A week of high drama in Washington reached a stunning climax on Friday: President Trump and Speaker Paul Ryan (R-Wis.) decided to pull the Republican bill that had sought to repeal and replace the Affordable Care Act rather than watch it go down to certain defeat.
There will be no second attempt anytime soon. Ryan said at a Capitol Hill news conference on Friday afternoon that the nation will “be living with ObamaCare for the foreseeable future.”
It’s an astonishing conclusion to one of the main fights that Republicans — including Trump — have sought for years.
As the dust settles, who are the biggest winners and losers?
Make no mistake, this was a humiliating defeat for a president who campaigned as the ultimate deal-maker who could shake up a moribund Washington and get things done.
His big legislative push has fallen at the first hurdle. Trump himself was deeply engaged in trying to win over reluctant Republican lawmakers — and it didn’t work.
There are many unknowns: How will this affect other items on Trump’s agenda? How much frustration among grassroots Republican voters will be focused on him rather than Ryan or the GOP lawmakers who refused to get on board?
In remarks on Friday afternoon, Trump sought to put a brave face on the situation, avoiding lashing out at any Republicans and arguing that the Democrats would continue to “own” ObamaCare, to their political detriment.
But when Trump said, “There’s not much you can do about it,” referring to ObamaCare, it seemed an oddly impotent remark for a sitting president with majorities in both houses of Congress.
This is a very big setback for Trump. Just how big will become clear only after more time has passed.
Speaker Paul Ryan (R-Wis.)
Friday’s developments were at least as damaging for Ryan as they were for the president.
Whether the American Health Care Act would ultimately have been signed into law or not, the fact that Ryan could not get it through the House is deeply embarrassing for the Speaker.
Ryan’s fingerprints were all over the legislation, which faced immediate and fierce pushback from conservative members of his own conference as well as several important interest groups.
Some Trump loyalists contend that Ryan erred by focusing on healthcare rather than tax reform out of the gate. And conservative media commentators are openly questioning his leadership.
Trump publicly insists that he retains confidence in Ryan. But the Speaker went down to a big defeat that revealed an inability to muscle his members into line.
Vice President Pence, Health and Human Services Secretary Tom Price, and Office of Management And Budget Director Mick Mulvaney
Pence, Price and Mulvaney were all once House members — in the case of the latter two, right up until they joined the Trump administration.
As such, the White House had suggested they would be especially effective in winning over members of the ultra-conservative House Freedom Caucus and other lawmakers. Mulvaney was a founding member of the group.
When all’s said and done, the trio failed to round up the required votes. That’s a political black eye for all three men.
The House Freedom Caucus
The conservative group won the battle — but the outcome of the broader war has yet to be decided.
The caucus, led by Rep. Mark Meadows (R-N.C.), held the line in opposition to the bill, despite the urgings of Trump himself. More than any other Republican group, they were responsible for the failure of the legislation.
The whole episode showed the power of the Freedom Caucus, but its members will have to deal with the consequences too.
They defied a president of their own party who — for all his broader struggles with popularity — is fervently supported by many grassroots Republicans.
They sank an effort to replace a law that many of those grassroots voters detest.
And the realpolitik argument for their position — that they could force Trump and the House leadership to come back to the table with a proposal that was more attentive to their concerns, appears to have proven untrue.
Former President Barack Obama
The bottom line is simple: Obama’s signature domestic achievement has survived – and at a moment when the White House, the Senate and the House are all controlled by people who have repeatedly pledged to destroy it.
Trump, speaking from the White House on Friday afternoon, insisted that the Affordable Care Act would explode under its own weight. But the current president did not make any pledge to renew his efforts to undo it, instead suggesting he would be open to some more incremental repairs in tandem with congressional Democrats.
Obama’s big law dodged a bullet here. And that strengthens his legacy as a president of considerable historical significance.
House Minority Leader Nancy Pelosi (D-Calif.)
Pelosi displayed the kind of grip on her party colleagues that Ryan so signally failed to exhibit.
Not a single Democrat broke ranks to support the Republican proposal. The position may not have been that surprising. But it did ensure that Republicans faced the steepest possible gradient.
Pelosi, who loves the hand-to-hand political combat of Capitol Hill, clearly took some pleasure in the Republicans’ disarray.
Trump’s son-in-law, among his most trusted advisers, was reportedly against the decision to move on healthcare from the get-go. But he was also out of Washington for much of the week, on a ski trip with his family in Aspen.
CNN reported that the president was displeased that Kushner was out of town.
But as someone who was physically and politically distant from the week’s messy horse-trading, he emerges relatively unscathed from the debacle.
Several GOP governors were critical of the replacement plan put forward by their colleagues in the House.
Ohio’s John Kasich, Nevada’s Brian Sandoval, Arkansas’ Asa Hutchinson and Michigan’s Rick Snyder wrote an open letter last week to Ryan and Senate Majority Leader Mitch McConnell (R-Ky.) stating that they could not support the legislation.
Their argument, in essence, was that the bill would have hit Medicaid too hard.
They gave political cover to lawmakers from their states who were also leaning against the legislation.
The organization for older Americans lobbied vigorously against the law.
It attacked one proposed change as “an age tax,” emphasized that 24 million fewer people were projected to have health insurance after a decade, and declared the issue to be an “accountability vote” — in other words, one where it would use its muscle against lawmakers who voted against its wishes.
The association’s efforts were a reminder that it is not to be underestimated.
The Memo is a reported column by Niall Stanage, primarily focused on Donald Trump’s presidency.