Why President Trump Couldn’t Close the Deal on Obamacare Repeal | “Trump’s Takeover” | FRONTLINE

President Trump thought he could use his skills as a salesman to bridge a divide in the Republican Party over the bill to repeal and replace Obamacare. There was a problem, though. As the FRONTLINE documentary “Trump’s Takeover” reports, the president didn’t seem to understand or care about the details of the bill he was selling.

“The president was not particularly engaged in the policy details. That was pretty apparent,” Rep. Charlie Dent (R-Penn.) tells FRONTLINE. “The president seemed to defer to Congress, largely, and basically, ‘Whatever you guys pass, I’ll sign.’”

This scene is an excerpt from the new documentary, “Trump’s Takeover,” which goes inside President Trump’s high-stakes battle for control of the Republican Party.

It examines how the president, who vowed to defeat the Washington establishment, has worked to remake the party in his own image — counter-punching when criticized, and publicly attacking Republicans who defy him.

From Trump’s attacks on party leaders on Twitter after the repeal-and-replace bill died, to a split over what many in the party said was the president’s inadequate response to deadly violence at a white supremacist rally in Charlottesville, to when Congress ultimately delivered a major legislative victory for Trump with the passage of tax reform, the documentary traces the president’s takeover of the party, from the perspective of Republican lawmakers.

“Trump’s Takeover” premieres Tues., April 10 at 10/9c on PBS & online: https://to.pbs.org/2GNBtMc

FRONTLINE is streaming more than 200 documentaries online, for free, here: http://to.pbs.org/hxRvQP

Funding for FRONTLINE is provided through the support of PBS viewers and by the Corporation for Public Broadcasting. Major funding for FRONTLINE is provided by the John D. and Catherine T. MacArthur Foundation. Additional funding is provided by the Abrams Foundation, the Park Foundation, The John and Helen Glessner Family Trust, and the FRONTLINE Journalism Fund with major support from Jon and Jo Ann Hagler on behalf of the Jon L. Hagler Foundation.

Doing the Health Care Two-Step

Medium-size reform creates the conditions for bigger things.

Recent state elections — the Democratic landslide in Virginia, followed by Democratic gubernatorial victories in Kentucky and Louisiana — have been bad news for Donald Trump.

Among other things, the election results vindicate polls indicating that Trump is historically unpopular. All of these races were in part referendums on Trump, who put a lot of effort into backing his preferred candidates. And in each case voters gave him a clear thumbs down.

Beyond offering a verdict on Trump, however, I’d argue that the state elections offered some guidance on an issue that has divided Democrats, namely health care. What the results suggested to me was the virtue of medium-size reform: incremental enough to have a good chance of being enacted, big enough to provide tangible benefits that voters don’t want taken away.

Remember, there was a third governor’s race, in Mississippi, in which the G.O.P. held on. True, Mississippi is a very red state, which Trump won by 18 points in 2016. But Louisiana and Kentucky are or were, if anything, even redder, with Trump margins of 20 and 30 points respectively. So what made the difference?

Personalities surely mattered. Louisiana’s re-elected John Bel Edwards was widely liked, Kentucky’s defeated Matt Bevin widely disliked. Demography probably also mattered. Urban and especially suburban voters have turned hard against Trump, but rural voters haven’t, at least so far — and Mississippi is one of the few states left with a majority-rural population.

But there’s another difference among the three states. Kentucky and Louisiana took advantage of the Affordable Care Act to expand Medicaid, leading to steep drops in the number of uninsured residents; Mississippi hasn’t. This meant that voting Democratic in Kentucky and Louisiana meant voting to preserve past policy success, while the same vote in Mississippi was at best about hope for future reform — a much less powerful motivator.

Back in 2010, as Obamacare was about to squeak through Congress, Nancy Pelosi famously declared, “We have to pass the bill so that you can find out what is in it.” This line was willfully misrepresented by Republicans (and some reporters who should have known better) as an admission that there was something underhanded about the way the legislation was enacted. What she meant, however, was that voters wouldn’t fully appreciate the A.C.A. until they experienced its benefits in real life.

It took years to get there, but in the end Pelosi was proved right, as health care became a winning issue for Democrats. In the 2018 midterms and in subsequent state elections, voters punished politicians whom they suspected of wanting to undermine key achievements like protection for pre-existing conditions and, yes, Medicaid expansion.

And this political reality has arguably set the stage for further action. At this point, as far as I can tell, all of the contenders for the Democratic presidential nomination are calling for a significant expansion of the government’s role in health care, although they differ about how far and how fast to go.

Which brings me to the latest development in intra-Democratic policy disputes: Elizabeth Warren’s proposal for a two-step approach to health reform. Her idea is to start with actions — some requiring no legislation at all, others requiring only a simple Senate majority — that would greatly expand health insurance coverage. These actions would, if successful, deliver tangible benefits to millions.

They would not, however, amount to the full Bernie, eliminating private insurance and going full single-payer. Warren still says that this is her eventual intention, and has laid out a plan to pay for such a system. But any legislative push would wait three years, giving time for voters to see the benefits of the initial changes.

Sanders supporters are, predictably, crying betrayal. For them it’s all or nothing: a commitment to single-payer has to be in the legislation from Day 1.

The trouble with such demands, aside from the strong probability that proposing elimination of private insurance would be a liability in the general election, is that such legislation would almost certainly fail to pass even a Democratic Senate. So all or nothing would, in practice, mean nothing.

But is Warren giving up on Medicare for All? After all, what she’s offering isn’t really a transition plan in the usual sense, since there’s no guarantee that Step 2 would ever happen.

The lesson I take from the politics of Obamacare, however, is that successful health reform, even if incomplete, creates the preconditions for further reform. What looks impossible now might look very different once tens of millions of additional people have actual experience with expanded Medicare, and can compare it with private insurance.

Although I’ve long argued against making Medicare for All a purity test, there is a good case for eventually going single-payer. But the only way that’s going to happen is via something like Warren’s approach: initial reforms that deliver concrete benefits, and maybe provide a steppingstone to something even bigger.

Free birth control begins in US today – what difference will it make to you?

Provisions in the Affordable Healthcare Act will give insured American women better access to basic care. How much do you currently pay for contraception? What difference will the new rules mean?

Many basic healthcare options for US women, including birth control and annual “well-woman” check-ups, become free on Wednesday as provisions in the Affordable Care Act come into force.

The new rules mean that many women will no longer have to stump up for “co-pays” or out-of-pocket expenses.

Trump rolls back access to free birth control

Donald Trump’s government has issued a ruling that allows employers to opt out of providing free birth control to millions of Americans.

The rule allows employers and insurers to decline to provide birth control if doing so violates their “religious beliefs” or “moral convictions”.

Fifty-five million women benefited from the Obama-era rule, which made companies provide free birth control.

Before taking office, Mr Trump had pledged to eliminate that requirement.

What happened?

The mandate requiring birth control coverage had been a key feature of so-called Obamacare – President Obama’s efforts to overhaul the US healthcare system.

But the requirement included a provision that permitted religious institutions to forgo birth control coverage for their employees.

The Department of Health and Human Services (HHS) said on Friday it was important to expand which organisations can opt out and deny free contraceptive coverage.

“We should have space for organisations to live out their religious ideas and not face discrimination because of their religious ideas,” said one HHS official, who did not wish to be named.

Why was the decision made?

In announcing the rule change, HHS officials cited a study claiming that access to contraception encourages “risky sexual behaviour”.

The department disputes reports that millions of women may lose their birth control coverage if they are unable to pay for it themselves.