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Health Care Reform Lives, Vindicating House Conservatives

The opinions expressed by columnists are their own and do not necessarily represent the views of

Repealing and replacing Obamacare is back on the menu, days after House Speaker Paul Ryan (R-WI) postponed and then canceled a vote on the American Health Care Act (AHCA), which he had claimed embodied Republicans’ only meaningful chance to replace the Obama-era Affordable Care Act (ACA).

In a press conference following a meeting of House Republicans on March 28, Ryan insisted his party and chamber would “get this right” because “it is just too important” and “Obamacare is doing too much damage to families.”

The announcement vindicates House conservatives, who banked on having other opportunities to replace ACA when they called Ryan’s bluff that AHCA in its current form would be their one and only shot. Now House leadership, instead of punishing members of the conservative and libertarian House Freedom Caucus, finally appears to be giving them a seat at the table:

“We all have to reflect on what we could have done better, and this discussion was an honest and very constructive step forward. … We don’t want a government-run health care system. We all agree on these things. So, we’re not going to retreat into our corners or put up dividing lines. Today we broke down many of those dividing lines within our conference. There’s too much at stake to get bogged down in all of that. We’re going to move forward on the things the American people sent us here to do. … It may take a little bit more time, but we are certainly listening, and we are going to get there.”

House Majority Leader Kevin McCarthy (R-CA) took the podium after Ryan, reiterating a promise to the American people to repeal and replace Obamacare, insisting the AHCA vote cancelation on March 24 “doesn’t mean we’re not going to get there.” House Majority Whip Steve Scalise (R-LA) said congressional Democrats’ celebration is premature, “because I think we’re closer today to repealing Obamacare than we’ve ever been before.”

What are the chances the House leadership’s display of party unity is just a show? Quite good. From a strictly Machiavellian viewpoint, the GOP leadership has an urgent need to project strength, even if it means deceiving constituents, most of whom don’t hear details beyond “Republicans failed last week,” and especially if it means deceiving Democrats and the mainstream media.

United or not, House Republicans have a faction among them unlikely to be tricked into passing major health care legislation that keeps Obamacare’s regulatory structure. As I wrote at The Washington Examiner with Justin Haskins, executive editor at The Heartland Institute, on March 27:

“Far from preventing a repeal of Obamacare or stifling what Ryan had called significant health care reform, House conservatives just wrote their ticket for enacting true free-market reforms in the future. … When the Freedom Caucus wants to bring better health care reform legislation to the floor, Ryan will have to let them, or he’ll risk getting stalled again and hold up Trump’s other agenda items.”

The House Freedom Caucus has demonstrated considerable savvy, and GOP leadership confirmed this by repeating promises to pass health care reform conservatives can agree with, even if meanwhile Trump and Congress move on to tax reform.

Republican strategist David Payne says the House leadership’s failure to deliver AHCA could motivate Trump to ally with Democrats: “[I]f a trend develops, the caucus might push Trump into the arms of moderate Democrats willing to pull bills to the left in exchange for passage,” Payne told Fox News on March 27.

It’s possible—even probable—Trump will curry favor with Democrats to run the table with big spending initiatives. But this will only confirm Trump had always planned to spend big anyway, and certainly with Democratic crossover. It’s doubtful a tycoon like Trump would decide on a massive spending spree spontaneously, even as retribution or to save face. Surely Trump’s overtures toward big defense, infrastructure, and a wall along the United States/Mexico border suggest the president set his sights on big spending long ago, regardless of how well Obamacare repeal and replacement would fare.

If (or more likely, when) Trump courts Democrats for votes, the mainstream media will spin it as Trump seeking more rational partners than the libertarian and conservative members of the House Freedom Caucus who held up the repeal and replacement of Obamacare. Let them spin. It won’t change the fact, as Haskins and I stated in The Washington Examiner, the “ill-fated American Health Care Act flamed out over Washington, DC, on Friday, a city whose ‘rendezvous with destiny’ is, it turns out, controlled by conservatives”—at least a little more than everyone thought.

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