OPIOID SERIES:

Ryan takes backseat to Pence in latest ObamaCare effort

Two weeks ago, Speaker Paul RyanPaul Davis RyanFreedomWorks backs Jim Jordan for House Speaker House, Senate GOP compete for cash Some doubt McCarthy or Scalise will ever lead House GOP MORE (R-Wis.) left it all on the field in trying to pass his ObamaCare repeal-and-replace bill.

He talked up the legislation during dozens of TV interviews. The former Ways and Means Committee chairman treated reporters to a half-hour presentation detailing why the current health insurance law was failing. And Ryan hosted countless meetings in his ornate office in the Capitol in a bid to flip members from no to yes.    

Now, Ryan’s taking a more hands-off approach.

The Speaker has taken a backseat to Vice President Pence when it comes to this week’s efforts to revive the American Health Care Act, which collapsed last month after Ryan and President Trump failed to cobble together the necessary votes to pass the bill out of the House.

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Pence, who spent a dozen years in the House, has been shuttling from meeting to meeting on Capitol Hill — his sizable entourage in tow.

But now, with talks between Pence and centrist and conservative wings of the GOP stalled once again, it is the vice president, not Ryan, who is quickly becoming the face of the failed healthcare push.

One House Republican, a Ryan ally, said the Speaker “feels like he did everything he could” to pass the bill and now is willing to let others take the lead and try a different approach. His thinking now is to give his members space to work out their differences and come to an agreement.

“When leadership gets involved and sort of big-foots and runs a meeting, those kinds of conversations don’t occur as well,” Ryan said Wednesday at an event hosted by WisPolitics.com. “I want members freely expressing themselves so that people understand what it is that they think and what their concerns are.”

Asked why Pence, rather than Ryan, appeared to be the “pivot point” of the health talks, Ryan replied, “There is no one pivot point.”

The Speaker also continued to tamp down expectations for any sudden breakthrough. “We can keep working this for weeks now,” Ryan said. “We don’t have some kind of artificial deadline in front of us.”

White House officials and some Republicans had hoped a vote could be held this week, before Congress leaves town Thursday for a two-week Easter recess. But with no deal in sight, that now appears all but impossible.

“We need a cooling-off period,” Chief Deputy Whip Patrick McHenry (R-N.C.) told reporters Wednesday in the Speaker’s Lobby just off the House floor. “We need people to stop, take a deep breath and think through the way to yes."

Despite Pence’s efforts this week on Capitol Hill, members of the centrist Tuesday Group and far-right Freedom Caucus are still clashing over the vice president’s proposal to give states the ability to opt out of three key ObamaCare regulations. The first lays out 10 essential health services an insurer must cover, the second bars insurers from charging sick people higher premiums, and the third prevents insurers from denying coverage to people with pre-existing conditions.

One Freedom Caucus member said his conservative colleagues prefer to negotiate with Pence, Health and Human Services Secretary Tom Price and White House Management and Budget Director Mick Mulvaney instead of Ryan and GOP leadership. Both Pence and Price had previously led the conservative Republican Study Committee, while Mulvaney is one of the Freedom Caucus's co-founders.

“They feel like Pence is one of us,” the Freedom Caucus member told The Hill. “And Pence had mentioned privately that if the Freedom Caucus had existed when he was in Congress, he would have been a member.”

Rep. Kevin Cramer (R-N.D.), who considers himself an ally of both Ryan and Trump, called the Speaker’s hands-off approach “a pretty good move.”

“Paul’s obviously made all of his points, and there are people who have to work these things out themselves. Letting them do that is pretty rich,” Cramer said in an interview outside the Capitol. “At the end of the day, Paul’s still got to take [the bill] to everybody, to the normal caucuses, as I like to say.”

It’s not that Ryan’s out of the loop. The Speaker is still being regularly briefed by lawmakers and top aides about the status of negotiations. He hosted the leaders of the Tuesday Group, Republican Study Committee and House Freedom Caucus in his office on Tuesday for their regular weekly meeting. And Ryan aides attended Tuesday night’s meeting between Pence and top House negotiators.

On Wednesday afternoon, Ryan was spotted huddling on the House floor with Energy and Commerce Chairman Greg Walden (R-Ore.), one of the authors of the original health legislation.

One of the reasons the Speaker needs to stay on top of the negotiations is to coordinate closely with his Senate counterpart, Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnell32 male senators back Senate women's calls to change harassment rules Duckworth brings her baby to Senate vote, drawing a crowd FreedomWorks backs Jim Jordan for House Speaker MORE (R-Ky.), and make sure any bill passed by the House can pass muster with the upper chamber’s Byrd Rule.

The rule, named for the late Sen. Robert Byrd (D-W.Va.), bars the Senate from considering any “extraneous matter” as part of a reconciliation bill, which is a type of budget legislation that allows the Senate to avoid use of the filibuster.

Michael Needham, the CEO of the conservative group Heritage Action, held a press call Wednesday to blame members of the Tuesday Group for blocking a deal.

But Needham also criticized Ryan for not pushing more aggressively for the proposal from Pence.

“It's the job for Paul Ryan to get that original [Pence] proposal through,” Needham said. “It's a win for all parts of the conference.”

“Rather than trying to build support for good policy, they've just kind of immediately abandoned [it],” Needham said of House leadership.

Asked why Ryan was taking a less active role in the healthcare talks, Ryan spokeswoman AshLee Strong replied: “This week's focus has been to get members talking to each other and seeing this discussion from beyond their own vantage point. That work continues.”