The Freedom Caucus Kills the Health Care Bill

This is an updated version of an article that appears in the April 3, 2017, issue of THE WEEKLY STANDARD.

Before Republicans captured Washington, the conservatives in the House Freedom Caucus were a nuisance. Then, with the GOP in control of the House, Senate, and White House, they became a roadblock. Now, in single-handedly killing the legislation to repeal and replace Obamacare, they’ve turned into gang of renegades running amok inside the House GOP. Neither President Trump nor House speaker Paul Ryan can sway the 30 or so Freedom Caucus members, much less control them. Trump, the supposed closer, was unable to forge a deal with them. Ryan offered changes in the bill, but that only egged on the Freedom Caucus to demand more.

The political damage from this stinging defeat could be enormous. Any effect it has on Trump’s first-year agenda won’t be good. Recall that the president started with repeal and replace of Obamacare partly because that would clear the way for a bigger tax cut. Its downfall now “makes tax reform more difficult,” Ryan said. “We’re going to be living with Obamacare for the foreseeable future.”

There’s worse, politically speaking. Democrats now have a chance to capture the House in the 2018 midterm election. They’ll run against the party that couldn’t govern. The average gain in the first midterm for the party that doesn’t control the White House is 32 seats. That’s 10 more than Democrats need in 2018.

Failing to redeem the GOP’s longstanding promise to get rid of Obamacare was an excruciating blow to Trump. His reputation as dealmaker in chief took a hit. Trump doesn’t have a habit of accepting blame for setbacks. He looks for scapegoats. It’s already been reported that he regrets following Ryan’s advice to start with health care, a problematic issue for Republicans. But he didn’t go that route. He praised Ryan.

Still, Ryan’s enemies list is likely to grow. If Trump counselor Steve Bannon isn’t a sworn enemy, he comes close. Bannon is chummy with the Freedom Caucus. Its members regard Ryan as having become “Washingtonized”—thus less conservative, more elitist—since he was elected to the House in 1998. Trump, having dealt face to face with the Freedom Caucus, understands what Ryan has to contend with.

As for the Freedom Caucus, its opposition had a kamikaze aspect. Its members damaged themselves along with the GOP. Some insisted repeal and replace would produce a health care system worse than Obamacare—a preposterous notion. And when interviewed on Fox News, Rep. Thomas Massie of Kentucky acted like a teenage boy who’d pulled off a prank. He grinned a lot.

There’s a reason the Freedom Caucus causes so much trouble. Its calling card is to demand what cannot be achieved. Anything short of that, such as the Trump-Ryan brand of repeal and replace, triggers opposition. Whatever you offer is never enough. That makes caucus troops hard to appease.

And when they stick together, they constitute a pivotal group. They can keep Republicans from winning votes. And they seem to delight in exactly that.

Which brings us to the American Health Care Act (AHCA), the proper title of the repeal and replace legislation drafted by Ryan and congressional leaders. The fact that it would eliminate most but not all of Obamacare was the source of the clash between Ryan and the Freedom Caucus.

The AHCA was designed to circumvent a Democratic filibuster in the Senate. That means it could sweep away only the parts of Obamacare on spending and taxes, with the broad framework of Obamacare surviving for the time being. By invoking a procedure known as “reconcilation” the measure can pass by majority vote—51 votes—with no filibuster allowed. Full repeal, the Freedom Caucus mantra, wouldn’t qualify for reconciliation.

It’s a tedious and unexciting process that requires careful attention to something called the Byrd rule, which is too arcane to explain. However, it has the advantage of providing a path to Senate passage. The Freedom Caucus lacks a path and simply ignores the fact that full repeal can’t get through the Senate.

Selling a limited but passable bill to House Republicans was a trial. Ryan could argue the AHCA alone would meet the rules of the Senate. But appeasing big-shot senators is the last thing mere congressmen want to hear.

The other arguments for the bill weren’t much better. Trump tried what has been dubbed the Tony Soprano approach when he spoke to the House GOP conference. He insinuated dissenters would be dealt with harshly, perhaps by his backing of primary challengers of those who vote no. This didn’t produce a slew of converts.

The president singled out the leader of the Freedom Caucus, Mark Meadows of North Carolina, and asked him to stand. “Oh, I’m gonna come after you,” Trump said. A readout from the event said, “Everyone laughed.” It didn’t note whether Meadows did.

When Freedom Caucus members came to the White House, Trump adviser Steve Bannon was quoted as offering this argument: “You all have to vote for this. We’ve got to do this. I know you don’t like it, but you have to vote for this.” His appeal didn’t work either. He can’t blame that on Ryan.

As ideological purists, caucus members stuck to their demand for “full repeal” as tenaciously as Democrats stayed glued to Obamacare. If they would have together, if it had come to that.

In one sense, the Freedom Caucus has the upper hand over Trump and Ryan. Most of the members are in safe Republican districts and unlikely to be threatened by a primary opponent—that is, unless Trump drops in to campaign against them.

Trump has other things to worry about at the moment. Cutting the corporate tax rate from 35 percent to 20 percent, shaving a few points off the individual income rate, and repatriating trillions from overseas—all that is more important. Disciplining the Freedom Caucus wouldn’t work anyway.

But caucus members will suffer. Because Trump never forgets.

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