On Senate Health Bill, Trump Falters in the Closer’s Role

WASHINGTON — President Trump began his all-hands meeting with Republican senators at the White House on Tuesday by saying they were “very close” to passing a health care bill, just as efforts to fast-track a vote this week collapsed.
If Republicans do manage to broker a deal — as Senator Mitch McConnell of Kentucky, the majority leader, cheap mlb hats, pledged to do during a lively East Room back-and-forth with the president — it is not likely to be because of Mr. Trump’s involvement. Until Tuesday afternoon, the president was largely on the sidelines as the fate of one of his most important campaign pledges played out.

Mr. McConnell, who kept the president at a polite arm’s length while he oversaw negotiations over the bill, asked Mr. Trump to arrange the meeting with all 52 Republican senators during a morning phone call, in part to show senators the White House was in fact fully engaged, according to two people with knowledge of the call.

When asked by reporters clustered on the blacktop outside the West Wing if Mr. Trump had command of the details of the negotiations, Mr. McConnell ignored the question and smiled blandly.


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Mr. Trump and his staff played a critical role in persuading House Republicans to pass health care legislation in May, with the president personally calling dozens of wavering House members. But the Trump team’s heavy-handed tactics have been ineffective in the Senate, and White House officials determined that deploying Vice President Mike Pence, a former congressman with deep ties to many in the Senate, was a better bet than unleashing Mr. Trump on the half-dozen Republicans who will determine the fate of the Senate bill to repeal and replace the Affordable Care Act.

Mr. Trump, who is fond of telling friends he is a “closer,” became more involved over the past few days, reaching out to a few reluctant conservatives like Senators Mike Lee of Utah, Ted Cruz of Texas and Rand Paul of Kentucky, cheap nfl jerseys, who emerged from an Oval Office meeting on Monday saying he was more optimistic about getting to a yes.

“The White House has been very involved in these discussions,” Mr. McConnell said in announcing that a vote on the bill was postponed until after the Fourth of July recess. “They’re very anxious to help.”

Yet over the past few weeks, the Senate Republican leadership has made it known that it would much rather negotiate with Mr. Pence than a president whose candidacy many did not even take seriously during the 2016 primaries. And some of the White House’s efforts have clearly been counterproductive.

Over the weekend, Mr. McConnell made clear his unhappiness to the White House after a “super PAC” aligned with Mr. Trump started an ad campaign against Senator Dean Heller, Republican of Nevada, after he said last week that he opposed the health care bill.

The majority leader — already rankled by Mr. Trump’s tweets goading him to change Senate rules to scuttle Democratic filibusters — called the White House chief of staff, Reince Priebus, to complain that the attacks were “beyond stupid,” according to two Republicans with knowledge of the tense exchange.

Mr. McConnell, who has been toiling for weeks, mostly in private, to put together a measure that would satisfy hard-liners and moderates, told Mr. Priebus in his call that the assault by the group, America First, not only jeopardized the bill’s prospects but also imperiled Mr. Heller’s already difficult path to re-election.

Mr. McConnell and “several other” Republican senators expressed their irritation about the anti-Heller campaign during the White House meeting, according to two people, one of them a senator, who were present.

The move against Mr. Heller had the blessing of the White House, according to an official with America First, because Mr. Trump’s allies were furious that the senator would side with Nevada’s governor, Brian Sandoval, a Republican who accepted the Medicaid expansion under the health law and opposes the Republican overhaul, in criticizing the bill.

According to the senator, the president laughed good-naturedly at the complaint and signaled that he had received the message.

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A few hours later, America First announced it was pausing its advertising assault against Mr. Heller, insisting it was doing so because of his willingness to come to the White House meeting with Mr. Trump.

America First was founded by a group of Mr. Trump’s loyalists — many of them with deep connections to Mr. Pence, including Nick Ayers, a Republican consultant who is regarded as the vice president’s top political adviser. The group compared Mr. Heller to Representative Nancy Pelosi, the House Democratic leader, and vowed a seven-figure advertising campaign against him.

