AP SPIN METER: Was Trump joking on health care?

SHAPIRO: Ultimately, if some states, like California and MA, want to take steps to cover everybody and other states, like SC or Wyoming, don’t, what’s wrong with that states’ rights approach to policy? Chief of Staff Reince Priebus and budget director Mick Mulvaney were supposed to know how to get things done in Washington.

House Democratic Leader Nancy Pelosi sent a letter to her colleagues Tuesday thanking them for protecting the ACA from what she called the “Republican’s monstrosity of a bill”, and said they must ensure the Trump administration does not “sabotage” the program out of spite. For the foreseeable future, a Republican Congress and president will coexist with a health care regime that both loathe but can not together repeal and replace. The proposal was pronounced dead on Friday. “But I think the idea that the president has put out there is that if people want to float ideas and suggestions on how we can grow this vote and get to a majority, he’ll entertain them”. “No one can fix this problem better than Katie”. The House v. Burwell (now renamed House v. Price) case, which you’ll remember is a legal challenge to the ACA’s cost-sharing subsidies filed by then Speaker John Boehner in 2014, continues to hang over the health care system like a dark cloud.

The White House was less committal.

Never mind votes from Democrats who will oppose everything Republicans support at least as long as Donald Trump is president. But at the same time, he doesn’t seem likely to strike an agreement just because Trump wants him to.

“Katie Walsh was instrumental in the victory in November”, said senior White House adviser Jared Kushner. Even McHenry thinks the framework of the existing GOP health care bill will remain intact. But I never regretted my vote. As Republicans hear from their constituents over the Easter break, he predicts, GOP opposition to the bill will only get louder.

In earlier periods, party divisions were of less importance than they are now.

But the hesitation started in the White House.

In his postmortem comments on the failure of the GOP plan to repeal the Affordable Care Act, Speaker Paul Ryan said it was the result of his members’ desire for the ideal and “the flawless being the enemy of the good, or very good”.

Tax reform beckons. Republicans tell themselves they will get better results on taxes because it is more natural terrain for the party, an implicit concession that the GOP – even after electing a populist president – still can’t bring itself to engage on kitchen-table issues that don’t involve tax cuts.

Or maybe the task was too much, not just for Paul Ryan, but for anybody at this point.

Fifty-eight per cent disapproved of his overall performance as president, not much different from his negative grade on health care.

The Tuesday morning GOP closed-door meeting was the first time the group met since the embarrassing admission that Republicans didn’t have enough votes to pass their own health care bill. The group also tweeted about health care and did a small digital buy on the topic.

During the campaign, Trump was nothing if not headstrong.

Perhaps it was inevitable that these factions would clash over an issue as sensitive as remaking the US health care system.

“We try to augment the lead of the White House, as we have done on his reform agenda items”, Eric Beach said.

Mr. Ryan declined to say what might be in the next version of the Republicans’ repeal bill, nor would he sketch any schedule for action.

“I won’t tell you the timeline because we want to get it right”, Ryan said, adding that members had a “very constructive meeting” where some who had pledged to defeat the bill last week appeared open to working with the rest of the conference to find a solution. Another key component of Obamacare is a mandate requiring everyone without insurance through an employer or other sources to purchase health care coverage through the Affordable Care Act or pay a gradually rising tax penalty. David Bossie, a former deputy campaign manager for Trump, said he began activating and raising money for Making America Great only a few weeks ago.

Emerging from their first conference meeting since the setback, Republican members said the message from their leadership was direct: it’s time to unify.