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Trump lashes out at Democrats, congressional rules as health care fight continues

President Donald Trump speaks in the Rose Garden of the White House in Washington, Tuesday, May 2, 2017, during presentation ceremony of the Commander-in-Chief trophy to Air Force Academy football team. (AP Photo/Susan Walsh)

President Donald Trump continues to face a steep learning curve in dealing with the Congress as his administration fights some in his own party to secure a big win on health care and begins suiting up for a fresh battle over tax reform.

For evidence of the president’s frustration with the legislative process, look no further than his Twitter account. On Tuesday morning, he called for a government shutdown if he does not get what he wants in negotiations for the 2018 federal budget and floated the idea of eliminating the filibuster in the Senate.

Hours later, Trump and Office of Management and Budget Director Mick Mulvaney publicly and passionately defended the 2017 spending compromise that he had complained about, insisting despite all appearances that the administration got what it wanted.

Speaking at an event ostensibly celebrating the Air Force Academy football team, Trump declared the spending bill a “victory under the radar” for the GOP and brought up the languishing Republican health care reform bill.

“How’s health care coming, folks? How’s it doing?” Trump asked.

The American Health Care Act is doing better than ever in the House, with more than 200 Republicans on board, but the GOP is still reportedly one “no” vote away from failing again to muster enough support to accomplish what they promised voters they would do for seven years: repeal Obamacare.

Jennifer Lawless, director of the Women & Politics Institute at American University, said Trump’s early struggles to show legislative progress illustrate that, even with unified control of government, Congress has substantial power.

“He is beginning to realize, I think, that checks and balances really mean something,” she said.

Amendments to the bill have secured the support of the conservative Freedom Caucus, but moderate Republicans are expressing concerns about provisions that put coverage for those with pre-existing conditions at risk and scale back the Affordable Care Act’s Medicaid expansion in future years.

“I’ve supported the practice of not allowing pre-existing conditions to be discriminated against from the very get-go,” Rep. Fred Upton, R-Mich., said in an interview with WHTC. “This amendment torpedoes that, and I told leadership that I cannot support this bill with this provision in it. ...It’s not going to get my yes vote the way that it is.”

White House officials and House leadership have stepped up pressure on undecided members. House Speaker Paul Ryan and others insisted at a Tuesday press conference that their bill actually provides better coverage for pre-existing conditions than Obamacare, a claim disputed by Democrats, patient advocacy groups, and many health care experts.

Prior to the latest revisions, the bill was viewed favorably by only 17 percent of Americans, according to a Quinnipiac University poll. The House plans to vote without a new score from the Congressional Budget Office, but the CBO estimated the previous version would lead to 24 million people losing insurance coverage, many because of high costs.

Under normal circumstances, Republicans might start over and draft a bill that earns more enthusiastic Republican support and gives Democrats less ammunition for attacks. As is demonstrated pretty much daily, the Trump presidency is not normal.

“Starting from scratch now, for [Trump], would be an admission of defeat,” Lawless said.

Defying the president and the speaker over the White House’s top legislative priority is risky for House Republicans, but Trump’s low approval ratings and the public’s distaste for the AHCA mean siding with him could be even riskier in some districts.

“I don’t think it’s necessarily that difficult [to vote no], given the way constituents have been reacting,” Lawless said.

Adding to members’ apprehension is Trump’s apparent disinterest or confusion about what is in the bill. In interviews over the weekend, he misstated facts about the legislation and overstated the benefits it provides.

"When I watch some of the news reports, which are so unfair, and they say we don’t cover pre-existing conditions — we cover it beautifully,” he told Bloomberg News.

Some House Republicans are pinning their hopes on the Senate to improve the bill, strengthen the Medicaid coverage, and provide more money for high-risk pools. However, it is unclear whether the legislation can get through the upper chamber at all or what will actually change before they vote on it.

“They’re being asked to trust the legislative process at a time when the 2018 landscape is giving them heartburn,” said Republican strategist Ford O’Connell.

