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As Trump’s Tactics Fall Short, Pence Takes Lead on Health Bill

WASHINGTON — President Trump personally lobbied House Republicans to pass health care legislation this year, but the Trump team’s heavy-handed tactics have been ineffective in the Senate, leaving him on the sidelines while Vice President Mike Pence led the effort to salvage the foundering bill.
Mr. Trump became more engaged on Tuesday, summoning all 52 Republican senators to the White House for some last-ditch diplomacy, but only after it became clear Republican leaders were postponing the vote until after the Fourth of July recess.
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“The White House has been very involved in these discussion,” Senator Mitch McConnell of Kentucky, the majority leader, said in announcing the postponement. “They’re very anxious to help.”
But the Republican Senate leaders have made it known that they would much rather negotiate with Mr. Pence than the president, according to several White House and congressional officials. And some of the White House’s efforts have clearly been counterproductive.
Mr. McConnell made clear his unhappiness to the White House after a “super PAC” aligned with Mr. Trump started an ad campaign against Senator Dean Heller, Republican of Nevada, when he said last week that he opposed the health care bill.
The majority leader called the White House chief of staff, Reince Priebus, to complain that the attacks were “beyond stupid,” according to two Republicans with knowledge of the tense exchange on Saturday.
Mr. McConnell, who has been toiling for weeks, mostly in private, to put together a measure that would satisfy hard-liners and moderates, told Mr. Priebus in his call that the assault by the group, America First, not only jeopardized the bill’s prospects but also imperiled Mr. Heller’s already difficult path to re-election.
America First was founded by a group of Mr. Trump’s loyalists — many of them with deep connections to Mr. Pence, including Nick Ayers, a Republican consultant who is regarded as the vice president’s top political adviser. The PAC compared Mr. Heller to Representative Nancy Pelosi, the House Democratic leader, and vowed a seven-figure advertising campaign against him.
Josh Holmes, Mr. McConnell’s former chief of staff, said, “That the White House is asking people to take a tough vote and then running ads against members while we’re still in negotiations is so dumb it’s amazing we even have to have the conversation.”
Mr. Priebus did not respond to numerous messages seeking comment.
A broad range of Republican senators across the ideological spectrum have indicated their unease with the compromise health bill, which was largely drafted in secret over the last month. But Mr. Trump has few ties with the group, and several Republicans who remain on the fence have tangled with Mr. Trump, either during the presidential campaign or since.
Top Trump lieutenants like Stephen K. Bannon, his chief strategist, who lobbied members on the House bill, have been all but sidelined. Mr. Priebus has also played a much diminished role.
Mr. Pence has been far more active in seeking out Republican senators. Seema Verma, Mr. Pence’s former adviser in the Indiana statehouse and now a top administration health care official, has been trying to reassure senators that their states will have flexibility on Medicaid under the bill, while Mr. Pence’s former chief of staff, Marc Short, now the White House legislative affairs director, has been quarterbacking the effort from his hideaway in the Capitol.
According to an administration official, Mr. Trump has spoken with several members of the Senate, including Ted Cruz of Texas, his main rival for the 2016 presidential nomination, as well as Mike Lee of Utah and one or two others. But the pace was nothing like the dozens of calls he made to help pass the House’s health bill, aides said.
And the fact that an ostensibly pro-Republican group would respond to Mr. Heller’s criticism of the legislation — he flayed the proposal in harsh terms on Friday but did not rule out eventually backing it — by swiftly accusing him of siding “with Nancy Pelosi” was a shock to Mr. McConnell, who has made no secret of his impatience with Mr. Trump’s impulsive style.
Mr. Heller, the only Senate Republican who will face voters next year in a state carried by Hillary Clinton in 2016, is the top target for Democrats facing a Senate map with few opportunities in 2018. And there were already seven groups — a mix of health care advocacy organizations and more partisan Democratic efforts — on the air in Nevada assailing the Republican health care overhaul, according to a Republican ad buyer tracking the ad traffic.
Neither Mr. McConnell’s office nor his top outside political advisers were warned about an impending attack on one of their most endangered incumbents. “They didn’t check in with anybody,” Mr. Holmes said. “There was no clearing of channels, no heads-up, nothing.”
The anti-Heller assault began with a digital ad buy over the weekend, but it was unclear whether the pro-Trump group would follow through with its threat to spend over $1 million attacking the senator. As of Tuesday, the group had reserved just over $250,000 for ads in Las Vegas and Reno, the two largest media markets in the state, according to the ad buyer.
The move against Mr. Heller had the blessing of the White House, according to an official with America First. Mr. Trump’s allies were furious that the senator would join Gov. Brian Sandoval, a Republican who accepted the Medicaid expansion under the health law and opposes the Republican overhaul, to blast the bill.
But the frustration on Capitol Hill with Mr. Trump and his allies runs far deeper than the ads aimed at the Nevada senator.
Mr. Trump has no centralized political operation. Mr. Priebus, who until he moved to the White House was the Republican National Committee chairman, is the nearest thing the president has to a political enforcer.
But given his day job, he has multiple other demands on his time. Yet Mr. Priebus remains the de facto head of the party. And he is increasingly on the receiving end of frustration from Republican lawmakers who are irritated about the disorganization and factional nature of Mr. Trump’s White House.
This month, Mr. McConnell had to place a call to Mr. Priebus simply to push the Republican National Committee to sign off on creating a coordinated campaign for Senator Luther Strange of Alabama, according to two Republican officials familiar with the call.
Mr. Strange, an ally of Mr. McConnell’s who was appointed to fill the seat vacated by Attorney General Jeff Sessions, is facing a primary this summer. Forming coordinated committees that can help incumbent lawmakers benefit from national party dollars is the sort of perfunctory step typically handled by aides at the party committee and the National Republican Senatorial Committee.
And while Mr. Trump has taken to Twitter and made phone calls in an effort to lobby his party to pass the health overhaul, he has also provided Democrats with potential weapons, namely his description of the House bill he worked to pass as “mean.”

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