But Republicans have a collective incentive to rectify—or at least be seen as trying to rectify—a humiliating failure for their party. And Congress has a long history of dilly-dallying, stumbling, and even falling flat on its face before striking a quick deal and acting on a moment’s notice. That’s especially true when lawmakers face a deadline, and the House is scheduled to recess for a two-week Easter break on Thursday. Notably, the murmurs of optimism are emanating from some of the conservatives who were most stridently opposed to the AHCA a few weeks ago.
“I think it’s serious,” Jason Pye, director of public policy for FreedomWorks, told me by phone on Tuesday morning. “I’m pretty optimistic about the path forward.” FreedomWorks, a conservative activist group, had criticized multiple iterations of the bill in March and vowed to penalize Republicans who voted for it.
Now that the White House seems willing to target the core insurance regulations at the heart of the Affordable Care Act, however, the right is listening. “The entire concept appears to be one of federalism,” said Dan Holler, a spokesman for the conservative group Heritage Action, “and if the Republican Party can’t get behind federalism, it’s sort of unclear what they could get behind.” Even Senator Rand Paul of Kentucky, who led the rebellion against the GOP leadership’s bill, is sounding optimistic notes after a round of golf with the president.
Still, there remain plenty of skeptics that the GOP can swiftly fix a proposal that registered just a 17 percent approval rating with voters and whose failure prompted Trump to lash out at conservatives, moderates, and Democrats alike.
Count Ryan as chief among them. At a press conference on Tuesday morning, the speaker downplayed the latest developments and talk of an imminent agreement. “Right now, we’re just at that conceptual stage,” he said. “It’s important that we don’t just win the votes of one caucus, or one group, but that we get the votes and get the consensus of 216 of our members.” The speaker seemed to be dashing hopes that negotiators could come up with an agreement fast enough for the House to vote on it in the next few days before the two-week recess. Conservatives briefed on the proposal said the White House could release text of an amendment as soon as Tuesday night. But if the House does not act this week, it’s likely that any repeat attempt to pass a health-care bill will have to wait until May, after Congress tries to avoid a government shutdown before federal funding runs out on April 28.
Ryan was alluding to the biggest ongoing challenge Republican leaders have faced on health care: How can they appease the conservatives who want a total repeal of Obamacare without losing the votes of moderates and electorally vulnerable members who don’t want to scrap the law’s popular parts or vote for a bill that would result in significant coverage loss for their constituents?