Mar 8, 2017 - Health

Why conservatives want more from Trump than Obamacare sales pitches

J. Scott Applewhite / AP

President Trump is meeting with conservative group leaders this afternoon, and Office of Management and Budget director Mick Mulvaney has invited Freedom Caucus members to go bowling next week. But the message from the conservatives is clear: It's going to take more than schmoozing to change their minds on the Obamacare replacement plan the House Republican leadership wants. They want big, substantive changes — enough to make it a fundamentally different bill.

What Trump is doing: He's bringing in leaders of some of the most powerful outside groups that have been agitating against the bill, including Americans for Prosperity, the Heritage Foundation, Heritage Action, and Club for Growth. In the meantime, Mulvaney has been getting more involved, showing up at last night's Freedom Caucus meeting and making clear that the bill is open to substantial changes, according to a Freedom Caucus aide.

What the Freedom Caucus wants: The problem is that the group wants more than just tweaks around the edges of the current bill. The conservatives want to get rid of the refundable tax credit, which they believe will be used by millions more people than the Obamacare tax credits. They also want to end the Medicaid expansion, not let the states that already expanded Medicaid keep getting extra money. And they want more in the bill that would explicitly reduce health care costs. "It's not going to look anything like what the leadership wants," said the Freedom Caucus aide.

This can't be fixed with schmoozing: Sources familiar with the interactions say that Paul Teller — the man picked to reach out to House conservatives — is trusted by the Freedom Caucus in a way that they don't trust other members of the administration. Teller understands the caucus' dynamics and he's doing a combination of gentle pushing and listening, carrying back changes to the administration. But a Freedom Caucus source said that there's nothing Teller can say or do. The changes need to be major.

Yes, but: An administration official said that while the conservatives have to be able to tell their constituents that they got some changes, "I'm not so sure the changes will be so major."

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