All the while, Pence got busy piloting the administration in ways few vice presidents ever had. Unlike the other West Wingers who nurtured narratives of their own indispensability—Steve Bannon, Jared Kushner, Kellyanne Conway, among others—it was the vice president who pulled the levers during the early months of 2017. Pence figured prominently in Trump’s selection of Gorsuch for the Supreme Court. He convinced the president to take specific actions on abortion and religious liberty. He stocked the cabinet agencies with longtime allies and kindred spirits. And he said nothing about any of it, deflecting all credit to the commander in chief. Whereas Bannon had put a target on his own back, giving countless interviews and even appearing on the cover of Time in early 2017 (“The Great Manipulator”), Pence understood how to survive and thrive in the Trump White House: Get the job done and avoid all acclaim in the process. The boss’s ego allowed for nothing else.
Trump quickly came to trust his second in command above all others, prizing Pence’s unwavering fidelity and discretion. And yet the vice president’s camp continued to operate in a continual state of apprehension, having been handed enormous latitude by a president known for his insecurities and his acute sensitivity to being overshadowed. Ken Blackwell, who ran the domestic policy wing of Pence’s transition team, put it this way in early 2017: “Mike Pence has a very full and complex portfolio in his briefcase. And he has to carry it like there’s a bottle of nitroglycerin inside.”
Pence had spent the final days of March coaxing the president in private conversations. The vice president explained to Trump, ever so gingerly, that while he didn’t want to second-guess his decision to move on from health care, it would hurt him politically. Republicans on the Hill, Pence said, would be eager to negotiate after the backlash from their constituents. He asked for permission to spearhead a new repeal-and-replace effort. And he assured the president, in so doing, of the myriad benefits it would have for him.
Pence had learned the same lesson as Ryan: Trump responds to what’s good for Trump.
With the president’s blessing, Pence met with warring factions of the House GOP—the Freedom Caucus and the moderate “Tuesday Group”—to pitch them on his proposal. It would allow states to opt out of certain Obamacare requirements. The debate over what insurance plans would be required to offer had been a sticking point in past negotiations, and Pence’s idea was a waiver to give states flexibility.
Both sides expressed interest. Pence’s office drafted language, and he got busy selling it to both tribes—first, Mark Meadows and his Freedom Caucus, and then, in a separate meeting, to New Jersey congressman Tom MacArthur, the leader of the Tuesday Group. After a joint gathering to iron out details, Pence had one request: He asked them to stop referring to the idea as the “Pence amendment.” He didn’t want or need any recognition.
Sure enough, the compromise on state-based waivers became known as the “MacArthur amendment,” and it led to the House of Representatives passing the American Health Care Act on May 4. Trump was ecstatic. Calling Ryan to congratulate him, the president told the Speaker, “Paul, you’re not a Boy Scout anymore. Not in my book.”
Ryan was taken aback, finally realizing that it had never been a term of endearment to begin with. “It’s like a dupe, a stupid person,” Ryan says, rolling his eyes. “Boy Scouts are stupid because they don’t cut corners, they’re not lethal, they’re not killers.”
The mood was festive in the Rose Garden a few hours later as House Republicans assembled behind the president for a celebratory press conference. Rarely had Trump seemed to enjoy his new job. But that afternoon, with the smell of his first significant presidential victory wafting through the springtime air, was an exception.
“How am I doing? Am I doing okay?” he said, laughing. “I’m president. Heh! Hey, I’m president!”
Pence kicked off the victory lap, which lasted nearly forty minutes and included speeches from no fewer than ten people, with a simple message. “Welcome to the beginning of the end of Obamacare,” the vice president declared.
It was a tad premature.
ALMOST IMMEDIATELY, REPUBLICAN SENATORS SIGNALED THEIR OPPOSITION to the House legislation. Mitch McConnell announced that he and his colleagues would devise their own health care bill, with the aim of merging it with the House version in a conference committee down the road. Trump was mystified by this. The intricacies of the legislative process and the complexities of the interchamber relationship—any aspect of governance that did not fit neatly into a tabloid headline, really—did not interest him. All he knew was that House Republicans had finally passed a bill repealing Obamacare, and now his advisers were telling him it wasn’t good enough for Senate Republicans. No wonder everyone hates Congress, the president groaned.
McConnell hadn’t invested much energy in the anti-Obamacare effort up until that point. For one thing, privately, he saw the benefits of the Affordable Care Action back home in Kentucky. The uninsured rate there had plummeted over the past six years thanks to the law’s Medicaid expansion, a provision that had become enormously popular in the deep-red state.1 The success stories in Kentucky were so plentiful that the new governor, Republican Matt Bevin, decided to leave the state’s Obamacare-driven Medicaid program alone after promising its demise as a candidate.
More to the point, McConnell had believed it was highly unlikely that House Republicans would pass a bill. There was no point driving into a legislative cul-de-sac, he told colleagues, when there were dozens of federal judicial vacancies in front of them waiting to be filled. When the House version passed, and Trump relayed his displeasure to McConnell at not having the Senate prepared to immediately follow suit, the majority leader scrambled to get to work.
The Senate’s bill-drafting process made the House’s look honest by comparison. In the nearly seven weeks between House passage on May 4 and the Senate GOP leadership’s release of its bill on June 22, hardly a soul on Capitol Hill outside of McConnell and his staff knew what was being written. This was infuriating to many of the rank-and-file senators, particularly conservatives such as Ted Cruz and Mike Lee, who felt the party was being hypocritical given its vilification of the process behind Obamacare. (“This massive piece of legislation that seeks to restructure one-sixth of our economy is being written behind closed doors, without input from anyone, in an effort to jam it past not just the Senate but the American people,” McConnell had told reporters in December 2009.)
One person who didn’t seem to mind was Trump. The president made it clear to McConnell and his team that his only concern was the end result. The process was unimportant, and frankly, so, too, was the policy. Having heard from liberal friends who decried the House legislation as hostile to low-income Americans, Trump had only one request for the senators as they fashioned their version. “We need to be more generous, add more money to help the people. We need to have heart,” Trump told senators over lunch at the White House, CNN reported. “Their bill is just mean.”
But the Senate bill wasn’t exactly warm and fuzzy. While less draconian than the House version in some respects—offering more in subsidies to the working poor, for instance—it also made steep cuts to Medicaid while ending the Obamacare tax hikes used to pay for it, amounting to a windfall for the wealthy while millions of working-class Americans stood to lose coverage.