Mulvaney: Restarting Health Care Effort Is Key to GOP Agenda

Mulvaney: Restarting Health Care Effort Is Key to GOP Agenda
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When House Republicans failed to reach an agreement on health-care reform last month, President Trump said he would concede the effort and “let Obamacare explode,” while Speaker Paul Ryan announced that his conference would “move on with the rest of the agenda,” including tax reform — leaving health care in the rearview mirror.

But, not two weeks later, the administration has now changed tack, attempting to restart the stalled discussions in a series of meetings at the White House and on Capitol Hill with lawmakers and conservative groups. The shift acknowledges that the rest of Trump’s agenda, including a tax reform package, is in fact inextricably linked to repealing/replacing the Affordable Care Act and the revenue it would raise.

Mick Mulvaney, director of the White House Office of Management and Budget, told RealClearPolitics on Wednesday that health care is a “linchpin” in the president’s agenda.

“Tax reform is numerically more difficult if health care doesn’t pass. Tax reform is procedurally more difficult if health care doesn’t pass. A lot of other things become easier if health care passes,” Mulvaney. “So, not only is it sort of a procedural linchpin, but it’s a numeric linchpin.”

“Things we want to accomplish get easier to do if health care is reformed first,” the former congressman added.

Like Trump and Ryan, Mulvaney insisted immediately after the American Health Care Act stalled that the administration had “moved on to other things” and would not revisit the issue until the existing law failed of its own accord.

This week, however, Mulvaney was among the posse of senior administration officials shuttling between the White House and Capitol Hill, hoping to pull a miracle compromise out of thin air.

On Tuesday, the White House arranged a meeting on short notice to discuss a potential health-care deal with leaders of influential conservative groups, including Tim Phillips, president of Americans for Prosperity; Jim DeMint, president of the Heritage Foundation; Michael Needham of Heritage Action; Grover Norquist of Americans for Tax Reform; and Matt Schlapp, chairman of the American Conservative Union. Vice President Mike Pence led the meeting, with Mulvaney, White House Chief of Staff Reince Priebus and policy staff also attending.

Pence expressed to the group, among them staunch AHCA opponents, that the White House was serious about bringing up a vote in the House this week on a new compromise, according to one person who attended the meeting. At the crux of the deal would be an option for states to automatically waive the health benefits required as part of a health plan, as well as a rule to ensure consistent pricing by area.

Afterward, some of the attendees were newly upbeat about the White House’s commitment to reviving the health-care push.

“They’re intent on crafting a compromise that can get the votes,” Schlapp told RCP on Wednesday morning.

The flurry of discussions culminated late Tuesday with a meeting in the House basement among key factions of the Republican conference, including the conservative Freedom Caucus and the moderate Tuesday Group, with Pence, Mulvaney and Priebus also attending.

The back-and-forth produced no legislative path forward, however, nor an agreement in principle. “I think that there is a great sense from members that ... we have to get to a better result than we did two weeks ago,” White House Legislative Affairs Director Marc Short told reporters Wednesday.

Efforts to revive a health-care plan have so far been steered by the White House, however, not House leadership — casting doubt on whether the talks reflect a clear-eyed understanding of the legislative challenges that remain. The administration, Mulvaney explained to RCP, is “trying to step in and see if we can help the conference function as best as it possibly can.”

But the administration and congressional Republicans have both publicly downplayed the potential for an agreement developing from this fresh engagement.

“Look, the president would like to see this done,” White House Press Secretary Sean Spicer told reporters Tuesday, adding, “I'm not going to raise expectations.”

And Ryan told reporters Wednesday, "We're at concept stage right now." Meanwhile, the House plans to recess Thursday for two weeks — assuring there will be no vote before the end of the month.

The GOP’s clumsy rush back into health-care negotiations suggests Republicans and the administration are not as content with this status quo as they initially indicated. While the White House is feeling pressure to strike a deal to advance its broader agenda, Republican holdouts are also facing their own heat from the outside to come on board with a plan.

On a March 28 conference call with its network of supporters, Heritage leaders defended their decision to oppose the AHCA in response to some searing questions, according to a person on the call.

“It seems like we won the battle but we lost the war,” said one caller, Jim, from Maryland. “The liberal side won. ... I’m worried about strategy.”

“It’s not about us wanting anything perfect,” DeMint, the Heritage Foundation president, responded.

Needham, of Heritage Action, added, “There was a strategy, and the result ... was the right result.”

Conservative groups and the Freedom Caucus have been working to rehab their reputations publicly after Trump blasted them on Twitter for scuttling the AHCA, with some aiming to shift blame to moderate Republicans for the standoff.

“The pressure needs to be put on the Tuesday Group to get to yes,” Needham told reporters on a call Wednesday.

Mulvaney, who conceded recently that he had expected the Freedom Caucus to eventually back the legislation, said Wednesday he remains “hopeful” that the band of House conservatives will come around.

"The Freedom Caucus is still working to improve the bill, we appreciate that. We’re working to improve the health care bill. We’re working to expand the appeal of the bill across all philosophies in the Republican conference,” Mulvaney said. “But I hope, when we finally do get to the end, the Freedom Caucus can claim victory because they have improved the bill, not only by making it more conservative, but by making it appeal to more Republicans generally.”

Rebecca Berg is a national political reporter for RealClearPolitics. She can be reached at


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