosi and Chuck Schumer, because they own Obamacare. They 100% own it,” he said.
Trump refused to bash the House speaker, Paul Ryan, but declined to answer a question about policy changes he would like to see in health reform. Instead, he said he was ready to move on to tax reform, saying: “We’re probably going to start going very strongly on big tax cuts. Tax reform that will be next.”
He added: “We all learned a lot. We learned a lot about loyalty.”
Earlier on Friday, as it became clear that Republican resistance to the bill was hardening, Ryan went to the White House to tell Trump in person that he did not have the votes to pass the bill.
The White House press secretary, Sean Spicer, had insisted the vote would go ahead at 3.30pm ET. “Has the team put everything out there, have we left everything on the field? Absolutely,” he told reporters at his daily briefing. “But at the end of the day this isn’t a dictatorship and we’ve got to expect members to ultimately vote how they will according to what they think.”
However, Spicer’s imagined 3.30pm deadline slid by, ignored by Republicans on Capitol Hill, and the first reports emerged that Trump had asked for the vote to be pulled. Minutes later House Republicans, short of votes, had withdrawn the health bill.
At a press conference soon afterward, Ryan admitted: “Moving from an opposition party to a governing party comes with growing pains and, well, we’re feeling those growing pains today. I will not sugarcoat this: this is a disappointing day for us.”
He said “doing big things is hard” and conceded that after almost a decade of saying no to everything in opposition, the Republicans had failed to come together and agree on something they have opposed for seven years. “We are going to be living with Obamacare for the foreseeable future,” he said.
Ryan said he had recommended the bill be pulled when he realized the votes were lacking. But he praised Trump’s role in the negotiations, adding: “The president gave his all in this effort; he’s really been fantastic. Still, we’ve got to do better and we will.”
Asked how Republican members could now go back to their constituents having failed to keep their promise, Ryan replied: “That’s a really good question. I wish I had a better answer for you.”
Separately, a Washington Post reporter described a call with Trump in which he said the bill would not return any time soon.
Ryan also conceded that Republicans would now move on to other priorities – securing the border, rebuilding the military and tax reform. “Now we’re going on to move on with the rest of our agenda because we have big, ambitious plans to improve people’s lives in this country.”
Although speculation had grown on Friday afternoon that the bill would be pulled, the announcement came as a surprise to Republican members.
An emergency meeting of the House Republican Caucus was called shortly before the scheduled vote. As it was announced, the House went to recess, with Democrats shouting in a taunting manner, “Vote, vote, vote”, daring Republicans to bring the bill up. They did not.
In a short meeting, Ryan announced that the bill was being pulled from the floor in a terse statement to members.
Many moderates in swing districts were wary of supporting the legislation, which included major cuts to Medicaid and was estimated by the non-partisan Congressional Budget Office to lead to 24 million fewer Americans having health insurance over the next 10 years.
Conservatives also objected to the legislation for keeping too much of the architecture of the Affordable Care Act (ACA), frequently referred to as Obamacare. Although the Republican leadership made a major concession to them on Thursday by removing the federal mandate that health insurance plans cover “essential health benefits” such as maternity care and mental healthcare, this was not enough to win them over.
As the Nevada Republican Mark Amodei put it, the GOP caucus “didn’t spend a lot talking about a unified Republican vision for what we should do with healthcare in the House”. Paul Gosar, a member of the hard-right Freedom Caucus, which was instrumental in this setback, pointed a finger at White House staff.
The result is a major political blow to Paul Ryan, a healthcare policy specialist who led the effort in pushing the AHCA. It also leaves Trump in a vulnerable position. The president ran on a platform of repealing the “disaster” of Obamacare and replacing it with “something terrific”. However, Trump, author of the Art of the Deal, failed to accomplish that goal in his first major attempt to negotiate on Capitol Hill.
Nancy Pelosi, the House minority leader, called Friday “a great day for our country”, adding: “What happened on the floor was a victory for the American people.”
The Senate Democratic leader, Chuck Schumer, said in a statement: “Ultimately, the Trumpcare bill failed because of two traits that have plagued the Trump presidency since he took office: incompetence and broken promises. In my life, I have never seen an administration as incompetent as the one occupying the White House today.
“They can’t write policy that actually makes sense, they can’t implement the policies they do manage to write, they can’t get their stories straight, and today we’ve learned that they can’t close a deal, and they can’t count votes.
“So much for The Art of the Deal.”
Members of the Republican caucus took different lessons from the failure to even bring the AHCA to the vote.
Louie Gohmert of Texas, an arch-conservative who was opposed to the bill, pointed fingers at House leadership, which he implied had left both rank and file and Trump boxed in with no alternative.
“The president didn’t really get involved until after they created this bill and he was fighting for it,” Gohmert said.
Bradley Byrne, a loyal Republican from southern Alabama, expressed his readiness to still vote for the AHCA after it was pulled. He mourned the fact that House Republicans fell just short, in his opinion. “There were 200 plus ... ready to do whatever it takes and ... with that group of people we can do a lot,” said Byrne. He didn’t blame anyone for the setback, praising both Ryan and Trump, who he described as doing a “great job”.
Republicans wondered whether this doomed any hope of healthcare reform. Gohmert seemed to sympathize with Trump’s desire to move on to tax reform, adding: “If I were president, I wouldn’t deal with healthcare any more, but as a legislator it is a problem and we should pick it back up and do it right.”
Speaking before the bill was pulled, the North Carolina congressman Mark Walker, chair of the Republican Study Committee, told reporters: “I can’t pretend that this is a win for us. I’m sure our friends on the left, this is a good moment for them. In fact, probably that champagne that wasn’t popped back in November may be utilized this evening.”