Trump on the House's health-care bill: "We will take care of our people or I'm not signing it"

A pregnant answer at 7:40 below in response to an excellent question by Tucker Carlson: How can a populist president support an ObamaCare bill that would mostly benefit the well-off at the expense of older, blue-collar, rural Americans — the very people who put him over the top against Hillary? Is he even aware that the bill does that? “Oh, I know,” says Trump, before emphasizing that everything’s negotiable. Well … yes, but all of the negotiating that’s been done so far has been designed to please conservatives, in particular accelerating the rollback of ObamaCare’s Medicaid expansion by starting it in 2018 instead of 2020. It may be that the concessions to the right are front-loaded in hopes of getting the bill through the House Budget Committee and that concessions to the middle will follow thereafter. But you can understand why Trump boosters like Chris Ruddy, Eric Bolling, Breitbart, and Carlson are nervous. This is Trump’s first major initiative, the bill that may make or break his presidency, and not only isn’t it populist, it risks actively damaging the right’s populist base if it lands on his desk in anything close to its current form. Even if it’s true that the bill will change, public opinion is forming and hardening minute by minute. How much political capital does he want to spend on it in its current incarnation?

His answer to Carlson, that he won’t sign it if it doesn’t “take care of our people,” is a warning to Ryan that the answer isn’t “as much as necessary.” And Ryan, who initially tried to sell the bill as a Hobson’s choice, suddenly seems to understand that:

House Speaker Paul D. Ryan said Wednesday that his health-care proposal must change to pass the House, marking a significant retreat from his earlier position that the carefully crafted legislation would fail if substantially altered.

Ryan acknowledged that changes would be made two days after an analysis issued by the Congressional Budget Office prompted a fresh round of criticism of his proposal. Among the report’s projections was that 14 million fewer Americans would be insured after one year under the Republican plan.

Speaking after a private meeting of GOP lawmakers, Ryan said that leaders would “incorporate feedback” from the rank-and-file in response to the CBO findings. He did not repeat his previous comments calling support for the bill a “binary choice” for Republican lawmakers.

“Now that we have our score we can make some necessary improvements and refinements to the bill,” he said, echoing Trump’s point that the bill is now subject to negotiation. The usual way for Congress to negotiate over legislation is for the House to pass something and the Senate to pass its own bill and then both huddle in a conference committee, but GOP senators aren’t keen on that idea. They’re rooting for an early death for RyanCare in the House, to spare them the dilemma of having either to cross Trump by voting no on the bill or pissing off downscale voters by voting yes:

“I’ve heard that maybe the best thing is that this doesn’t get out of the House so we’re not the ones who ditch it,” said a Republican senator who has publicly voiced concern about the bill but requested anonymity. “Right now this is disintegrating in the Senate, with everyone off on their own about what they don’t like about the bill.”…

“The best thing may be to kill it early so it doesn’t come over here,” [another] GOP senator said…

A third Republican senator said, “I think it’s better if it does not come out of the House in its current form.”

Truly we are a blessed nation to have pillars of courage such as these in our legislature. But their worries aren’t irrational: In all likelihood, there’s no bill even in theory that’ll be centrist enough for Lisa Murkowski and Rob Portman on Medicaid, say, and aggressive enough in cutting spending for Ted Cruz and Rand Paul, and that’s a very tight squeeze for a party with only 52 votes in the Senate. In all likelihood nothing can pass there, certainly not without a much more ferocious sales effort from Trump than what you see below; you can’t have a conference committee between the two chambers if you can’t get a bill through the upper chamber to begin with. Which leaves House Republicans who dislike Ryan’s bill with a dilemma of their own: Should they suck it up and vote for the bill anyway knowing that it’s a near-cinch that the Senate will kill it for them or should they kill it themselves so that they’re not on record as having supported a bill that Democrats are going to hang around their necks in 2018 whether it passes or not?

Exit question: Trump’s strategy here seems to be to make the bill more conservative in the House, which should make it easier to pass there, and then let “negotiations” in the Senate push it back in the direction of populism. But what’s the logic in that if a less conservative, more populist bill will be DOA once it goes back to the House? This is why Ryan was emphasizing early that his bill was a “binary choice.” With such a fragile coalition behind the bill in both houses, the more you tinker with it, the more excuses you create for reluctant supporters to bail out. Negotiation, paradoxically, may end up making the bill less likely to pass than a forceful “take it or leave it” pitch from Trump would.