Mr. Heller, the only Senate Republican who will face voters next year in a state carried by Hillary Clinton in 2016, is the top target for Democrats facing a Senate map with few opportunities in 2018. And there were already seven groups — a mix of health care advocacy organizations and more partisan Democratic efforts — on the air in Nevada assailing the Republican health care overhaul, according to a Republican ad buyer tracking the ad traffic.

Neither Mr. McConnell’s office nor his top outside political advisers were warned about an impending attack on one of their most endangered incumbents. “They didn’t check in with anybody,” said Josh Holmes, Mr. McConnell’s former chief of staff. “There was no clearing of channels, Cheap wholesale jerseys, no heads-up, nothing.”

Republican senators across the ideological spectrum have indicated their unease with the health bill. But Mr. Trump has few ties with the group, and several Republicans who remain on the fence have tangled with Mr. Trump, either during the presidential campaign or since.

Top Trump lieutenants like Stephen K. Bannon, his chief strategist, who lobbied members on the House bill, have been all but sidelined. Mr. Priebus has also played a much diminished role.

Mr. Pence has been far more active in seeking out Republican senators. Seema Verma, Mr. Pence’s former adviser in the Indiana Statehouse and now a top administration health care official, has also been trying to reassure senators that their states will have flexibility on Medicaid under the bill, while Mr. Pence’s former chief of staff, Marc Short, now the White House legislative affairs director, has been quarterbacking the effort from his hideaway in the Capitol.

Until Tuesday’s meeting at the White House, Mr. Trump had spoken with only a few members of the Senate, according to an administration official. The pace was nothing like the dozens of calls he made to help pass the House’s health bill, aides said.

A senator who supports the bill left the meeting at the White House with a sense that the president did not have a grasp of some basic elements of the Senate plan — and seemed especially confused when a moderate Republican complained that opponents of the bill would cast it as a massive tax break for the wealthy, according to an aide who received a detailed readout of the exchange.

Mr. Trump said he planned to tackle tax reform later, ignoring the repeal’s tax implications, the staff member added.

After the meeting, Mr. Trump played the role of cheerleader on Twitter, encouraging his weary Republican allies to keep working.

“I just finished a great meeting with the Republican Senators concerning HealthCare,” he wrote. “They really want to get it right, unlike OCare!”

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The Senate Democratic whip, Richard J. Durbin of Illinois, cheap jerseys, said the report by the Congressional Budget Office “did more to strike a dagger to the heart of this Republican repeal than anything else.”
In 2026, the budget office said, 15 million fewer people would have Medicaid coverage under the Senate bill than under the Affordable Care Act, and seven million fewer people would have coverage they purchased on their own. Faced with deep cuts in Medicaid, the report said, state officials would face unpalatable choices: restrict eligibility, eliminate services, reduce payments to health care providers and health plans, or spend more of their own money.

Appearing in Washington, Gov. John R. Kasich of Ohio cited the 22 million projection and expressed bewilderment that fellow Republicans would be on board with the bill.

“And they think that’s great?” he asked. “That’s good public policy? What, are you kidding me?”

Doctors, hospitals and other health care provider groups have come out strongly against the Senate bill, cheap snapback hats, as have patient advocacy groups like the American Heart Association. But business groups were ramping up their support. In a letter on Tuesday, the U.S. Chamber of Commerce urged senators to vote for the bill.

The Senate bill “will repeal the most egregious taxes and mandates” of the Affordable Care Act, allowing employers to create more jobs, said Jack Howard, a senior vice president of the group. The bill, he noted, would repeal a tax on medical devices and eliminate penalties on large employers that do not offer coverage to employees.

A separate letter expressing general support for the Senate’s efforts was sent by a coalition of business and employer groups including the National Association of Home Builders, the National Restaurant Association and the National Retail Federation.


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But Senate conservatives found themselves squeezed between business sentiment and their conservative base. The Club for Growth, a conservative group, came out against the Senate measure on Tuesday. The organization’s president, wholesale jerseys china, David McIntosh, noted that congressional Republicans had “promised to repeal every word” of the Affordable Care Act.

“Only in Washington does repeal translate to restore,” he said. “Because that’s exactly what the Senate G.O.P. health care bill does: It restores Obamacare.”

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