The lawmakers nodded and said they understood. They knew that Trump was not a policy maven but were disturbed by his dismissiveness nonetheless. For many of the members, the “little shit” meant the details that could make or break their support for the bill—and have far-reaching implications for their constituents and the country.
“We’re talking about one-fifth of our economy,” Mark Sanford, the South Carolina congressman, scoffed after the meeting.
Of the president’s hecklers in the GOP, none had become as truculent as Sanford. Once an ascendant superstar and the party’s most compelling contender for its 2012 nomination, the South Carolina governor’s career was set ablaze in 2009 by an extramarital romance that was discovered while he claimed to be hiking the Appalachian Trail. Sanford would later suggest, somewhat astoundingly, that he hoped to get caught in the affair because of his reluctance to seek the presidency. “I’ve oftentimes wondered,” he said, “was there some weird subconscious element that just wanted to derail the train and get off the train?”
Sanford’s career in politics seemed finished. And then, a butterfly flapped its wings; Jim DeMint resigned from the Senate, Tim Scott was appointed to succeed him, and a special election was held to replace Scott in South Carolina’s First District, formerly represented by none other than Sanford. After winning back his old seat, Sanford haunted Trump throughout the campaign, calling for the release of his tax returns and questioning his knowledge of the Constitution. Three weeks into the new president’s term, Sanford could no longer hold back.
During an interview in his office, he described how Trump “represents the antithesis, or the undoing, of everything I thought I knew about politics, preparation, and life.” Sanford added, “All of a sudden a guy comes along where facts don’t matter? Look, we’re in the business of crafting and refining our arguments that are hopefully based on the truth. Truth matters. Not hyperbole, not wild suggestion, but actual truth.”
Sanford knew these comments might cost him his job. “I’m a dead man walking,” he said, smiling. “If you’ve already been dead, you don’t fear it as much.”
Sure enough, the following month, after the Freedom Caucus meeting with Trump, Mick Mulvaney pulled Sanford aside. “The president wants me to let you know,” he told his friend, “that he’s going to take you out next year.”
While many of the Freedom Caucus members shared Sanford’s concerns, few were so bold as to air them publicly. Besides, in their fight over health care, Trump wasn’t the problem. For all their frustration with the mixed messages and strategic ineptness coming out of the White House, conservatives didn’t blame the president for their predicament. They blamed Ryan.
The Speaker had approached the health care effort with all the finesse of a forklift operator. Believing that House Republicans were uniformly supportive of the policy sketches in his “Better Way” agenda, which Ryan had promoted as the blueprint for a Republican government, he rushed headlong into drafting the American Health Care Act without the consultation of his conference—or any advice from the think tanks, lobby shops, activist groups, and media outlets that would render judgments of the legislation sooner or later. It seemed a no-brainer to proactively meet with these interests, answer their questions, accept their criticisms, and preempt any attacks on the legislation itself. Republicans had spent seven years promising to repeal and replace Obamacare; a few weeks of selling the product wouldn’t hurt one bit.
Ryan didn’t feel such preventative measures were necessary. And he was in a hurry, fearing that Trump was a ticking tweet-bomb, always one tantrum away from ruining the party’s best-laid plans. After days of drafting the bill in secretive locations at the Capitol—Senator Rand Paul exposed the absurdity by bringing reporters along as he hunted door to door for a copy14—the text was leaked, and then unceremoniously released, without any clearly coordinated media strategy between Ryan’s office and the White House. Conservatives around Washington, including some of the Speaker’s friends, were stunned. “The bill has had the worst rollout of any major piece of legislation in memory,” Rich Lowry, editor of National Review and a longtime Ryan ally, wrote in his Politico magazine column on March 15.
Leading health care experts on the right, such as Yuval Levin and Avik Roy, trashed the bill. Conservative outside groups and their media allies immediately branded it as “Obamacare Lite.” Only then did Ryan move to mitigate the damage, convening a group of conservative journalists in his office and doing interviews with the likes of Sean Hannity and Laura Ingraham. But it was too little, too late.
At the heart of the opposition to Ryan’s effort was the fact that he was not pursuing a full repeal of the Affordable Care Act. This ignored the realities at hand. Republicans had, while Obama was still in office, voted to eliminate the law in its entirety. But that was a statement vote on something that stood no chance of being signed by Obama. Now that they controlled the government, the circumstances were more fraught. For starters, Republicans didn’t have a filibuster-proof majority in the Senate; they could only repeal the parts of the bill that touched on taxation, which required 50 votes through the reconciliation process. There were also the politics of the matter: voting to strip health coverage from millions of people, with no ready replacement, had been a whole lot easier to do when a presidential veto loomed as the backstop. Now there were real consequences to consider; it was no longer an empty ideological exercise.
As Ryan pushed to close ranks around his embattled legislation, he got little assistance from Trump. The president had never been keen to wade into the quagmire of health care, despite his promises on the campaign trail to get rid of Obama’s signature law. Some of his advisers encouraged him to start with a bipartisan infrastructure push; others thought he should secure money and begin construction on the border wall as quickly as possible.
But Ryan was insistent. Republicans had spent the better part of a decade promising to repeal and replace Obamacare, he told the president. They had no choice but to do this, and the closer they got to the midterm elections, the harder it would be for members to take such a difficult vote. “We get this done early,” Ryan warned Trump, “or we don’t get this done at all.”
THE PRESIDENT KEPT THE SPEAKER’S HEALTH CARE BILL AT ARM’S length for more than a week after its unveiling on March 6, offering a smattering of favorable remarks but never fully embracing it. Ryan’s rivals in the Freedom Caucus, sensing daylight between the president and the Speaker, moved quickly to exploit it.
In the middle of March, during a budget meeting at the White House, Mark Meadows and Jim Jordan repeatedly diverted the discussion to health care, much to the annoyance of Budget Committee chairwoman Diane Black. When the meeting broke, Meadows and Jordan swiftly sought an audience with the president to discuss Ryan’s bill. Trump granted them the meeting. The conservative ringleaders complained to the president that Ryan was presenting members with a take-it-or-leave-it proposition that was doing the entire party a disservice. Trump replied that he was open to negotiation and new ideas, and Meadows and Jordan left the White House believing they had pulled the president into their corner.
When word got back to Ryan that Trump had undercut him—saying he wasn’t married to the current product after Ryan had spent the past two weeks telling members he was—the Speaker boiled over. He had gone out of his way to maintain a solid working partnership with the president. He had looked the other way and had bitten his tongue time and again over the first two months of the administration, hoping to preserve his influence over policymaking. Ryan knew that chewing out Trump would be counterproductive. The way to persuade the president, he had concluded, was to frame things in a way that sounded beneficial for Trump—not necessarily for the country and certainly not for the party.