How Conservatives Improved the American Health Care Act


House Speaker Paul Ryan introduced the American Health Care Act (AHCA) on March 6, 2017. It was touted as a bill to “end the Obamacare nightmare and give Americans access to truly affordable, quality health coverage.”


Unfortunately, the AHCA fell far short of those lofty ideals.


House Republicans had passed a stronger Obamacare repeal in January 2016, with 239 Republicans voting “Yes,” and only three liberal Republicans voting “No.” At that time, in 2016, Speaker Ryan said, “We have shown now that there is a clear path to repealing Obamacare without 60 votes in the Senate. So, next year if we’re sending this bill to a Republican president, it will get signed into law. Obamacare will be gone.”


That was the pledge Republicans, led by President Trump, campaigned on in 2016. As the promised fulfillment to that pledge, the AHCA was fundamentally flawed, especially in its failure to address the key drivers of rising insurance premium costs.


The Club for Growth immediately engaged on the issue. The attached timeline lays out some of the meetings, calls, and action steps we took to urge conservatives in Congress and the Trump Administration to quickly address the many problems with the AHCA.


House Republican leaders remained reluctant to make significant changes to the AHCA, and it was pulled from the House floor by leadership on March 24, 2017. The Club for Growth responded with a memo that said, in part, “The conservatives and moderates who opposed the plan should start by meeting together to see what common ground they have.”


Our proposal became the plan that conservatives and moderates followed, and now we are closer than ever to seeing the House vote on a bill that has been dramatically improved.


Because conservatives, including members of the House Freedom Caucus, remained at the negotiating table with the Trump Administration and House leadership, they were successful in bringing much-needed improvements to the AHCA. A summary of those improvements follows.




  • March 6– AHCA Released
  • March 8 – White House separate meetings with VP Pence and President Trump
  • March 16-18 – Meetings in FL with members of HFC and with VP Pence
  • March 20– Meeting with HHS Secretary Tom Price
  • March 20– House announces first amendments (taxes & Medicaid)
  • March 20 – 22– Club runs $500,000 ad campaign in ten House districts urging Members to oppose AHCA as it stood
  • March 22– Key Vote Alert against RyanCare
  • March 24– AHCA pulled by House leadership
  • March 24-25– Club releases memo urging HFC and moderates to negotiate way forward
  • March 30– Meeting with Speaker Paul Ryan
  • April 1-2– Phone conversations with VP Pence about allowing state waivers for regulations
  • April 3 – Meeting with VP Pence and Chief of Staff Reince Priebus
  • April 4 – Club releases memo urging all sides to approve deal facilitated by VP. Gave same message on Fox News, announcing support of the plan as facilitated by VP
  • April 7 – Club offers support on FBN’s Varney & Co. for Palmer-Schweikert amendment for high-risk pools
  • April 10–21– Club runs $1 million ad campaign: National ad endorsed Trump-Pence plan. Local ad in ten House districts urged moderates to stop blocking deal facilitated by the VP.
  • Week of April 17– Club remains engaged with phones conversations with WH and HFC
  • April 24– Club supports the Meadows-McArthur compromise and will no longer oppose the bill with this new amendment
  • April 28– Club launches TV ad thanking Rep. Tom McArthur for working toward a compromise with conservatives

* 10 House Districts (March 20-22)


Leonard Lance


Tom MacArthur (NJ-3)


John Katko (NY-24)


Brian Fitzpatrick (PA-8)


Rob Wittman (VA-1)


Ileana Ros-Lehtinen (FL-27)


Peter King (NY-2)


Charlie Dent (PA-15)


Darrell Issa (CA-49)


Don Bacon (NE-2)

* 10 House Districts (April 10-21)


Martha McSally


Adam Kinzinger


Patrick McHenry


Rodney Frelinghuysen


Chris Collins


Pat Tiberi


Greg Walden


Charlie Dent


Timothy F. Murphy


Evan Jenkins