Trump’s Attacks on Health Care Will Backfire

The administration’s chaotic reversals on Obamacare could deprive millions of coverage.

Meanwhile, the administration’s latest budget, released in mid-March, stands behind legislation known as “Graham-Cassidy,” which was pushed by Republicans in 2017 but never won enough support to be brought to a vote.

The Trojan horse of health care reform, the proposal provides for relatively small initial cuts in federal funding and then huge reductions starting in 2027.

According to a Brookings Institution reportGraham-Cassidy would cost 32 million Americans their health insurance by 2027, just as full repeal would. That’s Donald Trump’s idea of a “beautiful,” “terrific” and “unbelievable” health care plan.

.. The administration’s recent decision to submit a brief in a Texas case asking the court to declare all of Obamacare unconstitutional was well publicized.

Slipping by almost unnoticed was Mr. Trump’s instruction last June to the Justice Department, which was defending the A.C.A., to argue instead that certain key provisions — notably, the requirement that Americans with pre-existing conditions be treated equally — be declared unconstitutional.

A win by Mr. Trump in this case could mean that nearly 20 million Americans would lose insuranceaccording to the Urban Institute.

The Fleecing of Millennials

Their incomes are flat. Their wealth is down. And Washington is aggravating future threats.

For Americans under the age of 40, the 21st century has resembled one long recession.

I realize that may sound like an exaggeration, given that the economy has now been growing for almost a decade. But the truth is that younger Americans have not benefited much.

Look at incomes, for starters. People between the ages of 25 and 34 were earning slightly less in 2017 than people in that same age group had been in 2000:

 

The wealth trends look even worse. Since the century’s start, median net worth has plummeted for every age group under 55:

.. Why is this happening? The main reason is a lack of economic dynamism. Not as many new companies have been forming since 2000 — for reasons that experts don’t totally understand — and existing companies have been expanding at a slower rate. (The pace of job cuts has also fallen, which is why the unemployment rate has stayed low.) Rather than starting new projects, companies are sitting on big piles of cash or distributing it to their shareholders.

This loss of dynamism hurts millennials and the younger Generation Z, even as baby boomers are often doing O.K. Because the layoff rate has declined since 2000, most older workers have been able to hold on to their jobs. For those who are retired, their income — through a combination of Social Security and 401(k)’s — still outpaces inflation on average.

But many younger workers are struggling to launch themselves into good-paying careers. They then lack the money to buy a first home or begin investing in the stock market. Yes, older workers face their own challenges, like age discrimination. Over all, though, the generational gap in both income and wealth is growing.

Given these trends, you’d think the government would be trying to help the young. But it’s not. If anything, federal and state policy is going in the other direction. Medicare and Social Security have been spared from cuts. Programs that benefit younger workers and families have not.

.. The biggest example is higher education. Over the past decade, states have cut college funding by an average of 16 percent per student. It’s a shocking form of economic myopia. In response, tuition has risen, and students have taken on more debt. Worst of all, many students attend colleges with high dropout rates and end up with debt but no degree.

And as badly as the government is treating the young today, the future looks even more ominous.

First, the national debt, while manageable now, is on pace to soar. The primary cause is the cost of health care: Most Americans receive far more in Medicare benefits than they paid in Medicare taxes. The Trump tax cut also plays a role. It is increasing the debt — and it mostly benefits older, affluent households.

How to Talk So Trump Will Listen: A GOP Guide for Pelosi

A few Republicans have managed—really—to work successfully with the president. Here’s what the new speaker could learn from them.

But there’s no formula for successfully negotiating with this mercurial, ad hoc chief executive. Pelosi’s first attempt to do so, an agreement in September 2017 to protect the Dreamers from deportation in exchange for border security funding, fell apart not long after it was announced.

Still, there’s no reason to think Pelosi, or anyone in the nation’s capital, can’t find a way to a win with Trump. Here’s what we’ve learned about the art of making a deal with Trump from the few successful people in Washington who have figured out how to get what they want out of the president.

Convince Him He’ll Be Loved

Trump may want nothing more than to be well-liked and appreciated. The bipartisan criminal justice reform bill seems to have been sold to him as an opportunity to do just that. Versions of the First Step Act, a major reform that liberalizes federal prison and sentencing laws, had floundered in Congress for years. The policy already had support from across the political spectrum—but it needed a Republican president who could provide political cover to bring enough members of the GOP on board.

Trump wasn’t an obvious champion for sentencing reform. He ran a campaign promising “law and order” and selected the tough-on-crime Jeff Sessions as attorney general. Sessions’ Justice Department had issued reports critical of the bill. The president has suggested that convicted drug dealers deserved the death penalty. To get his support, the criminal-justice reformers would need to conduct a conversion.

The evangelist was White House adviser Jared Kushner, who, all accounts say, worked hard to persuade his father-in-law. Kushner met with everyone from members of the Congressional Black Caucus to Koch-funded interest groups to the news media to bolster an already large coalition. It helped that Kushner was able to deliver plenty of groups and individuals on the right.

