I listened to Hugh Hewitt the morning after it was released; he was stunned that he couldn’t get any of the Republican House leadership [sic] on his show to talk to his conservative audience about the biggest piece of legislation in Trump’s first term.
.. It says something about the relationship between Ryan and Mitch McConnell that Ryan hasn’t used the Senate as a scapegoat.
.. During the campaign, Trump promised he would repeal the law entirely, eliminate the individual mandate, permit the sale of health insurance across state lines, allow individuals to fully deduct health-insurance premium payments, require price transparency from all health-care providers and allow consumers access to imported, safe, and dependable drugs from overseas.
.. The bad things to come out of the Trump administration so far:
· Tweeting that President Obama tapped his phones at Trump Tower, an accusation that no one could find any evidence to support.
· Not merely the inability to pass health care reform on the first try, but the clumsy way it was handled, with Trump clearly not caring about the details and Bannon trying to bully the House Freedom Caucus, telling them they had “no choice” but to vote for it.
· Trump continues to make big promises with few details on how he’s going to make it work. Last night he said, “I know that we are all going to make a deal on health care. That’s such an easy one.” Is it? Is it really?
· The administration had a series of defeats in court; the initial travel ban appeared to be hastily written, ignored career lawyers of DHS, and created chaos at the nation’s airports.
· The FBI is investigating whether Trump’s campaign coordinated with Russia on illegal hacking of places like John Podesta’s computer and the DNC and other efforts to influence the election.
· The outlook for tax reform is complicated by the failure to get health-care reforms done first, as the reforms were supposed to create the savings to pay for the tax cuts. Ditto for the dreams of a big infrastructure bill.
· It’s very early, but there are signs that the “energized Democratic grassroots” storyline isn’t just media wish-fulfillment. Just as Republicans woke up and got active as the Obama era began in 2009, Democrats may be the same…
· We’re cool with a president golfing now, huh, conservatives?
· We don’t care if White House visitor logs are no longer accessible to the public, huh? We’re fine with the Trump administration being less open and transparent than the Obama administration?
Yesterday I wrote about one of the more bewildering and unnerving early stumbles of the administration, a persistent complaint about the “deep state” while failing to nominate anyone for hundreds upon hundreds of important positions. Yes, the Senate could confirm the 40 or so nominees faster, but the Trump administration just looks flatly unprepared for one of the key tasks of governing.
Negotiation with the Freedom Caucus: Trump Didn’t Care about Congressmen’s Issues
Tim Alberta offered a vivid anecdote:
Thursday afternoon, members of the House Freedom Caucus were peppering the president with wonkish concerns about the American Health Care Act—the language that would leave Obamacare’s “essential health benefits” in place, the community rating provision that limited what insurers could charge certain patients, and whether the next two steps of Speaker Paul Ryan’s master plan were even feasible—when Trump decided to cut them off.
“Forget about the little s***,” Trump said, according to multiple sources in the room. “Let’s focus on the big picture here.”
The group of roughly 30 House conservatives, gathered around a mammoth, oval-shaped conference table in the Cabinet Room of the White House, exchanged disapproving looks. Trump wanted to emphasize the political ramifications of the bill’s defeat; specifically, he said, it would derail his first-term agenda and imperil his prospects for reelection in 2020. The lawmakers nodded and said they understood. And yet they were disturbed by his dismissiveness. For many of the members, the “little s***” meant the policy details that could make or break their support for the bill—and have far-reaching implications for their constituents and the country.
Maybe to Trump these details about the bill were “the little s***.” But to the members in front of him, this was the make-or-break criteria of what makes a good reform bill. You would think the author of The Art of the Deal would have understood the importance of knowing the other side’s priorities. I seem to recall impassioned, insistent assurances during the 2016 Republican presidential primary that Trump was the ultimate dealmaker.
Why No GOP Health Care Bill Will Ever Be Really Popular
many members of the public have wildly unrealistic expectations about what their health care should be and how much they should pay for it, and no politician in either party has much incentive to be honest about hard truths. There’s a strong argument that the entire concept of insurance doesn’t work well for health care, compared to, say, auto insurance.
.. The vast majority of drivers will not get in a major accident in any given year, and plenty of drivers will go years and years without an accident. Consumers are comfortable with a system where most years, they will pay in a considerable sum and get nothing from their auto insurer for that year.
Auto insurance works because a lot of people pay in and get little or nothing in return
.. Even if we somehow forced medical schools to admit more students and produce more doctors, U.S. demand for health care is only going to increase as the Baby Boomers age.
.. As of 2015, only 67 percent of doctors take Medicaid, and only 45 percent of doctors take new patients on Medicaid.
.. They still believe that there’s some system out there where they can get the very best care, choose any doctor they like, see any specialist they prefer, and pay little or nothing for it. And until that perception is dispelled, any health-care reform proposal will be greeted as a disappointment.
.. We need to dispense with the cute kid conservative novelty acts and understand that our ideology — unlike liberalism — is not based on feelings and preferences but is instead drawn from a wisdom and understanding of human nature that comes only from hard-won life experience.
Ivy League “Assortive Mating”
Why, it would be like telling elite collegians that they should all move to similar cities and neighborhoods, surround themselves with their kinds of people and gradually price everybody else out of the places where social capital is built, influence exerted and great careers made. No need — that’s what we’re already doing! (What Richard Florida called “the mass relocation of highly skilled, highly educated and highly paid Americans to a relatively small number of metropolitan regions, and a corresponding exodus of the traditional lower and middle classes from these same places” is one of the striking social facts of the modern meritocratic era.) We don’t need well-meaning parents lecturing us about the advantages of elite self-segregation, and giving the game away to everybody else. …
.. reminding us of her de facto royal status.