The Republicans’ embarrassing abandonment of their efforts to repeal and replace Obamacare is a party-wide failure in which President Trump deserves less of the blame than the “Trumpcare” moniker might imply.
If the president gets his way on the GOP’s approach to Plan B, however, he might become a much bigger part of the problem.
Republicans certainly could have used more normal presidential leadership than what Trump provided. Sweeping changes of this kind are usually driven by the White House rather than on Capitol Hill.
The dealmaker-in-chief’s lack of interest in policy details or the motivations of the various Republican factions seriously inhibited his ability to meaningfully negotiate a healthcare bill majorities in both houses of Congress could get behind. He offered guidance over Twitter and in meetings warned lawmakers about the consequences of failure.
But moderates worried about protecting Medicaid expansion and conservatives who wanted to roll back more of Obamacare’s taxes and regulations needed to hear more from the president than that they should avoid looking like “dopes” by not passing something.
That being said, in a replay of the campaign, Trump’s political instincts on healthcare were often sharper than those with much greater policy acumen. He understood it was an important promise to keep after seven years of Republicans running on repeal. He was right that a replacement should come quickly and it should be competitive with Obamacare in overall coverage numbers.
If Trump understood policy better, he might have realized these often conflicting goals were difficult to reconcile. None of this was bad advice, however. And Trump was a good soldier for whatever House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell thought they could pass, even if he privately thought the bills lacked “heart.”
Faced with defeat on healthcare and backed into a corner by Democrats, Trump’s instincts may be starting to fail him. Even before a procedural vote on a new bill repeating old, 2015 language fully repealing Obamacare without a replacement, Trump began to speak openly about letting the healthcare law “collapse.”
Both clean repeal and collapse are aimed at forcing the Democrats to the negotiating table, since Republicans can’t seem to agree on a replacement in large enough numbers. That’s a debatable strategy at best, but Trump’s logic soon went further off the rails.
“And I think we’re probably in that position where we’ll let Obamacare fail. We’re not going to own it. I’m not going to own it,” Trump said. “I can tell you the Republicans are not going to own it. We’ll let Obamacare fail and then the Democrats are going to come to us.”
Make no mistake: Trump and the Republicans already own part of healthcare. Yes, Obamacare was passed by the Democrats without a single Republican vote. But Republicans hold both houses of Congress and the White House. They proposed bills to repeal and replace the law.
The fact that a Republican president, Senate and House could not do anything about Obamacare gives them some of the blame for the healthcare problems that persist here on out. Moreover, Democrats were willing to risk their majorities to see their vision of healthcare policy become law. Republicans plainly were not.
Worse, Trump’s callous language about Obamacare collapsing runs counter to his instincts on healthcare and makes him sound like he is rooting for problems that will hurt people who depend on the law.
It may all be political posturing or a bargaining tactic. Trump and the White House still seem more interested in twisting Republican arms on this issue than the GOP congressional leadership. Yet it already features prominently in Democratic healthcare talking points.
“Donald Trump has abdicated his responsibility as president of the United States,” said Virginia Gov. Terry McAuliffe. “He is now hurting Americans and he is going to pay the price politically.”
Democrats will accuse Trump of sabotaging Obamacare, as they have accused any Republican elected official who has resisted some aspect of the law. It will continue to muddy the waters as to how much of the exchanges’ problems owe to Obamacare’s shoddy design and inability to attract young, healthy consumers versus how much is due to GOP intransigence.
A savvy businessman once said, “Leadership: Whatever happens, you’re responsible. If it doesn’t happen, you’re responsible.”
It’s as true now as when Trump tweeted it in 2013.
James Antle III is politics editor of the Washington Examiner and author of Devouring Freedom: Can Big Government Ever Be Stopped?