Derailed, defeated

US President was done in by hardline conservatives' opposition to healthcare Bill

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House Minority Leader Nancy Pelosi and some of her fellow House Democrats rejoicing at a news conference after Republicans pulled their healthcare Bill. Mr Trump did not try to reach out to Democrats. Mr Trump had underestimated the importance of rep
Mr Trump had underestimated the importance of replacing Obamacare to his party base, seeing it as an obstacle to move past to get to his own agenda on taxes and trade. PHOTO: AGENCE FRANCE-PRESSE
House Minority Leader Nancy Pelosi and some of her fellow House Democrats rejoicing at a news conference after Republicans pulled their healthcare Bill. Mr Trump did not try to reach out to Democrats. Mr Trump had underestimated the importance of rep
House Minority Leader Nancy Pelosi and some of her fellow House Democrats rejoicing at a news conference after Republicans pulled their healthcare Bill. Mr Trump did not try to reach out to Democrats. PHOTO: AGENCE FRANCE-PRESSE

WASHINGTON • Shortly after House Speaker Paul Ryan unveiled the Republican healthcare plan on March 6, United States President Donald Trump sat in the Oval Office and queried his advisers: "Is this really a good Bill?"

And over the next 18 days, until the Bill collapsed in the House of Representatives on Friday afternoon in a humiliating defeat, the question continued to nag at the President.

Even as he thrust himself and the trappings of his office into selling the Bill, Mr Trump peppered his aides with the same concern, usually after watching cable news reports chronicling the setbacks, according to two of his advisers.

In the end, the answer was "no" - in part because the President himself seemed to doubt it.

"We were a little bit shy - very little, but it was still a little bit shy, so we pulled it," Mr Trump said on Friday in an interview with The Washington Post.

  • WHAT IS OBAMACARE?

    • A healthcare reform law introduced in 2010 by then President Barack Obama

    • Mandates that people who can afford to must obtain health coverage or pay a monthly fee

    • Allows young people under 26 to stay on their parents' plans

    • Bars insurers from denying coverage to people with pre-existing conditions

    • Requires companies with more than 50 full-time employees to offer insurance

    • Expands Medicaid, a public health insurance programme for low-income earners

    WHAT IS TRUMPCARE?

    • Scraps penalties for people who have not bought health coverage

    • Gives tax credits to make medical bills more affordable

    • Allows insurers to raise premiums for older people

    • Ends mandate that employers with over 50 full-time employees must offer insurance

    • Continues to let the young stay on their parents' plans

    WHAT DOES THE HOUSE FREEDOM CAUCUS WANT?

    • Repeal of Obamacare's "essential health benefits" which are 10 healthcare conditions that insurance plans have to cover, to force down premiums

    • Major reworking of Trumpcare's tax incentives

    • New Medicaid restrictions

For Mr Trump, it was never supposed to be this hard. As a real estate mogul on the rise, he wrote The Art Of The Deal, and as a political candidate, he boasted that nobody could make deals as beautifully as he could.

Replacing Obamacare, a Republican bogeyman since the day it was enacted seven years ago, was Mr Trump's first chance to prove that he had the magic touch that he claimed eluded Washington.

But Mr Trump's effort was plagued from the beginning. The Bill would have violated a number of his campaign promises, driving up premiums for millions of citizens and throwing millions more off health insurance - including many of the working-class voters who gravitated to his call to "make America great again".

The President was unsure about the American Health Care Act, although he ultimately dug in for the win, as he put it.

There were other problems, too. Mr Trump never made a real effort to reach out to Democrats and was unable to pressure enough of his fellow Republicans.

He did not speak fluently about the Bill's details and focused his pitch in purely transactional terms.

And he failed to appreciate the importance of replacing Obamacare to the Republican base; for the President, it was an obstacle to move past to get to taxes, trade and the rest of his agenda.

Mr Trump's advisers thought he could nudge the Bill over the finishing line by sheer force of personality. "He is the closer," White House press secretary Sean Spicer boasted last Wednesday. But by Friday, it was clear the closer could not close.

Mr Trump tried to orchestrate his own win. He cajoled uncertain party members, offering flattery to some and the vague threat of political retribution to others.

He invited members to the White House for bowling sessions, gave others rides on Air Force One and grinned for pictures in the Oval Office, where he reminded lawmakers of his margins of victory in their districts.

But legislating, it turned out, was different from cutting deals to splash his name across skyscrapers.

Less than 100 days into his administration, the President found himself a red-faced Don Quixote, railing against the intractable forces on Capitol Hill, where Republicans are wearied by years of infighting.

Reflecting on the failure, Mr Trump said he thought he had cultivated a good relationship with the House Freedom Caucus - the band of hardline conservatives who proudly opposed House leaders.

"I couldn't get them," Mr Trump said. "They just wouldn't do it."

Alluding to the long-running dramas on Capitol Hill, he added, "There are years of problems, great hatred and distrust, and, you know, I came into the middle of it."

WASHINGTON POST

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A version of this article appeared in the print edition of The Sunday Times on March 26, 2017, with the headline Derailed, defeated. Subscribe