March 24 (UPI) -- President Donald Trump on Friday slammed Democrats and a contingent of holdout conservative lawmakers in the House for effectively killing the Republican proposal to replace the Affordable Care Act -- and handing him the biggest political failure of his presidency to date.
The House shelved a vote scheduled for Friday afternoon on the American Health Care Act because GOP leaders still couldn't find the votes needed to approve and send the proposal on to the Senate.
The House vote was first set for Thursday, scrapped, rescheduled for Friday and scrapped again -- comprising a tumultuous 24 hours that saw Trump and his party mount a final push to get the replacement package for the ACA through the lower chamber.
In the end, though, hesitant conservatives could not talk themselves into voting for the AHCA -- and Trump, recognizing it was doomed to fail, had the bill pulled from Congress.
During a news conference in the Oval Office, a visibly frustrated Trump roundly criticized Democrats and repeatedly dismissed former President Barack Obama's signature health law, also known as "Obamacare," stating that it was "rammed down everyone's throat."
"They weren't going to give us a single vote," he said of House Democrats. "A lot of people don't realize how good our bill was."
Several Republicans have said the president is finished negotiating on the matter and will now just leave the ACA on the books as the healthcare law of the land.
"The best thing we can do, politically speaking, is let Obamacare explode," the president continued. "Bad things are going to happen to Obamacare. There's not much you can do to help it.
"It's not a question of, 'gee, I hope it does well.' I would love it to do well. I want great healthcare for the people of this nation. But it can't do well. It's imploding and will soon explode. And it's not going to be pretty."
Trump also chastised the conservative Republicans who would not get on board with the replacement plan.
"We learned a lot about loyalty," he said.
The president, who repeatedly praised the efforts of House Speaker Paul Ryan, R-Wis., to get the deal done, added that he will now turn his political focus to the next item on his agenda -- tax reform.
"We came up short," Ryan said at a news conference announcing the vote cancellation. "I won't sugarcoat this -- this is a disappointing day for us."
Ryan said he decided that pulling the proposal was the best course of action when it became evident it would fail on the House floor. Like Trump, he also mentioned several times that, "we were close."
The speaker's words, combined with Trump's, served again to underscore the existence of deep legislative fissures in Congress -- not just between Republicans and Democrats, but particularly among GOP moderates and conservatives.
"I think we were probably doing the Democrats a favor," Ryan said of trying to supplant the ACA with the Republican plan. "Well, I guess that favor is not going to be given to them."
"What would be really good, with no Democrats aboard, is the Democrats -- when it explodes, which it will soon -- if they got together with us and got a real healthcare bill. I would be totally open to it," Trump said.
"Whenever they are ready, we're ready."
The president went for an aggressive gambit Thursday night by issuing a stern ultimatum to unconvinced House conservatives -- to either pass the AHCA in its current form or reject it and live with the ACA -- and got burned.
"In a way I'm glad I got [this issue] out of the way," Trump told Washington Post reporter Robert Costa.
"The biggest losers are [House Minority Leader] Nancy Pelosi and [Senate Minority Leader] Chuck Schumer, because now they own Obamacare. They own it, 100 percent own it," Trump continued. "[The ACA] is not a Republican healthcare [program]. This is not anything but a Democrat healthcare [law].
"Just remember, this is not our bill. This is their bill. When they all become civilized and get together and try to work out a great healthcare bill for the people of this country, we are open to it."
Pelosi, however, clearly didn't feel like a loser on Friday.
"Today is a great day for our country," she said at a Democratic news conference in response to the AHCA's defeat. "It's a victory for the American people."
"This is pretty exciting for us. Yesterday, our anniversary [of the ACA's passage], today a victory for the Affordable Care Act and, more importantly, the American people," she continued.
"Let's just, for a moment, breathe a sigh of relief for the American people that the Affordable Care Act was not repealed."
Pelosi later tweeted that "TrumpCare was about spite. It was brought up because they loved the optics of a vote on ACA's 7th anniversary -- not because it was a good idea."
At least some Democrats indicated Friday that they are indeed open to working with Republicans to produce a healthcare solution.
"This bill went down today, and it went down today because the majority of the representatives of the American people in the House of Representatives thought this was a bad bill -- went in the wrong direction, left 24 million people behind," House Minority Whip Steny Hoyer, D-Md., said. "I hope we can work with the administration and with the other side, and not just abandon this effort."
The president and his party are now left basically with four options -- continue to push the AHCA in its current form, try and win the needed votes through a series of revisions to the bill, junk the proposal and start fresh, or do nothing and keep the ACA as the law. The responses from Trump and Ryan on Friday make the first two possibilities seem unlikely.
Trump, at times appearing agitated during his White House news conference, said the prolonged fight for the GOP proposal "has been a very interesting experience."
The president predicted that there will eventually be a bipartisan healthcare bill to replace the ACA in the near future -- with Democratic support -- and that it will be even better than the AHCA.
The Republican plan did share some similarities with the ACA, like mandating coverage for people with pre-existing conditions and providing insurance subsidies. Unlike the Obama law, though, it would have reduced subsidies and Medicaid spending and used those savings to cut out taxes for wealthy Americans and medical companies.
Lawmakers in the conservative Freedom Caucus panned the bill because they said it didn't go far enough in repealing the ACA. Trump attempted this week to persuade the holdouts with a warning that Republicans could lose control of Congress next year if they didn't approve the bill. On Monday, several changes were written into the package to assuage lingering concerns.
"The irony is that the Freedom Caucus, which is very pro-life and against Planned Parenthood, allows P.P. to continue if they stop this plan!" Trump tweeted Friday morning.
Key Republican votes became even tougher to find after a Congressional Budget Office report said the updated version of the AHCA would cost billions more without adding any new coverage. Hardline conservatives balked at the inflated price tag, moderates said it didn't improve access or lower premiums, and the CBO said it was essentially a more expensive version of the same plan.
According to the CBO, the amended AHCA would cut the federal deficit by $150 billion by 2026 -- far less than the $337 billion the un-amended bill would have saved. Further, the updated analysis said the changes failed to ramp-up coverage -- a key concern for opponents -- and would still cover 24 million fewer Americans than the ACA would in the next decade.
The CBO report also estimated that average premiums for individual plans would increase by up to 20 percent over the next two years, but would rebound and become 10 percent lower by 2026.
Obama, through his foundation, celebrated the ACA's 7th anniversary on Thursday by emphasizing its accomplishments.
"After 100 years of talk and countless failed efforts, Barack Obama was the President who finally made health care reform a reality for America," the foundation said.