President Trump gives a thumbs-up as he walks down the steps of Air Force One upon his arrival at Palm Beach International Airport in West Palm Beach, Fla., on March 3, 2017.(Photo: Luis M. Alvarez, AP)
WASHINGTON — If President Trump can get his party united behind the Republican plan to repeal and replace the Affordable Care Act, it might just be his best deal yet.
The former businessman and his administration have kicked off "a full-court press" to get skeptical conservative lawmakers and advocacy groups to a "yes" on the health care plan that was released by House Republican leadership Monday night. Trump has shown a willingness to negotiate the details of the bill, in sharp contrast to House Speaker Paul Ryan, R-Wis., who has said there wasn't much room for changes in the first phase of legislating.
“I talked to the president this week about Obamacare and my objections to the current bill,” Kentucky Sen. Rand Paul told reporters at the Capitol on Thursday. “I think he was open to hearing from conservatives."
“I think there’s gonna be a negotiation, definitely,” Paul said when asked whether he felt “wooed” by Trump.
Trump summoned leaders from conservative groups Club for Growth, Heritage, Americans for Prosperity, FreedomWorks, Heritage Action and Tea Party Patriots to the White House on Wednesday evening. All of those groups had come out against the current legislation.
"It was a good meeting with the president. He understands our concerns and he clearly wants to get a bill passed. I think he may need to take over the negotiations to get this to a bill that conservatives can get behind," Club for Growth President David McIntosh told USA TODAY on Thursday morning.
The bill has divided Republicans. Paul and Utah Sen. Mike Lee have joined with conservatives in the House to call for a full repeal separate from a replacement. On Thursday, Paul reintroduced the 2015 repeal plan that had passed both the House and Senate but was vetoed by President Obama. Ohio Rep. Jim Jordan introduced the companion bill in the House.
Conservatives lawmakers and advocacy groups piled on the criticism after the draft of the bill was released Monday night. Hardliners felt the legislation was not a clean repeal of the Affordable Care Act and included provisions, such as refundable tax credits, that they could not support.
“President Trump tweeted that House Republican leadership’s health care bill was ‘out for review and negotiation.’ We had a constructive conversation. The president and we agree that we should repeal and replace ObamaCare," FreedomWorks President Adam Brandon said in a statement after Wednesday's meeting. “The concerns that have been raised by Sen. Paul, Sen. Lee, and members of the House Freedom Caucus are real, and we believe that we can negotiate on these provisions, address them in a substantive way, and get to ‘yes’ on this bill and throw ObamaCare into the dustbin of history."
From left, Club for Growth President David McIntosh, Tea Party Patriots President Jenny Beth Martin, Americans for Prosperity President Tim Phillips and FreedomWorks President Adam Brandon give statements outside the West Wing on March 8, 2017, after meeting with President Trump. (Photo: Andrew Harnik, AP)
Just hours earlier, FreedomWorks had announced they'd be spending six figures on ads "to take down ObamaCare lite."
"The Republican Party is unified on Obamacare repeal,” Paul said in a statement Thursday. “We can honor our promise right away by passing the same language we acted on in the last Congress. Then, we can have a separate vote on replacement legislation that will deliver lower costs, better care, and greater access to the American people.”
"Despite what you hear in the press, healthcare is coming along great. We are talking to many groups and it will end in a beautiful picture!" Trump tweeted Thursday.
But House leadership sees little room for negotiation, at least on what they're calling phase one of the plan.
“The president supports this plan, is working for this plan," House Majority Leader Kevin McCarthy, R-Calif., said on Fox & Friends on Thursday morning. "I think everybody should get on board. This is one of three phases. If you want to see Obamacare replaced, this is the best opportunity to do it. If you want to see replacement that lowers the premiums and actually gives greater quality of care, this is the only option we have going forward."
The House is using a budgetary procedure that allows for the first step of the repeal process to move through with a simple majority of votes in the Senate, rather than the usual 60 votes. McCarthy said Thursday that negotiation can come during what they envision as phase three of the process. That's when they'll need 60 votes in the Senate to do additional replacements.
But the White House is giving other signals.
Trump is "a deal maker," White House press secretary Sean Spicer said Wednesday. "If anybody can get a deal on something, it's going to be Donald Trump."
Because no Democrats are expected to vote to repeal the ACA, conservatives in both chambers have real power if they stick together. House Republicans can lose only about 20 votes before they lose their majority. If Senate Republicans lose three votes, the legislation won’t move.
The president and his aides will be targeting certain members’ districts and states, and the White House also has plans for op-eds in local newspapers.
"This is going to be a very, very aggressive [and] comprehensive approach," Spicer said. "I think you will see an awful lot of travel and a lot of activity.”
The White House has also been deploying administration officials to meet with key conservatives on Capitol Hill to try to get them on board.
"This week, what’s going on behind the scenes is a charm offensive," Paul said on MSNBC Wednesday. "Every conservative that’s come out publicly opposed to this has been called by the White House and is being cajoled and wooed by the White House to give in."
And now, Vice President Pence is making a Saturday trip to Paul's home state of Kentucky — also the home of Senate Majority Leader Mitch McConnell, who backs the legislation.
Lee — the other Republican senator who has criticized the bill for not going far enough — met with Health and Human Services Secretary Tom Price on Wednesday morning. He also had dinner with Pence in the evening.
Office of Management and Budget Director Mick Mulvaney met with members of the House Freedom Caucus — a group of roughly 40 of the most conservative lawmakers — during their meeting Tuesday night. Before he joined the Trump administration, Mulvaney was a member of the group.
But it isn't just conservatives that the White House is trying to convince. On Thursday morning, Pence and Price met with Ohio Sen. Rob Portman, who had previously sounded alarms over concern that the legislation would hurt people in his state who had benefited from the Medicaid expansion under Obamacare.
"We all share the goal of repealing and replacing ObamaCare with a better plan that will lower health care costs for all Americans. I appreciated the opportunity to address my concerns about our Medicaid expansion population in Ohio," Portman said.
In the wee hours of the morning Thursday, Republicans in the House Ways and Means Committee approved the legislation, clearing its first hurdle. There was no Democratic support.
Contributing: David Jackson, Gregory Korte