Why is the withdrawal of the American Health Care Act such a devastating blow for Trump and Ryan?

Question

The AHCA was withdrawn without it going to a vote. The media is playing it out like this is a humiliating defeat for Donald Trump and Paul Ryan and there are even talks that Ryan may need to resign as speaker.

Whilst it's not good news, I'm just wondering why this is such a big deal? Donald Trump didn't even seem like he was that passionate about healthcare to begin with - he stated he didn't even know how complicated it was.

What is the impact of this for them? Does it mean the Republicans won't be able to repeal Obamacare now? Can't they just adjust the bill a bit and have a second go at trying to get it through in the next four years?

Answer 1

The media is playing it out like this is a humiliating defeat for Donald Trump and Paul Ryan and there are even talks that Ryan may need to resign as speaker.

Some media organisations argue that he does not have the leadership capabilities if the bill fails to pass since he could not convince all Republicans to vote for it. But, in reality, it's not entirely his fault since there some more conservative members are adamant of the bill since they are worried that they might face more conservative challengers in the 2018 House elections.

Whilst it's not good news, I'm just wondering why this is such a big deal?

It's not really a major blow. However, it does shows that the Republicans aren't united. It's also embarrassing for them as they couldn't pass a healthcare bill 8 years in the making with majorities in both chambers of Congress and also controls the executive branch.

What is the impact of this for them?

As for impact, nothing much changed except that the Affordable Care Act (Obamacare) will continue to the the law for healthcare in the foreseeable future as mentioned by Donald Trump.

Does it mean the Republicans won't be able to repeal Obamacare now?

Theoretically, they can repeal it. However, you need to have a replacement for the bill. I believe this answer elaborates more on this.

Can't they just adjust the bill a bit and have a second go at trying to get it through in the next four years?

Of course. Trump has also mentioned that he's open to having another try to reform healthcare should the Democrats agree. But, now, he's moving on to tax reform.

This's what he said:

• And I honestly believe -- I know some Democrats, and they're good people. I honestly believe the Democrats will come to us and say, look, let's get together and get a great health care bill or plan that's really great for the people of our country. And I think that's going to happen.

• But I want to have a great health care bill and plan, and we will. It will happen. And it won't be in the very distant future. I really believe there will be some Democrat support and that will happen, and it will be an even better bill. I think this was a very good bill. I think it will be even better the next time around.

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Conclusion

Some has described it as a major blow as they see it as Donald Trump's first test in Congress as President and also a showcase of his deal-making skills which he has frequently mentioned on the campaign trail. Others have described it as a setback for the “repeal Obamacare” effort.

• Should the bill Republicans named the American Health Care Act fail, it could begin the unwinding of their convenient coalition. At the very least it would mark an embarrassing defeat for the president who promised to use his dealmaking skills to make Washington work. -- Time

• The decision to delay the vote marks an acute embarrassment for the President, who had gambled big by presenting holdout House conservatives with a take-it-or-leave it ultimatum Thursday night and put his own credibility on the line. -- CNN

• On Capitol Hill, the failure of newly empowered Republicans to make good on their biggest campaign-year promise exposes the deep divisions that remain in the party. It also, importantly, raises profound dangers ahead of next year’s midterm elections.
  
  [ ... ]
  
  Mr. Trump won the White House by selling an image. He told people he was the dealmaker who would get his way — with foreign leaders, chief executives and with Congress — through the strength of his personality and his negotiating skills.
  
  [ ... ]
  
  That, more than anything, was undercut by Friday’s failure. Having fundamentally misread the likelihood of success, Mr. Trump and his advisers fully embraced the health care legislation. While the president never slapped his name on the bill, he happily accepted the personal challenge of getting it passed. -- NYT

Answer 2

Even though Republicans control all branches of government, in order to get any real legislation passed they still need support from 8 Democrats/Independents in the Senate to avoid a fillibuster, barring any changes to the Senate rules. They were able to identify a workaround through the budget reconciliation process, and developed a multi-stage plan in order to enact as much of their desired policies as possible without assuming any Democratic support.

The first part of that plan has failed, and has called into question the entire proposed process. Now it seems likely that the Republicans must try to engage with Democrats in order to get any legislation passed, which is a tall order from all sides in the current political climate. It is a blow to those further to the right politically, many of which President Trump has embraced, since Democrats in the Senate will (in all likelihood) now be included more in national discussions and legislation can begin to move forward under this administration.

Alternatively, entrenched positions could become more entrenched, and the status quo continues, though Trump has signaled that he really just wants to move forward and save as much face as he can. His public statements are to just let the healthcare industry implode, but as a President that is not a politically viable option so "deal making" maybe will still have a chance to happen, if and when improvements to the current system can be identified, proposed and debated, but the Big Deal™ is that Obamacare survives _{(for now)} during a time of Republican control after years of not only talking about repealing it from the ground up but actually voting to do it when it didn't really matter.

When it did matter, they failed to actually come to an agreement among themselves on exactly what they wanted to do differently. Now, any future legislation on healthcare cannot happen under the budget reconciliation process. Unless Republicans can pick up 8 more Senate seats in the midterms (which is not impossible), they must secure additional votes from Democrats who are unlikely to support much without significant concessions. Historically, midterms are more a referendum on the sitting President, with their party generally losing more than winning, and Republicans shouldn't bet on getting a chance to do a re-do. Moreover, hard feelings about the process may persist, which could impact negotiations in other big landmark legislation such as tax reform.

This all assumes the filibuster survives until then. Ultimately, though, I feel this is a bigger blow for Paul Ryan, since his persona is more as the Republican's deep policy idea pusher, and this was more or less his healthcare plan. Trump himself has proved to be fairly slippery with regards to personal responsibility.

Answer 3

The fate of the AHCA is a portent of the fate of the Administration's other initiatives. Any signature achievement will have to go through a process of bargaining and negotiation similar to what the AHCA went through. If the failed in this case, then it calls into question their prospects for successfully negotiating equally complex legislation like tax reform or a massive infrastructure project.

In my opinion, this reflects worse on the Speaker than on the President. As you say, the President didn't really invest much in getting this legislation passed. For him to admit that he had no idea how complicated it was (and to more or less give up when he found out) is kind of a bad look, but perhaps you can argue that he'll be more committed when it's an issue he cares about. It's not a great argument, but it's at least plausible.

The Speaker of the House, on the other hand, is supposed to be in control of his caucus. He is supposed to maintain party discipline, and he has a lot of tools at his disposal for doing so. Moreover, this particular Speaker is supposed to be a policy expert. Yet, the legislation he came up with was a dog's breakfast that satisfied none of the factions in his party, and he wasn't able to bring any of them into line. It was an exceptionally poor performance, and I think it's fair to ask, if this is how he's fared on his first major legislative initiative as Speaker, then what reason is there to expect that he'll ever be effective in the role? At best, he has a lot of learning to do if he expects to still be Speaker by the time the midterms come around.