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Tipsheet

Ben Domenech On GOP Health Care Defeat: The House Freedom Caucus Isn't Going Anywhere, You Have To Work With Them

As House Republicans lick their wounds over their failed attempt to rollback Obamacare (though conservatives would disagree it would do much), CBS’ Face The Nation had The Atlantic’s Ronald Brownstein, The Washington Post’s Juliet Eilperin, Slate’s Jamelle Bouie, and The Federalist’s Ben Domenech to glean from the ruins what happened with this failed push on behalf of Republicans.

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Eilperin noted that the health care industry wasn’t involved in the process. No input was solicited regarding the crafting of this legislation.

“Well, and you can’t -- and you can’t underestimate the fact that there was no negotiation,” she said. “I was talking to a health care lobbyist yesterday who said, it’s not that they shut their doors and they didn’t take our calls, but they didn’t solicit our input and more importantly they -- there wasn’t a negotiation.”

Domenech agreed more transparency has to occur with big bills like this, especially since they touch upon an issue that represents one-sixth of the U.S. economy. It cannot be behind closed doors. As for the House Freedom Caucus, Domenech noted that they’re not going away, that their brand of conservatism is here to stay, and that their presence is big enough to derail big pieces of legislation.

GOP leadership needs to recognize a lesson that they can take away from this moment, which is that the Freedom Caucus and what it represents, fiscal conservatives who have support in their districts, support that far outpaces the president of the United States, are here to stay. And they’re a large enough faction to be able to get what they want done. The fact is that, you know, today, Adam Kinzinger, a representative from Illinois, came out and said he thought that leadership should take the lesson that they should abandon dealing with these conservatives and instead reach out to centrist Democrats, to which I say it’s fun to play pretend. The reality is that this faction is not going away and in order to include them in the process, to bring them, to not draft legislation behind closed doors, you have to have a more open, a more collaborative process that includes them and other stakeholder groups from the get-go. The real, hard problem that leadership has to face is that it wasn’t just conservatives who killed this bill, it wasn’t just the Heritage Foundation that opposed it, it was the AARP, it was every major medical group -- everyone. If you -- if you had seven years to put that together, how could you even make that happen.
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Moreover, while the news media and establishment Republicans are ripping the House Freedom Caucus for killing the bill, let’s not forget that moderates also bolted. In fact, as Brownstein noted from Sen. Tom Cotton, who was interviewed prior to the panel, “in most of the whip counts, there were more people outside of the Freedom Caucus who opposed the bill who were -- than those who were inside.”

Domenech also noted the political grenade that was possibly dodged with this bill, notably how if this immensely unpopular bill were passed (it only had 17 percent approval), then House members would have to defend a bill that really wasn’t formulated well. Domenech noted the Senate schedule, which could have opened House Republicans to endure weeks of punishment for supporting a bill that wasn’t well executed.

[A]s a health policy person when I looked at this was not an ideological question. I have my own positions when it comes to health possibility. It was more about workability. Is this even going to work? And I think in this sense you were asking, you know, this past week, for all these members of Congress to come out and vote for something that they didn’t have a final CBO score for, that they really didn’t know how it would apply to their districts, and you can look at the Senate’s schedule going forward, they’re going to do Montenegro next and they’re going to do Gorsuch and then there’s going to be a recess and then they’re going to do a CR, and all of those things mean House members will be flailing for five weeks defending a bill that they didn’t even fully understand.
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Yes, a new CBO score was released on the eve of the vote, but GOP House members were scrambling to find ways to give the Trump White House the votes they needed. Moreover, it wasn’t good. The number of uninsured by 2024 remained the same and the cut in the over a ten-year period was cut in half, from $337 billion to $150 billion.

Brownstein also noted how this fight showed how Trump’s economic agenda collided with his base (and traditional conservatism), while Bouie adding that the modern presidency is heavily involved in policy. We saw that with the Obama White House ramming through Obamacare. Yet, we don’t, in Bouie’s opinion, have the policy expertise, or muscle, that’s needed to get things done with Trump:

BROWNSTEIN: The reality is, 60 percent of House Republicans are in districts that are older than the national average and a majority of Donald Trump’s votes came from whites over 45. CBO said people in their 50s would have a 25 percent premium increase and would suffer much of the -- of the coverage loss. They were colliding with their new coalition.

You remember in healthcare in the ‘90s, they twice passed a block grant for Medicaid under Bill Clinton without fuss or muss among Republicans. Now it’s a lot of their voters who will get hit by that.

[…]

BOUIE: It is true that Paul Ryan and House leadership should have had a better sense of how to go forward because they’ve been working on this for seven years. But we’re also living in an age where the presidency is pretty involved in policy matters. And a White House has to have policy expertise. It has to have some sort of knowledge and know how about how to get these things done. And the fact of the matter is, is that not only does the Trump White House not have these things, it has a lot of people new, not just to national politics or government, but new to just policy-making period.

But Donald Trump himself, if you look at his career as a businessman, what he is skilled at is branding. Putting his name on a bill that the House produced is 100 percent what you’d expect Donald Trump to do. And I’m not sure -- I think this may demonstrate that Trump himself does not actually have the kind of skills necessary to shepherd these kinds of big legislative programs through.

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Given that, while the GOP and conservative groups want Republicans to give health care reform another go—it seems as if the same old divisions and wounds could derail it again. Another aspect the Federalist publisher noted on the panel was how much White House Chief Of Staff Reince Priebus reportedly lost in terms of clout with the president in this legislative defeat.

“My sources who are close to the White House tell me that Reince Priebus, who is obviously very close with Paul Ryan, the White House chief of staff, is now on extremely shaky ground, said Domenech. “That the president really doubts him, and was assured by him multiple times through this process that things were going well, that they were going to come out of this with a bill.”

Is he on his way out? We’ll see what happens. For now, Priebus has been going after conservatives, noting that he’s willing to reach out to Democrats to get something done on health care (via Associated Press):

White House chief of staff Reince Priebus scolded conservative Republicans, explaining that Trump had felt "disappointed" with a "number of people he thought were loyal to him that weren't."

"It's time for the party to start governing," Priebus said. "I think it's time for our folks to come together, and I also think it's time to potentially get a few moderate Democrats on board as well."

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