Not in the best of health: Trump on the legislative treadmill

Reporting from Washington  —  Presidents whose parties have a congressional majority almost never lose a major piece of legislation in the House; the fact that President Trump is in danger of doing so says much about both his administration and his party.

Trump’s administration has lurched from crisis to crisis in its seven weeks, impelled by a combination of inexperience and errors of judgment. The GOP has had a majority in the House for six years and in the Senate for two, but as Speaker Paul Ryan noted this week, it still has not adjusted to the difference between opposition and governing.

Good afternoon, I’m David Lauter, Washington bureau chief. Welcome to the Friday edition of our Essential Politics newsletter, in which we look at the events of the week in Washington and elsewhere in national politics and highlight some particularly insightful stories.

FIVE DECISIONS THAT HAVE BOXED IN THE GOP

Republicans have campaigned against Obamacare for more than six years but never have come together around a proposal to replace it.

The Republican leadership’s initial plan — repeal the law first, delay implementation and promise to come up with a replacement in the meantime — proved unpopular. So they’ve been forced to cobble together a replacement bill in a hurry.

The plan, which was unveiled Monday, would make huge changes in healthcare, almost certainly depriving health coverage to millions of Americans, as Noam Levey and Lisa Mascaro write.

Here’s a side-by-side comparison of chief features of the existing Affordable Care Act and the proposed Republican plan.

The haste with which the bill was put together, combined with several strategic decisions by GOP leaders, have put Republicans at risk of losing at least the first round of a defining political fight.

The first big decision was to abandon any effort at bipartisanship and opt for a legislative path — the so-called budget reconciliation process — that allows passage with Republican votes, alone. Republicans note that the Obama administration passed the Affordable Care Act with no Republican votes. Democrats did so, however, only after spending more than a year in an ultimately fruitless effort to negotiate.

The GOP decision to give up on that effort without even trying has left party leaders with very little margin for error.

A second strategic decision was to concede a major point to Democrats and accept the principle that the federal government has a responsibility to help low-income Americans buy health insurance if they don’t get coverage through their jobs. Speaker Ryan and other GOP leaders see that as political reality: Some 20 million adults — voters and their relatives, including many Republicans — have gotten help through the current law; yanking it away from all of them at once would be politically perilous.

Rather than uproot Obamacare entirely, that has left Republicans seeking to trim it. Their bill almost certainly would take health coverage away from millions of Americans — a finding that the nonpartisan Congressional Budget Office likely will make next week. But it still would leave the government more involved in the healthcare system than it was before President Obama’s law passed.

That concession of a principle has upset many conservatives who are trying to defeat the current bill.

A third big decision was to abandon a major goal of Republican health policy experts: changing the tax treatment of employer-sponsored healthcare. Currently, the health benefits that most workers get on the job are tax free. Republican policy experts argue that favorable treatment encourages overspending on healthcare. They’ve long argued for leveling the field and taxing health benefits the way that wages are taxed. That idea was at the core of Ryan’s earlier health reform plans, but Republican leaders realized earlier this year that its unpopularity almost certainly would sink their bill.

Dropping the tax plan deprived the Republican bill of intellectual coherence, as well as a lot of revenue that could have been used to resolve other problems.

A fourth decision was to sweeten the deal for Republican lawmakers by putting a big tax cut at the center of the healthcare bill. Obamacare imposed several new taxes to help pay for its benefits. The new bill would eliminate most of them, notably two tax increases on Americans with incomes of $250,000 and higher, which amount to more than $20 billion per year, mostly from the top 1% of earners. To cover those tax cuts without increasing the deficit and still provide help to working families, the bill imposes deep cuts on Medicaid.

That has upset GOP senators from states like Ohio, Maine and Arkansas, who have many constituents who have benefited from Obamacare’s expansion of Medicaid.

Finally, to keep overall costs down, the bill drops Obamacare’s flexible system that provides more aid to people in areas where healthcare costs more. The GOP bill also allows insurers to charge more to older people, which would allow lower premiums for the young. High-cost areas tend to be rural because they have less competition. So the counties that would be the worst off under the GOP bill tend to be rural places with older populations — exactly the places that voted most heavily for Trump in the last election.

Each of those decisions has boxed in Republican lawmakers.

Now, Trump has moved into “sell mode,” but as Mascaro and Noah Bierman write, he’s encountered more resistance than the White House expected, including harsh reviews of the proposed bill from Breitbart News, once run by his top strategist, Steve Bannon.

It’s not clear whether Trump’s hints at negotiating flexibility are helping or just undermining Ryan and his efforts to prod GOP members into line.

Some members of Congress wonder if, in the end, Trump will simply let Ryan take the fall for a loss. But after repeatedly promising their voters to repeal the law, failure now would be a severe blow to Republican credibility. That’s why, in the end, the party’s lawmakers probably will pull together, at least in the House, to get a bill through.

Passage of the current bill in the Senate, however, seems a very difficult proposition.

Meantime, if the GOP bill does become law, one provision could cause special difficulty in California, Melanie Mason writes: The Republican proposal would forbid people from using their federal subsidies to buy any health plan that includes coverage of abortions. But California law requires nearly all health plans to cover the procedures.

PARTIAL SURRENDER ON THE TRAVEL BAN

When President Trump issued the first version of his temporary ban on travel from seven mostly Muslim countries, he did so with great fanfare, one week after taking office.

The revised version, issued Monday, came with almost no visible sign of the president, who signed the new order without TV cameras watching. Instead, Trump’s appointees, Homeland Security Secretary John Kelly, Atty. Gen. Jeff Sessions and Secretary of State Rex Tillerson, announced the new order, making brief statements and taking no questions.

