Analysis: Health care victory boon or bust for GOP?

Nearly four months into the era of Trump, Republicans gave weary supporters reason to think there's still hope for the bold promises of Campaign 2016.

With a House vote Thursday to repeal former President Barack Obama's health care law, the party showed it could pick up the pieces after a humiliating failure six weeks ago and demonstrated the first flicker of signs that it may be able to find consensus within its divided ranks.

The momentum appeared to carry over beyond health care. The House vote came hours after Trump signed an order to promote religious expression. GOP legislators moved closer to rolling back Obama-era financial regulations. The Senate approved a spending bill averting a government shutdown that would have been disastrous for the party with a monopoly on power.

"I think that it's promises made, promises kept," said Dee Stewart, a Republican strategist in Raleigh.

But the hunger for a win may have come at a cost. House Republicans pushed through the health care bill with only a vote to spare – every North Carolina Republican in the House voted for it, except for 3rd District Congressman Walter Jones. It had no Democratic support, which is reminiscent of all House Republicans voting against the passage of the so-called "Obamacare" law the new measure would unravel.

Democrats also quickly served notice they would hold Republicans accountable for what they predicted could be a disastrous impact on some of the sickest Americans.

"They're going to face the wrath of voters in 2018," said Morgan Jackson, a Democratic consultant in Raleigh.

Immediately after the health-care vote, House Republicans piled onto buses and headed to the White House for a sun-splashed Rose Garden celebration – a rare event for a bill that has cleared only one chamber of Congress.

"This really helps," President Donald Trump said, saying that the vote had brought fractious Republicans together and laid the foundation for future victories on tax cuts and more.

Getting ahead of himself, Trump used the event as an opportunity to make the case, none too subtly, that this was a campaign promise kept.

"Make no mistake, this is a repeal and a replace of Obamacare," Trump said. "Make no mistake about it. Make no mistake."

Jackson predicted the victory lap-style ceremony will become a scene in countless political ads next year.

"What they've done is undercut the most vulnerable in society, and that is a dangerous, dangerous place to go politically," he said. "They touched the new third rail of health care in pre-existing conditions."

The American Health Care Act allows states to opt out of regulations implemented under Obama's Affordable Care Act that require insurers to cover people with existing health problems.

"What the Rose Garden celebration did was build some momentum," countered Stewart.

The event was a sign of how badly the GOP needed the boost. Trump's travel ban executive orders have been blocked in the courts, investigations into his campaign's contacts with Russians have been a big and ongoing distraction and he's had to put off action on a wall at the Mexican border for now. Trump's first push for the long-promised health care repeal ended without a vote and with talk of moving on to a tax overhaul plan, a startling admission of defeat on a campaign promise that has animated his party for seven years.

"At the end of the day, we needed to succeed, and we needed to prove we could deliver on our promises to the American people, and this is proof that in the House, at least, we can," Oklahoma Republican Congressman Tom Cole said Thursday.

Princeton University historian Julian Zelizer said the day's development will help steel Republicans for battles ahead.

"There is nothing as satisfying in politics as a victory," Zelizer said. "It might embolden them to deal with the consequences and the fallout of the health care vote and energize them for other fights."

"I don't think there's anyone's who's surprised that, after seven years of campaigning on repealing and replacing Obamacare, that the House of Representatives actually did follow through on it," Stewart said. "So, I think it's going to energize Republicans."

But there's a danger in reading too much into one good day.

Just as the 100-day mark was too early to pronounce the Trump administration a failure after early missteps and struggles, this newest mile marker also is too early to say the party has everything figured out.

The Senate is certain to make substantial changes to the bill, with some members concerned about its cuts to the Medicaid program for low-income people.

"I have long said that any replacement to Obamacare must address the millions of Americans with pre-existing conditions and provide a way for younger Americans under 26 to stay on their family’s health insurance plans," North Carolina Republican Sen. Thom Tillis said. "Ultimately, we need health care reform that will be an improvement over Obamacare, which has led to skyrocketing premiums and fewer choices for hardworking families in North Carolina and across the nation."

U.S. Sen. Richard Burr couldn't be reached for comment Friday.

Should a version of repeal get through the Senate and take effect, Trump is now responsible for the promises he flatly delivered in the Rose Garden:

"Premiums will be coming down," he said. "Deductibles will be coming down. It's a great plan."

In the Rose Garden, backed up a cheerleading squad of House Republicans, the new president seemed to be savoring the idea that he's finally come into his own.

Oddly enough, it was the Democrats who did the chanting as the House vote for repeal was announced.

"Hey, hey, goodbye," they sang – indicating that they are eager to hang the repeal vote around the Republicans' necks.

"You will glow in the dark," House Minority Leader Nancy Pelosi warned Republican legislators.

She said the nearly party-line health care vote would be "tattooed" on GOP lawmakers and become "a scar" they will forever carry.

Democrats should know.

Obama's health care law also passed narrowly and without bipartisan support, and soon enough, GOP legislators turned Obamacare into a cudgel to use against Democrats in future elections.

"What you're going see is very much like what the Republicans did in 2010," Jackson said. "You've got an active base of Democrats that are very fired up in a low-turnout election, and that puts a lot of folks in jeopardy."

Democratic National Committee Chairman Tom Perez predicted: "Trump and Republicans will own every preventable death, every untreated illness and every bankruptcy that American families will be forced to bear if this bill becomes law and millions lose access to affordable health care."

But Stewart noted that the mid-term election is still 18 months off and that Democratic efforts to use health care as an issue will fail.

"There's a long time between now and the November 2018 elections, but I would say, as the election draws nearer, voters are going to look and say, 'Which party actually engaged in trying to make health care better?'" he said.