President Donald Trump, a consummate dealmaker, is embarking on a high-stakes negotiation in a new arena as he tries to quickly muscle through a nationwide health care system.

The opening pitch, however, was a messy one.


House Republicans on Monday evening rolled out their plan to repeal and replace Obamacare with little fanfare. On Tuesday morning, there was a stark absence of high-profile White House surrogates on some of the morning shows to advocate for the plan — though White House officials did hit some talk radio shows. And throughout the day, the administration raised eyebrows with a less-than-full-throated endorsement, as Health and Human Services Secretary Tom Price called the bill a “work in progress.”

Trump himself initially appeared less than enthusiastic, tweeting on Tuesday morning that he looked forward to "review and negotiation” as he used real-estate speak to promise that “phase 2 & 3” of the rollout would still be coming.

But as powerful conservative forces lined up against the bill, Trump offered a forceful thumbs-up by the afternoon, telling lawmakers during a sit-down with the House deputy whip team that he was “proud” of the House GOP legislation.

“It's a great bill, we're going to have tremendous — I really believe we're going to have tremendous support,” Trump said. “I'm already seeing the support not only in this room, I'm seeing it from everybody.”

He added, “I'm proud to support the replacement plan released by the House of Representatives and encouraged by members of both parties.”

The president's comments heartened some Republicans after a day in which the law's opponents — conservative members of Congress, influential outside conservative groups and other critics — dominated the debate by pecking off various critiques of the plan, and hijacked the branding of the new plan by dubbing it “Obamacare 2.0” and “Obamacare-lite.”

According to several legislators present at the afternoon meeting in the East Room, Trump asked who was against the bill, and promised he would invite opponents to the White House.

He committed to doing everything he can to win over lawmakers and to using his bully pulpit to garner support. And he agreed with the argument that Republicans face a binary choice: Get behind a replacement that can pass, or swallow the bitter pill of backing Obamacare.

"This guy is the king of negotiation, there's no doubt about that," said Rep. Dennis Ross, a Florida Republican in the meeting.

Republicans are acutely aware that the fate of Obamacare largely hinges on a president who is notorious for shifting his positions. They hope he will stay focused and use his influence to shepherd it through, and they were hopeful Tuesday afternoon when he signaled initial support for Speaker Paul Ryan's plan as the withering criticism piled up.

The House GOP’s replacement bill — years in the making — would gut Obamacare by offering less generous insurance tax credits and phasing out the law’s Medicaid expansion while striking its unpopular individual mandate penalty.

But for many conservatives, that wasn’t enough.

The Heritage Foundation’s advocacy arm called it “bad policy.” FreedomWorks panned it as “Obamacare-lite.” And the Club for Growth called it a “warmed-over substitute for government-run health care.”

The fierce blowback demonstrated just how difficult it will be for Republican lawmakers to agree on a plan that will fulfill their long-delivered promise to ax former President Barack Obama’s signature legislative achievement.

There remains trepidation about the bill among some senior administration officials, according to a person familiar with the matter, and it remains a point of debate in the White House.

The health care law is the first legislative test for a president with no government experience, who has sometimes struggled to maneuver Washington's gears and has occasionally grown impatient with its ways.

What has worried some Republicans, while heartening others, is Trump's tendency to agree with critics when they are talking to him, his impatience, and his ability to dominate the news cycle with his every utterance.

Many lawmakers are hoping Trump will keep his involvement relatively narrow, whipping votes by wooing lawmakers at the Oval Office as promised, while leaving the details to them and dominating the news cycle with strong messages that support a House-backed plan.

They fear he will change his mind when he talks to the law's critics, stray to other issues before the law is passed and instead dominate the news cycle with distracting messages, like voter fraud or his unverified claims that Obama tapped his Trump Tower phones. And the law is likely to face protests from both the left and right, which have been known to rattle Trump even as they are embraced by his top aides, including White House chief strategist Steve Bannon.

But others recognize Trump’s unique messaging power, with one senior GOP aide saying the president could use his Twitter account to whip votes.

