An extensive list of major health care organizations that are opposing a Republican overhaul measure were consulted as it was crafted, but the White House says those groups’ views were cast aside in favor of a “patients-centric bill.”

From the American Medical Association to the American Hospital Association to the AARP, a seemingly ever-growing list of influential groups that backed the Obama administration’s 2010 overhaul push are opposed this time around. But each are part of the Washington “swamp” of plugged-in policy influencers that President Donald Trump vowed to drain, which his White House made clear Wednesday.

The groups cited a panoply of reasons for their opposition, saying the GOP bill, called the “American Health Care Act,” would strip too many people of coverage, create coverage that was too expensive, and complicate Medicaid coverage for millions, and others.

As the Obama administration was crafting its 2010 health care law, officials kept those groups involved, and incorporated their views while crafting the legislation. And the groups stated their support, or at least muted neutrality, before it hit the House and Senate floors.

This time around, however, is a different story. In fact, the White House on Wednesday contended that while it would “love” to have every association on board, Trump administration officials felt no need to give Washington-based health and medical groups a seat at the table, or even consider their insights.

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“This isn’t about how many special interests in Washington got paid off,” White House Press Secretary Sean Spicer said at his daily briefing, referring to associations that represent and lobby on behalf of medical industries, physicians and more than 30 million senior citizens.

“I have respect for some of the work that some of these … D.C.-based associations do,” Spicer said, although some, like the Chicago-based AMA, are not based in Washington. But “at the end of the day, this is about patients and the input from doctors who are on the front lines of seeing patients … and the care they are able to give and not give to people.”

The health sector groups “got a really good deal last time,” he said. “This is a patients-centric bill.”

On Capitol Hill, senior Republican aides reported little surprise that the health-sector associations are opposed to the measure.

“It’s not surprising that groups that helped pass ACA don’t want to see it repealed,” said one House GOP leadership aide, referring to the 2010 law by its acronym. 

And another senior Republican source described the groups as having had “many opportunities to offer their feedback and voice their suggestions throughout the entire months-long process leading to this bill.

“In addition to this week’s meeting hosted by [House GOP Whip Steve Scalise’s] office, leadership has met with and held calls with many of these groups directly over the last several months to ensure an inclusive process,” the senior Republican source said.

In a statement to Roll Call, the American Medical Association said it was in “frequent communication” with Republican and Democratic leadership offices, as well as relevant committee chairmen and ranking members. AMA officials also presented its “Vision for Health Reform” blueprint to those offices, as well as to Trump transition officials, late last year. The group followed up with a letter to those same entities in January.

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“In our conversations, we communicated our goals and the complex challenge that was facing Congress,” the AMA’s statement read. “The Affordable Care Act needed to be improved, but we emphasized that people who were insured because of it should not lose their coverage under a replacement.”

The association did not describe any formal role in what went into and was left out of the GOP bill.

David Certner, legislative counsel at the AARP, said his group was mostly in contact with lawmakers and aides on Capitol Hill, matching what the senior Republican source reported. AARP officials have been meeting with “a lot of folks” in both chambers for months to voice their top concerns, Certner said.

Because many Trump administration posts are still unfilled, Certner called it “premature” to expect very much back-and-forth with the White House as the measure was being crafted. And he acknowledged the substance of the bill does not match AARP’s health care overhaul goals. Nor, he said, did it match the campaign-trail rhetoric of Trump and congressional Republicans.

At the White House on Wednesday, while Spicer never said the GOP overhaul measure was written with those campaign-trail “drain-the-swamp” chants in mind, it certainly sounded like it.

“When you look at a lot of doctors versus the associations here in Washington, we have had tremendous input from doctors themselves,” he said while jousting with reporters.

“Dr. Price, himself a doctor, is the one who crafted this,” he said, referring to Health and Human Services Secretary Tom Price, a former orthopedic surgeon Atlanta.