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House Approval Of Health Care Bill Represents Major Victory For Trump


You can call it the art of the health care deal. Republicans' push to repeal and replace the Affordable Care Act is moving on to the Senate, and the White House says President Trump will be fully engaged in that effort. He pushed hard to get the House to pass the repeal bill. And while House leaders didn't always welcome the president's involvement, they say it ultimately helped the bill succeed. NPR's Scott Horsley reports.

SCOTT HORSLEY, BYLINE: The Obamacare repeal effort still has a long way to go, but President Trump isn't waiting to celebrate. He quickly organized a Rose Garden victory party after yesterday's House vote. And Vice President Mike Pence welcomed his former congressional colleagues to the White House.


VICE PRESIDENT MIKE PENCE: Thanks to the leadership of President Donald Trump, welcome to the beginning of the end of Obamacare.


HORSLEY: It was quite a turnaround from six weeks ago when Trump's ultimatum to Republican House members backfired. He tried to force a hurry-up vote on the health care bill only to learn it didn't have the necessary support. A chastened president chalked it up to experience.


PRESIDENT DONALD TRUMP: We all learned a lot. We learned a lot about loyalty. We learned a lot about the vote-getting process. We learned a lot about some very arcane rules in obviously both the Senate and in the House.

HORSLEY: It was opposition from the conservative House Freedom Caucus that torpedoed that first try at repeal. But caucus leader Mark Meadows of North Carolina did not walk away. Instead he brokered a compromise with moderate Congressman Tom MacArthur of New Jersey. It was their negotiations that laid the groundwork for yesterday's House vote. But Meadows says Trump helped by cheering them on.


MARK MEADOWS: A president who wouldn't give up, a president who got engaged, a president who said, you know, I don't care what the mainstream media is saying; we're going to get this done, and we're going to make it better for the American people.

HORSLEY: Trump's engagement had little to do with the substance of the bill. Even now, the president describes the legislation in only the vaguest of terms, and his descriptions are sometimes at odds with what the bill would actually do. What Trump did was keep the pressure on while lawmakers like Fred Upton of Michigan worked out the details. House leaders sometimes chafed at that pressure, especially when the White House tried to dictate the timing of a vote. But in the end, House Speaker Paul Ryan was happy with the result.


PAUL RYAN: This is the fourth presidency I've served with. I have never, ever seen any kind of an engagement like this.

HORSLEY: Another member of GOP leadership Kevin McCarthy agrees. This president is especially involved.


KEVIN MCCARTHY: Walk into my office yesterday morning, and they say the president's calling again.

HORSLEY: Ordinarily someone in McCarthy's position might ask the president to reach out to certain lawmakers to help close the deal. In this case, McCarthy said their roles were reversed.


MCCARTHY: I happen to be the majority leader, the former whip. I know my members well. The president gives me a list of who he thinks I would be best to talk to on the list.


MCCARTHY: And he was right. And Mr. President, they all voted for the bill.


HORSLEY: The White House says Trump also made personal appeals to 15 or 20 members of Congress. And even as he played that inside game, Trump also kept up the outside pressure with a steady drumbeat of health care tweets. Senate Majority Leader Mitch McConnell has occasionally complained about the president's Twitter habit, but Trump's not likely to stop lobbying with his thumbs. He said last night after the House vote, it's an effective tactic.


TRUMP: I really think it helped today when - you know, on health care. I think it's a great way to communicate, and it's a modern way to communicate.

HORSLEY: A White House spokeswoman says Trump will be just as hands-on as the health care bill moves to the Senate. But the president has learned a lesson about timing, and he won't be setting any artificial deadlines. Scott Horsley, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

Scott Horsley is NPR's Chief Economics Correspondent. He reports on ups and downs in the national economy as well as fault lines between booming and busting communities.
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