This is the party, after all, that just a few months ago lost the presidency to the most unsuitable, unfit, unappealing major-party candidate in American history, and has spent most of the time since then blaming Russia for its own ineptitude.
.. Neoliberal, managerial, centrist globalism is being challenged by populists of the anti-liberal right and left. Right now, the right-wing variant holds power in Washington. If Trump had the guts to combine his populist-nationalist appeals with support for a single-payer health-care system, he just might succeed in realigning both major American parties by scrambling their policy commitments.
.. Maybe he’s gambling that for the bulk of his voters, making sure they aren’t paying for insurance for the “undeserving” is precisely the point.
.. Meanwhile, by 2020 the state of the economy and job growth is what will really matter to voters, or at least an electoral college majority thereof.
.. It would normally be strange for a Republican president to want his own party’s majority to suffer a major black eye like that. But this is Ryan’s bill, and Trump has no love for Ryan.
.. Moreover, inasmuch as Bannon is in competition with Ryan-ally and Chief of Staff Reince Priebus for influence over the White House’s agenda, it’s very much in his interest specifically for Ryan to fail. The collapse of the AHCA would be a massive failure — and would likely invite a leadership challenge.
.. And if it failed quickly, it would be easy for Trump to blame Ryan for getting it wrong, tinker with ObamaCare around the edges (particularly in ways that could be done without even passing legislation), and then when the exchanges don’t collapse claim he fixed them.
.. Trump could yell at a bunch of insurance executives, watch premiums stabilize, and claim victory.
.. The most exotic possibility is that Trump not only wants the bill to fail and Ryan to take the blame, but that he wouldn’t be too upset to see the Freedom Caucus defanged
.. There are certainly people in Trump’s inner circle who see the big problem with ObamaCare as being its support of private insurers, and who would prefer a relatively stingy single-payer plan to either ObamaCare or ObamaCare light. Trump doesn’t have a legislative majority for a reform like that — but maybe after some strategic losses in 2018 he would?
.. it is important to recognize that Trump’s position is far less exposed than Ryan’s is.
.. the dominant political fact about the Trump presidency. He won by attacking his own party’s leadership. He can’t win again without retaining the support of the Republican base — which means he has to be supportive of any effort to repeal ObamaCare, because the base has demanded that for years. But he will take every opportunity to convince that same base that they should be more loyal to him than to a GOP leadership for which they have already demonstrated mistrust. Which means failures by that leadership can be turned to his advantage.
Erick Erickson: Don’t Try to Fix Obamacare. Abolish It.
Republicans ran advertisements noting they had voted 70 or more times to repeal the Affordable Care Act, and they would do it as soon as they had control of Congress and the White House.
Voters gave them just that. And now Republicans, who had used the word “repeal” like a meditation chant, act like the proverbial dog that caught the car. The plan they all liked in 2015 — one that would have ended the law’s mandates, subsidies and Medicaid expansion — would not pass today.
.. Mr. Trump’s voters supported a man who promised a government-run health care plan that would provide universal coverage. In other words, he promised more than Obamacare. For that matter, Mr. Trump promised more government involvement in health care than Hillary Clinton did.
.. Mr. Trump’s voters want Obamacare, but they want Mr. Trump’s gold-plated branding on it.
.. Democrats were far more focused on expanding coverage and ensuring every American could get insurance than they were on making coverage affordable.
.. Instead, they should focus on cost.
.. Increasing competition and choice would lower prices for all kinds of insurance.
.. Watching many Americans demand repeal, while voting for a man who promised a government-run, universal coverage solution, only increases politicians’ cynicism about the American voter.
The Original Lie About Obamacare
How did the party’s leaders put themselves in this position? The short answer is that they began believing their own hype and set out to solve a problem that doesn’t exist.
.. Obamacare obviously has flaws. Most important, some of its insurance markets — created to sell coverage to the uninsured — aren’t functioning well enough. Alas, Paul Ryan, Mitch McConnell and Donald Trump are not trying to fix that problem. They’re trying to fix a fictional one: saving America from a partisan, socialistic big-government takeover of health care.
Republicans Should Kill Obamacare or Let It Die
That very inflexibility is probably one reason that buildings like the Pantheon survived for us to admire them. Other ancient treasures were torn apart by the locals looking for building materials, but concrete buildings could not be repurposed stone by stone.
.. By the time Obamacare came on the scene, America already had government programs that were propping up health care for almost everyone in the country: tax-subsidized employer-sponsored health insurance, Medicare, Medicaid, the VA. No one was willing to shoulder the cost of knocking those things down and designing a rational, well-built structure to take their place
.. The base may rejoice when they hear that Obamacare has been “repealed” (sort of). But their cries of glee will be drowned out by their wailing when they find that they cannot buy individual insurance at all.
.. What do they think will happen after they proudly proclaim that they’ve repealed Obamacare—followed in short order by the complete implosion of the individual market? Do they really imagine that they will be allowed to leave the rubble-filled lot there and proclaim that they’ve undone President Obama’s mistake?
.. But insurers will start to submit their proposed rates for 2018 in a few months. That is likely to become the effective deadline for any further tweaks, because if insurers think the collapse of the individual market is imminent, they will decline to sell into that market, and then the collapse will no longer be a forecast, but a historical fact.
.. they should do nothing, and start preparing their rebuilding strategy while they wait for the flaws in Obamacare’s structure to bring down the individual market on its own.