The lower profile was no surprise. Despite much brash rhetoric from the White House in the weeks since federal judges blocked the original order, the new version represented a major retreat on multiple fronts, as Bierman, Mike Memoli and Brian Bennett report.

Not only was the list one country shorter — Iraq was dropped — but all 60,000 existing holders of U.S. visas were protected, as were permanent U.S. residents. The administration also dropped the provision of its original order that gave preference to Christians from the Mideast. It gave up the permanent ban on refugees from Syria. And it provided multiple exemptions from the travel ban itself.

The final version of the order essentially had two major provisions left: a reduction in the total number of refugee admissions for this year, from 110,000 to 50,000, and a temporary slowdown in issuing new visas for people from the now six Middle Eastern and North African countries.

The change left Iraqis happy to have been taken off the revised list, Molly Hennessey-Fiske reports from Irbil. But it did not stop attorneys general in several Democratic states from renewing their court challenges, most of which lean heavily on Trump’s campaign statements promising a ban on Muslims.

Meantime, on immigration more generally, the administration can tout some evidence that deterrence may be working: Apprehensions at the southern border have declined sharply since Trump took office, Jennie Jarvie reports.

Even critics of the administration say much of the change reflects Trump’s tough rhetoric, which has discouraged would-be migrants, especially Central Americans coming up through Mexico fleeing violence in their home countries.

If the trend continues, expect to see members of Congress question the need to spend billions of dollars to build more border fencing, especially as the administration now seems to want to pay for its wall, not by billing Mexico, but by cutting the budget for airport security and the Coast Guard.

A CHANGING CLIMATE AT THE EPA

In the 1990s, restrictions on federal regulation forced the Environmental Protection Agency to give up trying to control exposure to asbestos. The resulting lack of government oversight led to a flood of lawsuits against manufacturers and the bankruptcy of the industry. Some 15,000 Americans still die every year from asbestos-related disease.

Now, Evan Halper writes, the GOP is trying to insert similar restrictions into the law that governs regulation of a much broader range of environmental hazards. The result could be to render the EPA almost powerless.

The GOP’s proposed change in regulatory policy comes as the new EPA chief, Scott Pruitt, continues to put his stamp on environmental policy. This week, he expressed his doubts about the degree to which human activity was influencing the climate — a view that flies in the face of overwhelming scientific evidence.

ALL THE PRESIDENT’S TWEETS

The president ended last week in a very bad mood, by multiple accounts, frustrated by the continued attention on Russia’s potential interference in the 2016 election and angered by his attorney general’s decision to step aside from any role in the case.

Saturday morning, he vented his frustration with an astonishing series of tweets, accusing Obama of having “had my ‘wires tapped’ in Trump Tower.”

Neither Trump nor White House officials offered any evidence for the charge, which essentially accused Obama of a felony. Obama’s spokesman denied it. So did a series of former top officials. The head of the FBI, James Comey, privately asked the Justice Department to repudiate Trump, as Del Wilber and Laura King report.

Over the next several days, the White House gingerly backed away from Trump’s accusation without ever actually retracting it. Spokesman Sean Spicer began with a statement declaring that Trump wanted Congress to investigate his charge. As the week went on, he repeatedly declined to offer any evidence. GOP leaders said they would look into the issue but mostly seemed to want to keep Trump’s accusation at arm’s-length.

Twitter has long been Trump’s favored means of pushing his message. We’re compiling all of Trump’s tweets. It’s a great resource. Take a look.

CAN THE ADMINISTRATION INVESTIGATE ITSELF?

Atty. Gen. Sessions’ decision to step aside from the Russia investigation removed one issue for the administration, but it still faces a much bigger one, Cathy Decker writes: Can the White House create public confidence in the administration investigating itself?

The man in whose lap that task will mostly fall, Rod Rosenstein, Trump’s nominee to be deputy attorney general, had his Senate hearing this week. Rosenstein, a career prosecutor who has a strong reputation for nonpartisanship, resisted Democratic calls that he commit in advance to appoint a special prosecutor to lead the Russia investigation, Wilber writes. He is widely expected to win confirmation.

Meantime, on another, smaller, legal issue involving Trump, Joe Tanfani writes that a lawsuit from a downtown Washington wine bar could lead to a court test of claims that Trump’s ownership of his DC hotel violates the terms of his lease.

FOREIGN POLICY IN THE DARK

After seven weeks’ absence, the State Department finally returned to daily briefings on U.S. foreign policy this week, Tracy Wilkinson reports. The hiatus — far longer than during any other recent presidential transition — reflected Secretary of State Tillerson’s apparent preference for minimal press coverage.

Tillerson plans to head to Asia next week without bringing any reporters with him, a departure from the practice of his predecessors going back at least half a century. Press organizations have appealed to Tillerson to reconsider, arguing that taxpayers have a right to have eyes on what their diplomats are up to.

Some foreign policy experts cite another concern: Not having a press corps with him means that Tillerson will give foreign governments a big advantage in establishing the public narrative of how their meetings go.

There’s also the issue of influence within the administration — a scale on which the State Department appears to be losing weight. When Mexican Foreign Minister Luis Videgaray came to Washington on Thursday, he headed straight to the White House and did not make even a courtesy stop at State, although he did speak to Tillerson by phone.

As Brian Bennett notes, however, U.S. diplomats did gain some new leverage as a result of a clause in the revised travel ban. The order directs diplomats to negotiate new agreements with countries over the granting of U.S. visas. The administration wants to use that process to force some countries to change policies against taking back their nationals when the U.S. tries to deport them.

LOGISTICS

That wraps up this week. My colleague Sarah Wire will be back Monday with the weekday edition of Essential Politics. Until then, keep track of all the developments in national politics and the Trump administration with our Essential Washington blog, at our Politics page and on Twitter @latimespolitics.

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David.lauter@latimes.com

@davidlauter