The Senate’s Obamacare repeal-and-replace legislation may be a train wreck but at least it’s finally put to bed the myth of President Trump as the master deal-maker.
Trump spent last weekend before the collapse of the legislation watching the U.S. Women’s Golf Open—at a Trump owned golf course, naturally, in Bedminster, NJ—seemingly oblivious to the impending demise of the Senate’s health care legislation. Perhaps he took the opportunity to hobnob with Senate fence-sitters? Perhaps he was working the phones behind the scenes? At the time, the White House would not say, according to pool reports.
Judging by Twitter—the only reliable barometer for all things Trump—he was more fixated on the tournament over the weekend, tweeting about it six times. He also managed to fire off four tweets about the Russia scandal. Health care got just one tweet. And it didn’t even crack his top three list of priorities for the upcoming week. (They were, in order: trade, military, and security.)
Last Monday there was little hint of a White House in crisis mode: Trump mugged for cameras with a baseball bat, cowboy hat, and fire truck for Made in America Week. That night he did host Republican Senators to a strategy session over steaks, but they weren’t the ones he needed to win over, Politico reported. After the dinner ended, two of the uninvited, Sens. Mike Lee and Jerry Moran issued statements opposing the bill, torpedoing it. The resurrected 2015 repeal-only bill was even more short-lived, expiring within a day. Another luncheon with Senators on Wednesday so far, as of this writing, has failed to resuscitate it.
Trump’s failure as a negotiator is best measured against his own 11 rules in The Art of the Deal.
Rule 1: Think big. “I like thinking big. I always have. To me it’s very simple: if you’re going to be thinking anyway, you might as well think big,” Trump (or his co-author) wrote.
But where were the big ideas in the Senate bill? It peeled away some of the more outrageously onerous elements of Obamacare, such as the individual mandate, but left in the bulk of regulations. It cut some taxes but saved most of them. Its approach to the refundable tax credits for health insurance premiums screamed small-minded: the credits were kept and the income threshold was merely tweaked from 400 to 350 percent of the federal poverty level.
It would do what the federal government does best: spend money, creating a $112 billion bailout for insurers affected by Obamacare, that one conservative analyst says is the gateway to a single-payer system.
Conspicuously absent were stock conservative ideas about health care reform. Did the bill allow the purchase of insurance across state lines? Nope. High risk pools for the otherwise uninsurable? Not there. It does address health savings accounts—another conservative hobbyhorse—but makes only “minor adjustments” to them, according to one analysis. It creeps towards federalism, by merely relaxing Obamacare’s already-existing guidelines for how states can seek waivers from some of its requirements.
Obamacare had one big overarching goal in mind: make health insurance accessible to the uninsured. Everything the law did—from its regulations on pre-existing condition and its allowance for children to be on their parent’s plans until age 26 to its creation of refundable tax credits—served this higher purpose. But what was the Republican goal? Simply fix Obamacare? Rein in rising costs? Cut Obamacare’s taxes? Or enact some type of fundamental conservative reform, such as returning health care to more of a free market system? (Which it wasn’t, by the way, pre-Obamacare.)
Trump personifies the GOP’s poverty of ideas. He famously advocated for universal health care before jumping on the repeal-and-replace bandwagon, but still flirts with the former. He lauded the House version only to later denounce it as ‘mean.’ He has promised everything Americans across the spectrum want—lower costs, better plans, no cuts to Medicaid, no dropping of coverage for the sick—while offering few, if any, concrete ideas for achieving these potentially divergent ends. It’s hard to negotiate when you don’t know what you really want. And it’s hard to compromise your principles when you’re not sure what they are in the first place.
Trump seems to have flubbed his other deal-making tactics as well, such as Rule 4: Know Your Market. The dynamics of Congressional politics seem to have eluded him. So has the epic unpopularity of the bill. Even the bank bailouts and the Clinton health care plans were more popular, according to historic polling data. Likewise, a New York Times analysis found that the bill lacked majority support in every single state.
In the Art of the Deal, Trump talks openly about how he learned to manipulate the media. “One thing I’ve learned about the press is that they’re always hungry for a good story, and the more sensational the better.”
His example is land he bought in the Upper West Side of Manhattan in 1985, known as Television City. He boasted that he would build the world’s tallest building there. He never did, but the resulting media buzz increased the value of the land, so Trump claims. (In reality, Trump blew a chance to sell it for $550 million and was compelled to bow out of the project by his lenders.)
Trump has talked big about health care but he’s done little proactively. Yes, he’s made a point of holding rallies as president, but those appear to be more about chasing the adrenaline high and adulation of campaigning than building public support for the bill. Where were the town halls to win over a public skeptical on the health care bill? Why no prime time television address to tout it? The White House press office has followed suit, mainly playing defense on the bill. Trump says he refuses to ‘own’ Obamacare. But did he ever even own Trumpcare?
At some point, Trump concedes in The Art of the Deal, you have to “deliver the goods”: “You can’t con people, at least not for long. You can create excitement, you can do wonderful promotion and get all kinds of press, and you can throw in a little hyperbole. But if you don’t deliver the goods, people will eventually catch on.”
At one point, in the depth of his frustration last week, Trump flirted with policy—and likely also political—suicide: let Obamacare fail completely, he said, presumably so the resulting widespread misery will drive Democratic lawmakers to eventually come to him begging for compromise. He then turned around and lectured GOP lawmakers on the perils of ‘inaction.’ Trump is now pressing for a vote on the repeal-only bill before the August recess—and before the American people have more time to catch on.
Stephen Beale is a freelance writer based in Providence, R.I. Email him at [email protected].