Trump showed early signs of doing just that, tweeting on Tuesday evening, “I feel sure that my friend @RandPaul will come along with the new and great health care program because he knows Obamacare is a disaster!”

When asked whether the president could also use his Twitter account to hurt the process or damage negotiations, the aide conceded that was a distinct possibility. "You never really know," this person said.

And Trump could entirely change his mind. After having lunch with Ohio Gov. John Kasich last month, Trump indicated he might back a plan pushed by Kasich. Democrats say they've left meetings heartened that he didn't really want to repeal the entire law. He has shown in the past that it does not bother him in the least to contradict himself.

Longtime observers of Trump said lawmakers would be wise to listen to Tuesday’s message — and to ignore the surrogates who say what Trump will do. As Corey Lewandowski, Trump’s former campaign manager, has said: "The only person who speaks for Mr. Trump is Mr. Trump."

A senior administration official said the administration's initial statement Monday night — which called the bill an “important step” — was designed to not inflame. People close to Trump also said he would be amenable to changes, and that the opposition could still change him. "He mainly cares about getting it done," one administration official said.

"He's in deal-making mode," said Republican Sen. Lindsey Graham, after leaving a separate lunch at the White House.

Inside the White House, there was some acknowledgment that the rollout had not sufficiently included all the necessary stakeholders, for whom they hoped to still “paint the full picture,” as one official put it.

“This is exactly the type of backroom dealing and rushed process that we criticized Democrats for, and it is not what we promised the American people,” complained Sen. Mike Lee, R-Utah.

The White House was trying to sell the bill as only the first of three steps in the repeal-and-replace process — not the full end-product.

But those details were lost in the din of anger and accusations emanating from the right.

“Once our conservative friends see the full picture, they’ll have a better understanding of why this is true repeal and replace,” said one White House official.

That sales job began before the day was over as two former members of Congress who have joined the Trump Cabinet, Mick Mulvaney, now the head of the Office of Management and Budget, and Price were dispatched to meet separately with restive conservative lawmakers.

For critics of the plan, the private messages from the White House left them feeling some hope. Vice President Mike Pence huddled with Freedom Caucus Chairman Mark Meadows (R-N.C.) and Vice Chairman Jim Jordan (R-Ohio) to reassure them. Meadows said Pence told him that the current bill wasn’t the bill that would pass and that there would be changes. Meadows said he didn’t lay out requirements for a bill he would vote for but told Pence about their concerns with the tax credits and the bill overall.

“Its better to give the administration more flexibility to find a solution than to make lines in the sand,” he said.

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Rep. Mark Sanford, a South Carolina Republican, said it was important to show Trump that activists and Republicans outside of Washington were upset. "There's still going to be a tug of war," he said.

Freedom Caucus member Dave Brat predicted a different type of fireworks. The Virginia Republican is banking on Trump to internalize all the pushback he’s seeing from conservatives, and to come around to their way of thinking.

“Trump is very good at listening to the grass roots of the American people,” Brat said. “By the end of tonight, when the news cycle goes, and he hears. … When they start screaming tonight; he is a good listener, and that’s what you’re going to see. I think his response in the short-term will shock you.”

Members of Ryan's team said they found some solace in Trump's message. The speaker crowed during an afternoon news conference that he was sure he would get 218 votes. Sen. Lamar Alexander, a Tennessee Republican who has opposed some of Ryan's plan, said it would be difficult to turn down the House version if it comes "with the full support of the president."

Rep. Chris Collins, a New York Republican and early Trump supporter, said Republicans wanted to get the repeal-and-replace plan through quickly, even though there will be widespread opposition, because there is momentum — and limitations, with governors who don't want to lose their Medicaid expansion, and limits to how reconciliation can be used.

Conservatives noted that Republicans criticized Obama's team for rushing a bill through, and many said they'd prefer to take time.

But Collins said he had faith in Trump’s deal-making skills.

"We're going to need him to twist some arms, to bring people in the Oval Office and look them in the eye and tell them 'I need your vote,'" Collins said. "It will be hard for a Republican to tell the president no. We aren't going to get any Democratic votes, so we need every Republican."

Shane Goldmacher and Burgess Everett contributed to this report.

