In a private Oval Office meeting with conservative activists Wednesday, President Donald Trump sold Paul Ryan's health care bill as strong and necessary. But minutes later, his top aides offered some willingness to consider changing some of the core provisions, even as Trump himself suggested a fallback position — that they could try again in two years, and Obamacare will fail on its own, leaving Democrats to take the blame.

In other words, Trump was ready to deal.


The president and his top officials crisscrossed Washington to sell conservatives on a contentious health care plan Wednesday, one day after a rocky rollout and criticism from the right had many questioning the plan's fate. But the White House team offered seemingly different messages at times, according to sources familiar with the meetings — leaving lawmakers, activists and others convinced the administration wanted to pass the plan quickly for fear of losing momentum but uncertain how many changes, if any, they'd be willing to accept.

Trump huddled at the White House with top activists from The Heritage Foundation, Club for Growth, Tea Party Patriots and Americans for Prosperity, whose big checkbooks and vast network of activists give them outsize influence. The groups have trashed Ryan's bill — calling it "Obamacare-lite." They left heartened that the administration was open to major change, including moving up a rollback of the current Medicaid expansion to 2018, a year earlier than the Ryan bill would. The administration also said it was open to delaying changes in the insurance market happening in 2018 and 2020, people in the meeting said.

"There were a number of changes that were discussed," said Jenny Beth Martin, who leads the Tea Party Patriots.

Yet at a breakfast meeting of Grover Norquist's anti-tax group, Kellyanne Conway, the president's counselor, indicated the bill as written would be close to the final product. At a meeting in their headquarters near the White House, Conway told Norquist's group that the bill was essentially a done deal — and that "the White House is behind the bill, and if it failed, it would be a big failure for the president," according to a person familiar with her remarks. Another person familiar with her remarks said Conway intimated it would be a big problem for Republicans running for re-election in 2018.

"This is a full-court press," Norquist said. "They want to make sure that Republicans know they ran against Obamacare for six years, and voting against repealing it is a make-or-break issue for their careers."

One senior administration official said: "The time for major input and ideas is over." Asked about the bill, another senior administration official said: "It's just a bill."

A White House spokesman couldn't be reached for comment.

In an attempt to win a vote, Trump had dinner at the White House with Sen. Ted Cruz and his wife. During the campaign, Trump famously called the Texas Republican "Lyin' Ted," and he promised to "spill the beans on his wife." Vice President Mike Pence dined with senators at his residence and talked to local TV stations. Top aides called governors across the country and chatted with House leadership on a strategy. Some lawmakers received personal calls from Trump's office. The White House has to overcome widespread opposition, from hospital and health care groups to Republican senators to conservative House members.

It remains unclear whether Trump has sufficient votes in either body.

Many conservatives in the House and Senate were careful not to criticize Trump — worried about the power of his Twitter account and the potential wrath from constituents over voting against a repeal effort. As if to underscore that point, Trump is planning to go to districts where he is popular and some of the lawmakers live.

Still, many conservative lawmakers remain hopeful they can secure some concessions during negotiations.

"It will be fun," said Rep. Dave Brat of an invitation extended to conservatives to bowl at the White House in the coming days. Right now, the Virginia Republican opposes the Ryan plan. "He's a negotiator. I can't wait!"

Some called for the process to slow down, as Ryan's office aims for a vote in two weeks. And others huddled with Trump aides, trying to figure out the scope of changes they would consider.

“The Trump administration said they were open to amendments,” said Rep. Joe Barton (R-Texas), who is offering an amendment to phase out the current Medicaid expansion in 2017 rather than 2020. “The Freedom Caucus, of which I am a member, has come out in opposition — at least informally, to the bill. ... If they accept my amendment or some version of it, it would … go a long way toward getting conservatives to support the bill.”

Republican Study Committee Chairman Mark Walker (R-N.C.), who railed against an older draft of the bill last week, also suggested he could possibly support the measure if leadership were to adopt Barton’s amendment. He also wants them to consider changing health care tax credits included in the Ryan measure. Conservatives say the credits will create a new entitlement, and they’re pushing leadership to change the provision to a deduction, which doesn’t allow lower-income Americans, many of whom don’t pay taxes, to receive checks in the mail.

“We’ve come up with two things that we’re asking for some help on: One is the refundability of the tax credits and the second thing is an immediate freeze on the Medicaid expansion — well, not immediate, within the 115th Congress,” he said. “If we had some help on those two areas, then I’ll go ahead and say for the first time, we’ll be a hard yes.

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Privately, senior Republicans sources say they’re dreaming. Such changes to the bill would likely turn off moderate members of the conference. GOP leadership will do whatever it needs to “protect” the legislation from poison pills that kill it — and many top Republicans believe these might tank the repeal effort.

In the meeting with activists, who sat around the president's Oval Office desk in a semi-circle, Trump made a 90-second case for tax credits, the people with knowledge said. Top aides like Conway, strategist Steve Bannon, chief of staff Reince Priebus and legislative affairs head Marc Short were present butstayed mostly silent, and Trump largely listened during much of the meeting. Budget Director Mick Mulvaney and domestic policy aide Andrew Bremberg led discussions.

The administration showed a willingness to consider moving Medicaid changes from 2019 to 2018 and insurance changes from 2020 to 2018, the people with knowledge said, surprising some of the activists — who thought there might be less policy flexibility. It was unclear whether Trump would actually move forward, several people with knowledge of the situation said.

"There was no budging on tax credits," one official in the meeting said. "That remains the biggest sticking point."

The activists and the administration squabbled over a bill put on the president's desk in 2015. The activists said that bill didn't have tax credits, while the administration maintained that it did, the people with knowledge of the meeting said. Neither side conceded.

"We detailed the concerns we had, especially on the tax credits," said Tim Phillips, who leads Americans for Prosperity, the Koch brothers group.

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Martin said the administration reminded them there would be several phases and that they promised to "do a lot from the regulatory standpoint in phase two," while adding that phase three — which allows people to buy insurance across state lines — is "moving along much faster."

In her briefing with Norquist's group, Conway also emphasized the importance of the phases, a person familiar with her comments said. "These are three planes leaving Casablanca — it's not a panic," Norquist said.

Former Sen. Jim DeMint, who leads The Heritage Foundation, said he was hopeful the administration will continue to work with his group, particularly on expanding health savings accounts. He spent much of his time broaching that subject. But he didn't leave supporting their plan."I was most impressed they had a number of policy people there, and we were really able to talk," he said.

"We will continue to oppose the bill as it is," he said. "We don't want a new federal program that locks in a new entitlement."

Annie Karni contributed to this report.