What GOP Outside Groups Learned From the Health Care Fight

Activists and advocates hope to get in earlier on what will likely be the next big legislative debate—tax reform.

The House Rules Committee meets to shape the final version of the Republican health care bill before it goes to the floor for debate and a vote, at the Capitol in Washington, Wednesday, March 22, 2017.
AP Photo/J. Scott Applewhite
Andrea Drusch
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Andrea Drusch
April 2, 2017, 8 p.m.

Conservative groups that flexed their political muscle to stop the House health care plan are already looking for a more diplomatic approach in the GOP’s next policy battles.

Though many of the same groups that vowed big money to oppose the American Health Care Act have drawn a similar line in the sand over key components in House leadership’s tax-reform plan, leaders from Americans for Prosperity and Heritage Action say they’re taking lessons from the chaotic health care debate to avoid another showdown with leadership on a top policy priority this spring. Chief among their takeaways: Be more engaged in the initial legislation—something conservatives think they’re in a better position to do after forcing leadership to pull a vote on the health care bill.

“The era of a small group of folks in leadership going into the proverbial smoke-filled room, coming out, and ramming something through 10 days later, is over,” Americans for Prosperity President Tim Phillips said in an interview with National Journal.

Though Phillips initially said AFP didn’t want to “micromanage the process” on repeal-and-replace, it opposed the AHCA for not going far enough to remove Obamacare tenets. Koch groups pledged millions in electoral support to members who bucked leadership on the bill, and Phillips said AFP would follow through with ads explaining that position to allies’ constituents back home.

“From our standpoint of lessons learned, it’s to be even more vigilant in proactively detailing key components of the legislation that need to be there,” Phillips said. “We’re working very hard to do that on tax reform, and hopefully on the budget and broader spending as well.”

But those plans come as leadership is already exploring ways to further cut health care dissenters out of their process. In the wake of AHCA’s failure, the White House suggested that it would instead reach out to moderate Democrats for help on health care, and President Trump took to Twitter threatening retribution against members of the House Freedom Caucus in the 2018 midterms.

While House Speaker Paul Ryan downplayed the idea that Democrats could give them the votes needed for Obamacare repeal, outside groups aligned with House leadership are also gearing up for a more-stick-than-carrot approach to wrangling their own members. The Ryan-aligned House super PAC, Congressional Leadership Fund, pulled reelection support for vulnerable Rep. David Young of Iowa after he came out against AHCA, and has no plans to go back in on his behalf. The policy group, American Action Network, ran TV ads in the districts of House Freedom Caucus members, drastically increasing spending from previous policy fights.

“I wouldn’t be surprised if there’s a bigger focus in reaching out to those districts even earlier,” said AAN spokeswoman Ruth Guerra, who predicted the group’s tax-reform campaign would easily surpass the $10 million it spent on health care. “We’re always looking for new and more aggressive ways to ensure we can pass these big legislative priorities.”

While Trump wasn’t able to persuade Freedom Caucus members in the first health care debate, Guerra said the president’s personal investment in tax reform could also up the ante on how far he’s willing to go.

Right now it’s unclear whose side Trump will take on one of the more controversial components of Ryan’s blueprint, the border-adjustment tax. Conservative groups consider the proposal to be a giant national sales tax, and have already stated railing against it. Trump recently signaled support for the BAT, but some of his chief advisers oppose it, and his own comments have left room for questions about where he stands.

Even without the border-adjustment tax, outside groups are laying out very specific standards for their support.

“It’s a hopeful sign that there are some general areas of agreement, like genuinely deeply lowering the corporate rate … but that isn’t enough,” said Phillips. Pointing out the disconnect on health care, he said AFP would “go further” in laying out expectations, including sending its state directors to the Hill to communicate those goals with members.

Regardless of leadership’s threats to find new allies, conservatives are optimistic that their experience on health care has increased their chances for a seat at the table.

“The best case scenario is that folks … take a deep breath and realize that important policy objectives are within reach,” said Dan Holler, vice president of communications and government Relations at Heritage Action. “There’s a realization that legislation of this importance and magnitude needs buy-in from the conservative part of your conference, the moderate part of your conference, and the middle part of your conference.”

Holler also downplayed the idea that leadership could make up those votes with Democrats.

“I don’t think those members of the Democrat Party exist anymore,” said Holler. “Their mode right now is resistance.”

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