Some Republicans worried Trump will do more harm than good in selling health care bill

Next steps for the Senate health care bill

It was a platform most politicians can only hope for: A captivated, 6,000-person crowd and more than an hour of live, prime-time television coverage to hype the Republican vision for a new health care system.

But when President Donald Trump got around to talking about the Republican plan — about 15 minutes into his speech — he was wildly off message. Instead of preaching party lines about getting the government out of Americans' health decisions and cutting costs, he declared: "Add some money to it!"

President Donald Trump says getting approval of a Senate health care bill will be "very tough." But he predicts that Republicans will at least "get very close" and may "get it over the line."

The moment captured a major dilemma for Republicans as they look for ways to jumpstart their stalled health care overhaul. A master salesman, Trump has an inimitable ability to command attention, and that could be used to bolster Americans' support for Republican efforts and ramp up pressure on wavering lawmakers. But some lawmakers and congressional aides privately bemoan his thin grasp of the bill's principles, and worry that his difficulty staying on message will do more harm than good.

"You know, he's very personable and people like talking to him and he's very embracing of that, so there will be certain people he'd like to talk to," said Sen. Bob Corker, R-Tenn. "But I'd let Mitch handle it," he continued, referring to the lead role Senate Majority Leader Mitch McConnell has played thus far.

McConnell delayed a vote on the health legislation this week after it became clear he couldn't muster enough Republican support to offset the unanimous opposition from Democrats. GOP leaders are now hoping to pass a bill in the Senate and reconcile it with an earlier version approved by the House before lawmakers head home for their August recess.

Trump has largely ceded the details to McConnell, deferring to the Kentucky lawmaker's legislative expertise. He has spent some time talking privately to wavering senators, including Ted Cruz of Texas and Mike Lee of Utah, testing his powers of persuasion. But he's invested no significant effort in selling the American people on the impact the Republican bill would have on their health care coverage, beyond making sweeping declarations about how wonderful he expects it to be.

"We're looking at a health care that will be a fantastic tribute to your country," Trump said during a White House event Wednesday. "A health care that will take care of people finally for the right reasons and also at the right cost."

His approach is a contrast to former President Barack Obama, who delivered an address to Congress on health care and held town halls around the country about the Democrats' legislation in 2009. The Obamacare measure barely cleared Congress and became a rallying cry for Republicans, something Obama blamed in part on a failure by his party to communicate its virtues clearly to the public.

At times, even Trump's largely generic health care commentary has left Republicans fuming. Some lawmakers were particularly irked by Trump's assertion that the House bill — which he robustly supported and even celebrated with a Rose Garden ceremony — was "mean."

One Republican congressional aide said that comment left some lawmakers worried that the president — who had no real ties to the GOP before running for the White House — could turn on them if a bill passes but the follow-up becomes politically damaging. The official insisted on anonymity in order to describe private discussions.

Newt Gingrich, the former GOP House speaker and a close Trump ally, said Republicans have struggled to communicate about the complexities of health care policy because "nobody has served as a translator." He said Trump is well-positioned to take the lead, but acknowledged that the real estate mogul-turned-politician would need some help from policy experts in formulating a sales pitch.

"Trump will be able to repeat it with enormous effectiveness once somebody translates it," Gingrich said.

The White House disputes that Trump isn't steeped in the details of the Obamacare repeal efforts. Economic adviser Gary Cohn and other officials on the National Economic Council have convened several meetings with him to explain differences between the House and Senate bills. One senior White House official described the president as "fully engaged" in the process.

During a private meeting Tuesday with Kentucky Sen. Rand Paul, who is strongly opposed to the current Senate bill, Trump said his priority was to increase the number of insurance choices available to consumers and lower monthly premiums, according to an administration official with direct knowledge of the discussion. The official said the president also specifically highlighted the non-partisan Congressional Budget Office's projection that average premiums would be 30 percent lower in 2020 if the Senate bill took effect.

To some Trump allies, more public engagement on a substantive policy debate like the future of the nation's health care system would also be a welcome reprieve for a president whose approval ratings have tumbled amid the snowballing investigations into possible collusion between his campaign and Russia.

"I think his numbers would go up if he had a couple of addresses," said Sam Nunberg, a former Trump campaign adviser. "If he communicates directly with the American people, he cuts through the noise."

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