Bob Mann, a former Senate press secretary and a professor at Louisiana State University, said many in the House have no faith the Senate, and conservative members may balk at the prospect of the bill being watered down. He also argued that Republican incumbents will be saddled with the bill they vote for by their opponents, not the potentially tamer legislation eventually passed by the Senate.

“What the Republicans are doing, to me, seems almost suicidal,” he said.

If Republicans fail yet again to pass a health care bill, they may be better served by moving on and seeking a win on another issue, according to O’Connell.

“The best chance for Trump to deliver on a promise is tax reform,” he said.

The ACA is enjoying a rare moment of popularity, but he predicted Republicans will get another swing at repealing it when voters experience “sticker shock out the wazoo” over 2018 premium rates. Now may be their only shot on taxes.

The path forward for rewriting the tax code may not be much smoother, however, even though Republicans broadly agree taxes should be cut for corporations and individuals.

“They’re much more united on it,” O’Connell said. “The question for them is going to be the process.”

With some Democrats positing the release of Trump’s tax returns as a prerequisite for negotiating on tax reform, any legislation would likely need to be passed through reconciliation with 51 votes in the Senate, meaning it would have to be revenue-neutral. That gets tricky when nonpartisan analysts estimate the proposed rate cuts would reduce federal revenues by trillions of dollars over the next decade, and the internal divisions that have waylaid the AHCA would threaten to reemerge.

“I’m not sure you wind up with the same people opposing it for the same reasons,” Lawless said, but there will be heated debates within the party.

She noted that Republicans had hoped to use the savings of the Obamacare repeal to offset tax cuts. If this latest AHCA push sinks, the calculus becomes more complicated.

According to Karlyn Bowman, a senior fellow at the American Enterprise Institute, recent infighting over a border adjustment tax may be a preview of the fight to come.

“It’s just not a united Republican block,” she said.

Bowman, an expert on public opinion, emphasized that voters view taxes and health care very differently.

“On health care, the general public at least, it seems to me, fears change… On tax reform, I think the dynamic is entirely different. I think change is something the public embraces,” she said.

Polls have shown an urgency to create jobs, and correctly or not, many believe tax reform will do that.

The Trump administration released a one-page plan last week laying out priorities for what would be the biggest tax cut in history. Liberal and conservative economists have concluded the plan would balloon the federal debt if enacted, but some say it could spark significant economic growth.

As Trump struggles to build momentum with the aid of congressional Republican, his relationship with Democrats has further soured.

The president has insulted and mocked Democratic leaders frequently throughout the last 103 days, and Monday’s May Day protests are the latest indication that their progressive base is as committed to the resistance as they were on January 20.

“The Democrats are not going to help the Republicans, certainly not on Obamacare, for fear that they’re going to get primaried,” O’Connell said.

Ten Senate Democrats are up for reelection next year in states that Trump won in 2016, making them low-hanging fruit, but Republicans would need to flip eight of them to overcome a filibuster.

“Chuck Schumer’s going to pressure these folks every which way from Sunday not to break,” O’Connell said.

After eight years of Republicans win elections while fighting President Obama on nearly every issue, Lawless said Democrats have reason to believe obstructing Trump will help them politically.

“I don’t see what the incentive is for Democrats to cooperate with Republicans and Donald Trump,” she said.

Some Democrats are already confident Republicans will stumble.

“Tax reform is dead on arrival unless Trump releases his taxes, which ain't ever going to happen, for whatever reason, so take that off the table,” said Democratic strategist Craig Varoga. “And the Republicans can't corral themselves on repealing Obamacare, so that's also dead.”

If that is the case, Trump is in danger of appearing inconsequential to the legislative process.

“I think it shows him to be at best a paper tiger and at worst incompetent in getting his agenda passed through Congress,” Mann said.

If the president’s tweets are to be taken literally, though, Lawless suggested a possible upside if his health care and tax reforms die in the Senate. It would strengthen his case for nuking the filibuster on all legislation, which would make it virtually impossible for the minority party to stop him in the future.

“If Paul Ryan and the House can get this through and pass the buck and place the blame on the Senate, that can in some ways help the Trump agenda,” she said.

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