President Trump's spirited entrance into the Republican push to replace the Affordable Care Act with the American Health Care Act has been a mixed blessing for House Speaker Paul Ryan (R-Wis.), who needs the bill signed in order to move on to other parts of the GOP agenda, notably revamping America's tax code. But Trump is more popular with some of the conservative lawmakers who are dismissing the bill as "dead on arrival" than Ryan and other GOP leaders, so his lobbying and dealmaking efforts — including hosting House conservatives at the White House bowling lane and calling for help from state GOP officials and activists — could be crucial to whipping up support.
On the other hand, Politico says, "Trump's early efforts to court conservatives opposed to the GOP's ObamaCare replacement is backfiring in Congress — emboldening the far right to demand changes that could repel centrists critical to its passage." Ryan and other architects of the House GOP bill tried to carefully balance the demands from the Freedom Caucus wing and more moderate GOP senators who don't want to scrap the Medicaid expansion in their states. Trump strongly supports the bill, but has also signaled he's open to "negotiations," encouraging conservatives to amend the bill to their liking.
"The mixed signals have allowed hard-line conservatives and leadership to hear what they want to hear," Politico reports. "Each side is taking Trump's words and arguing he's in their corner," and the president has been "sufficiently vague" to give hope to both sides. "We've been told by the vice president and [OMB Director Mick] Mulvaney that he's flexible," Freedom Caucus chairman Mark Meadows (R-N.C.) said Thursday. "Are they sure that's what Trump said?" House Majority Leader Kevin McCarthy (R-Calif.) asked Politico. "When Trump says, 'If you have better ideas,' I think he's thinking in the [later] phase they offer bills going forward."
Key Senate Republicans, meanwhile, are tapping the brakes and insisting that the Senate make its own imprint on the bill, which would scuttle Ryan's carefully crafted timetable. If the White House bowling alley doesn't do the trick, though, Trump has other tools at his disposal — presumably, Mar-a-Lago is nice this time of year.