GOP looks to heal from healthcare divisions

GOP looks to heal from healthcare divisions
© Greg Nash

For Republicans, the successful House vote Thursday to repeal and replace ObamaCare was a moment of celebration. But it also was a time for inward reflection. 

The past two months exposed deep divisions within the broad 238-member GOP conference, saw President Trump unleash Twitter attacks on individual GOP members and factions, and raised questions about whether Speaker Paul RyanPaul Davis RyanElection Countdown: Cruz, O'Rourke fight at pivotal point | Ryan hitting the trail for vulnerable Republicans | Poll shows Biden leading Dem 2020 field | Arizona Senate debate tonight Paul Ryan to campaign for 25 vulnerable House Republicans GOP super PAC pushes back on report it skipped ad buys for California's Rohrabacher, Walters MORE (R-Wis.) and his team could deliver on the GOP’s top campaign promise.

And while GOP leaders mustered just enough votes to push the healthcare bill through their chamber, the tortuous experience has left Republicans asking themselves: How can we do things better next time?


In a closed-door gathering before the health vote, Ryan told rank-and-file Republicans that the conference needs to figure out what they did right, what they did wrong and what they can learn from the experience, sources in the meeting said.

“What we would do in the Army is an after-action review,” said conservative Rep. Warren Davidson (R-Ohio), a retired Army Ranger. “What went wrong? How do we make sure we do this better going forward? If we get a better product-development process, we’re going to launch better bills faster.”

Several lawmakers said Trump’s decision in recent weeks to get directly involved in negotiations and lobby for the health bill helped push it over the finish line, and they want to see the president intervene earlier in the coming debates over tax reform and infrastructure. Rep. Dave Brat (R-Va.) called Trump a “spark plug” full of “constant energy.”

Leadership also needs to figure out how to engage members on the front end of the bill-writing process, not the back end, members said. During the past year, Ryan’s team hosted countless listening sessions and policy meetings to solicit ideas on the GOP bill, but not everyone participated or thought those gatherings were useful.

When the American Health Care Act was rolled out in early March, many had issues with it. Weeks later, Ryan had to yank the legislation off the House floor after the conservative House Freedom Caucus rejected it. Over the next six weeks, the bill had to be tweaked to attract the bloc of roughly 30 conservatives and then tweaked again to secure a handful of moderate holdouts. 

“There was a lot of turbulence, no doubt about it,” Rep. Tom Reed (R-N.Y.), a Trump ally and member of the powerful House Ways and Means Committee, told The Hill. “The more we can get our product out in front of people and our stakeholders, the better. I know you run the risk of a death by a thousand cuts, but if we have good sound policy, we should lead with it. We don’t hide in any way. 

“We engage members, give them as much information as possible so we’re not educating as much toward the end of the process as opposed to up front. That would be helpful.” 

Rep. Luke Messer (R-Ind.), a member of leadership who heads the House GOP Policy Committee, agreed that more member input is needed in the future, even if he and his colleagues haven’t figured out how to achieve that. 

“This legislative victory is another reminder that people support what they help create. As more member solutions were added to the bill, the bill gained greater and greater momentum,” Messer told The Hill. “The trick with tax reform will be to create the mechanism to capture great ideas from our members — with maybe a touch less drama.” 

Others on Capitol Hill seemed to acknowledge that all the setbacks and stops and starts were simply part of the inevitable sausage-making process.

“Like with a lot of things, we sometimes make it tough. Looking back, I don’t like the way it played out,” Rep. Bill FloresWilliam (Bill) Hose FloresTexas lawmaker: GOP facing funding disadvantage The Hill's Morning Report — Presented by PhRMA — Trump, Pence fan out to protect the Rust Belt Jordan hits campaign trail amid bid for Speaker MORE (R-Texas), a former chairman Republican Study Committee, told The Hill. “But at the end of the day, we did the right thing for the American people to keep them from the horrors of ObamaCare.”

The long, drawn-out process had tested the patience and temperament of the new, inexperienced GOP president; it also tested his relationship with Ryan and his Republican colleagues on Capitol Hill. After the Freedom Caucus derailed the first health vote, Trump took to Twitter and threatened to back primary challengers against them unless they got on board. 

And Trump and his top aides were pressuring Ryan almost on a daily basis to bring the bill back to the floor. 

The House’s healthcare victory has helped ease those tensions and foster more trust between the White House and Capitol Hill that will be helpful going forward. After Thursday’s narrow but successful 217-213 vote, Republicans descended the Capitol steps, boarded buses, and made the short drive to the White House to take a victory lap with Trump and Vice President Pence.

It was a rare show of GOP unity after weeks of negative stories about White House infighting and intraparty squabbles over health care.

“I don't think we're here without [Trump]. I think he brokered a lot of these compromises along the way. He worked the members pretty actively,” said Rep. Tom Cole (R-Okla.), who arrived in Congress during the first term of President George W. Bush.

“He's really good at this, and it's actually been good for us. We got to know him better."

Freedom Caucus Chairman Mark Meadows (R-N.C.), an influential voice in the healthcare negotiations who spoke at the White House news conference, said he never doubted the legislation could be resuscitated. 

“I always believed that we would find a way to move it forward. I can tell you who believed it more than me: the president of the United States,” Meadows told The Hill in a Capitol elevator. “I must have talked to him three dozen times; he has consistently been wanting to make this bill better. If I had doubts, the president was there to encourage me not to have doubts."

“Everyone will want to claim victory today. This really is a victory for the president and the American people,” Meadows added.

As the elevator descended, Meadows said GOP leadership needs to ensure they seek “real input” and defer to committees who have jurisdiction over specific pieces of legislation.

“That’s really important,” chimed in House Judiciary Committee Chairman Bob GoodlatteRobert (Bob) William GoodlatteHouse Judiciary chairman threatens to subpoena Rosenstein Fusion GPS co-founder will invoke 'constitutional rights not to testify': lawyers House GOP sets deposition deadline for Fusion GPS co-founder MORE (R-Va.), who was riding in the same elevator.

Jessie Hellman contributed.