I wrote on Wednesday that Republicans forced themselves into a corner with seven years of lying and overpromising about healthcare. The fact that nothing they do now will live up to the promises they made before is a big political problem.
- Trump doesn’t really care what the bill does, exactly, so long as he can sign it and say that it “repeals and replaces” Obamacare.
.. You don’t walk into a negotiation and tell your counterparty that you’re desperate to make a deal fast and on any terms. But Trump did just that, which is why Freedom Caucus members knew the White House was bluffing when it claimed the bill was closed and wouldn’t be amended further.
.. Trump might be making such promises. But because he has a decades-long reputation for reneging on his promises to counterparties, members are unlikely to trust Trump when he does so.
.. Trump’s assurance that the bill’s limitations — for example, its limited impact on insurance regulations under Obamacare — will be addressed through executive action and future legislation do not seem to be convincing enough of his party’s own representatives to get this bill passed.
.. Trump seems to have been personally unprepared for the interconnected nature of healthcare policy. Moving the wrong piece can cause the healthcare market to crash down like a Jenga tower, and Trump has no idea how to determine which blocks are loose.
.. if you’re going to repeal EHB, you also need to repeal Obamacare’s rule that requires insurers to cover preexisting conditions, as otherwise insurance markets could collapse.
.. If Trump understood health-insurance policy (or asked someone who did), he would have known that EHB rules and preexisting-condition rules go together like peas and carrots, and he shouldn’t offer to repeal one if he’s dead set on keeping the other.
.. Trump shifted the focus of his professional endeavors away from businesses that were heavy on dealmaking and toward businesses that were heavy on marketing, particularly arrangements in which he would rent his name to somebody else who was actually in the business of developing real estate.