“I think the broad popularity of the policy was the gateway,” says one of the bill’s advocates, who watched the process at the White House up close. “The president was also given a booklet of dozens of conservative organizations and individuals making supportive statements on the bill to show grassroots political support. And then it took some convincing that law enforcement was on board.”

The last piece proved crucial, because there’s perhaps no interest group Trump cherishes more than law enforcement. The marquee names—the

  • Fraternal Order of Police, the
  • International Association of Chiefs of Police, the
  • National District Attorneys Association—

were enough to get the president on board. With seemingly few people opposed (Tom Cotton, otherwise a devoted Trump ally, the most prominent) and even staunch critics in the media like Van Jones making the trek to kiss Trump’s ring at the White House, Kushner and his partners succeeded in selling Trump on the most important provision of the First Step Act: Mr. President, you will be loved for signing it.

It won’t be easy for Pelosi, but the Democratic speaker may be able to use similar tactics to goad Trump into supporting some bipartisan health-care initiatives. The administration has already begun proposing some form of federal intervention to lower prescription drug prices, while Democrats have long argued that Medicare should negotiate with Big Pharma on bringing down drug costs. Some kind of compromise bill could get the support of both Capitol Hill and the White House. Your older, Medicare-using base will love you for it, Pelosi might tell the president. That would get his attention.

Remind Him of His Campaign Promises

Earlier this month, Trump and Kentucky Senator Rand Paul were having one of their frequent conversations about the American military presence in both Syria and Afghanistan. Paul, a persistent, longtime critic of the continued deployment of troops in the Middle East, has found the strongest ally of his political career on the issue with Trump.

After their discussion, Paul sent the president some news articles supporting his view that the time was right to withdraw from Syria, says top Paul aide Doug Stafford, who says Trump sent back a note alerting him that he would “see some movement on this soon.” On December 19, Trump announced the forthcoming withdrawal of the roughly 2,000 U.S. troops fighting ISIS in Syria. The move was resisted by just about everyone around Trump, inside and outside the administration, including John Bolton, Jim Mattis and Lindsey Graham. All, except Paul.

I think people mistake it like Rand is trying to get him to do what Rand wants. But this is what Donald Trump ran on,” says Stafford. “Rand sees his role more as keeping the president where he wants to be and where he said he would be against some people who are inside of the White House and other senators who are trying to push him off of his beliefs and his position.”

Paul’s strategy was partially to ingratiate himself with the man he once, in the primary season, called an “orange-faced windbag.” Trump and Paul have played golf together, a favorite pastime for the president and a way other former antagonists have overcome bad blood.

.. in recent months, Paul has ramped up his public praise for Trump and joined the chorus of Republican criticism for the president’s treatment in the press. Trump has returned the favor with praiseworthy tweets. Paul had raised concerns about two of Trump’s high profile nominations in 2018, for their defenses of the government’s data surveillance apparatus. But he dropped his public skepticism of Brett Kavanaugh and, earlier in the year, did an about-face on his opposition to Mike Pompeo.

Stafford gives credit for Paul’s success to the senator’s constant prodding of the president to be true to himself and his base. “It’s not just Rand’s voice. People who voted for Donald Trump don’t want to still be there either,” Stafford says. “He ran on it, he was loud and clear on it, and he believes it.”

Like opposition to military interventionism in the Middle East, an increase in infrastructure spending is one of the few major Trump campaign pledges that aligns him more with Democrats than his fellow Republicans. Trump’s failure to embrace a major infrastructure bill in favor of the divisive travel ban at the outset of his presidency may have doomed his ability to work across the aisle on the issue. Yet Pelosi could get more than enough of her caucus to embrace some form of new infrastructure spending by reminding the president of his 2016 promise to invest more federal dollars in roads and bridges. If she persists in nudging Trump to fulfill his pledge, Pelosi could deliver a longtime Democratic wish list item.

Stay Outside the Room Where It Happens

Before he was the White House national security adviser being overruled by the president on Syria, John Bolton was arguably more influential with Trump as a private citizen—albeit one with the right platforms to reach him. A fixture on Fox News for the first year of the Trump presidency, Bolton used his cable perch and the host of outlets that would publish him to make an argument directly to Trump: Get out of the Iran nuclear deal.

Trump, who had run hard against what was officially called the Joint Comprehensive Plan of Action, had been persuaded to recertify the deal in early 2017 until the new administration could get off the ground. His national security team, particularly Mattis and Rex Tillerson, were insisting Trump recertify at the next deadline, in July. Trump was resistant but acquiesced to the pleas of his team to allow them to finish crafting a new interagency strategy on Iran. On July 13, my colleague Stephen F. Hayes and I reported in The Weekly Standard that Trump would recertify the deal a second time.

But four days later, on the day of the deadline, an article by Bolton in the Hill made its way to Trump via Iran-deal opponent and White House aide Steve Bannon. The headline read: “Trump Must Withdraw from the Iran Nuclear Deal—Now.” In his op-ed, Bolton argued that Trump “should stop reviewing and start deciding” how to exit the deal. For several hours that day, according to reporting by Hayes and me, Trump reversed his decision to recertify the deal. The White House team scrambled to roll out a brand-new policy. In one meeting that day with his national security team, Trump called up Senator Tom Cotton and placed him on speakerphone as Cotton made the case against recertification.

In a final meeting in the late afternoon, Tillerson and national security adviser H.R. McMaster prevailed on Trump to follow through on the plan to recertify, at least once more. Trump eventually assented, but not before vowing it would be the last time he would do so. It was: Trump did not recertify in October 2017 and, in May 2018, pulled the United States out of the agreement. Bolton and Cotton, working from the outside, won.

This may be the most difficult tactic for Pelosi, who so far has been unable to demonstrate she has Trump’s trust or respect—something the outside voices have always been able to draw on. She’s not

  • one of Trump’s old business friends in New York,
  • a consistent defender in the conservative media,
  • or a former campaign or White House aide.

The best way for Pelosi to persuade Trump from the outside is to do perhaps the unthinkable for a liberal Democrat from San Francisco: Go on Fox News. A lot. Pelosi or her deputies won’t be the obvious choices for the booking producers at Fox & Friends and Hannity, but House Democrats would be wise to take every opportunity to speak directly to Trump on his favorite cable network. A few solid appearances on Fox News Sunday, for instance, would help Pelosi immensely.

Pelosi herself already seems to recognize the necessity of making a public case, most obviously on television, for compromise with Trump. “You know how I talk to him?” she told Draper. “I just say it in public. That’s what he hears: what people say in public.” A Democrat in Trump’s Washington could do worse.

Trumpism Is ‘Identity Politics’ for White People

After Democrats lost the 2016 presidential election, a certain conventional wisdom congealed within the pundit class: Donald Trump’s success was owed to the Democratic abandonment of the white working class and the party’s emphasis on identity politics. By failing to emphasize a strong economic message, the thinking went, the party had ceded the election to Trump.

.. the meantime, Trump’s administration has seen that economic message almost entirely subsumed by the focus of congressional Republicans on tax cuts for the wealthy and plans to shrink the social safety net. But even as the message has shifted, there hasn’t been a corresponding erosion in Trump’s support. The economics were never the point. The cruelty was the point.
.. Nevertheless, among those who claim to oppose identity politics, the term is applied exclusively to efforts by historically marginalized constituencies to claim rights others already possess. 
.. Trump’s campaign, with its emphasis on state violence against religious and ethnic minorities—Muslim bans, mass deportations, “nationwide stop-and-frisk”—does not count under this definition, but left-wing opposition to discriminatory state violence does.
.. A November panel at the right-wing Heritage Foundation on the threat posed by “identity politics,” with no apparent irony, will feature an all-white panel.
.. But the entire closing argument of the Republican Party in the 2018 midterm elections is a naked appeal to identity politics—a politics based in appeals to the loathing of, or membership in, a particular group. The GOP’s plan to slash the welfare state in order to make room for more high-income tax cuts is unpopular among the public at large. In order to preserve their congressional majority, Republicans have taken to misleading voters by insisting that they oppose cuts or changes to popular social insurance programs, while stoking fears about

.. In truth, without that deception, identity politics is all the Trump-era Republican Party has.

.. Trump considers the media “the enemy of the people” only when it successfully undermines his falsehoods; at all other times, it is a force multiplier, obeying his attempts to shift topics of conversation from substantive policy matters to racial scaremongering.

.. The tenets of objectivity by which American journalists largely abide hold that reporters may not pass judgment on the morality of certain political tactics, only on their effectiveness. It’s a principle that unintentionally rewards immorality by turning questions of right and wrong into debates over whether a particular tactic will help win an election.

.. In the closing weeks of the campaign, the president has promised a nonexistent tax cut to the middle class after two years in which unified Republican control of government produced only a windfall for the rich
.. Trump’s nativism, and the Republican Party’s traditional hostility to government intervention on behalf of the poor, have had a happier marriage than some might have expected.

.. But that wasn’t what Trump promised—rather, his 2016 campaign pledged both generous social-insurance benefits for working-class white Republicans and cruelty for undeserving nonwhites.

.. Republicans are scrambling to insist that they will cut taxes on the middle class, offer robust health-care protectionsand protect Medicare, Medicaid, and Social Security, even as GOP leaders in Congress plot to slash all three to cut the deficit created by their upper-income tax cuts.

.. When armed agents of the state gun down innocent people in the street, when the president attempts to ban people from entering the U.S. based on their faith, or when the administration shatters immigrant families, these are burdens that religious and ethnic minorities must bear silently as the price of their presence in the United States.

And in the impoverished moral imagination of Trumpist political discourse, any and all white Americans who also oppose such things must be doing so insincerely in an effort to seek approval.

.. America is not, strictly speaking, a center-right or center-left nation. Rather, it remains the nation of the Dixiecrats, in which the majority’s desire for equal opportunity and a robust welfare state is mediated by the addiction of a large chunk of the polity to racial hierarchy. It is no coincidence that the Democratic Party’s dominant period in American history coincided with its representation of both warring impulses and ended when it chose one over the other. The midterms offer a similar choice for the American voter, in rather stark terms.