The GOP Base Is Beyond Trump’s Control 

You can get elected as an outsider, but once in office, you have to actually govern.

The conservative movement is caught in a Catch-22 of its own making. In the war against “the establishment,” we have made being an outsider the most important qualification for a politician. The problem? Once elected, outsiders by definition become insiders. This isn’t just a semantic point. The Constitution requires politicians to work through the system if they’re going to get anything done.

.. Look at all the senators who rode the tea-party wave into power: Ted Cruz, Rand Paul, Marco Rubio, Ron Johnson, Pat Toomey, Mike Lee. To one extent or another, they are now seen as swamp things, not swamp drainers, by the pitchfork populists.

.. Merely talking like a halfway responsible politician — “we don’t have the votes,” “we have to pay for it” — is proof of selling out. Trump bashes NBC News as ‘Fake News’ on Twitter

.. He wore the animosity of his colleagues, including the GOP leadership, like a badge of honor. He was the leader of the insurrectionists. He had only one problem: He talked like a creature of the establishment — largely because the Princeton- and Harvard-trained former Supreme Court clerk and career politician was one. He knew the lyrics to every populist fight song, but he couldn’t carry the tune.

..But not only did Donald Trump jump into the fray at the height of populist fervor, the field was also divided 17 ways. No one spoke less like a politician. No one who understood how governing works would have promised the things Trump promised —

  • health coverage for all, for less money,
  • eliminate the debt,
  • bring all those jobs back, etc. —

because they’d either know or care that such things are literally impossible.

.. The establishment remains the villain and Trump the hero for his willingness to say or tweet things that make all the right people angry. For his most ardent supporters, the fault for his legislative failures lies entirely with the swamp, the establishment, or the “Deep State.”

.. he most important factor was Moore’s demonization of the establishment, particularly Senate majority leader Mitch McConnell. The voters valued sticking their thumbs in the establishment’s eye more than giving Trump a win.

.. there is remarkably little intellectual or ideological substance to the current populist fever. Strange was more conservative than Moore but less bombastic. Moore opposed Obamacare repeal and, until recently, couldn’t say what DACA was. In other words, MAGA populism is less of an agenda and more of a mood.

The Simplicity of a Health Deal

The GOP must realize protection for pre-existing conditions is here to stay.

Will the most conservative members of Congress accept that the politics of health care have changed?
.. Will they acknowledge that any reform must include continued protections for pre-existing medical conditions?
.. two camps of defectors from the Senate’s reform bill. One consists of Republican moderates— Rob Portman, Dean Heller, Susan Collins, Lisa Murkowski —who claim the bill is too mean to poor and sick people.
.. With the stakes this high, the Senate leadership will gladly shuffle some money toward opioid treatment, rural health-care providers or Medicaid. So getting the “moderates” on board is simple and transactional. They name a price, they get pork, they vote yes.
.. Sens. Ron Johnson, Mike Lee, Rand Paul and Ted Cruz have been clear from the start that any bill must lower premiums, which involves getting rid of costly ObamaCare mandates. And there is no question that among the most expensive mandates are those designed to protect individuals with pre-existing conditions—in particular “community rating,” which requires insurers to charge the same prices regardless of health status.

The House Freedom Caucus was so intent on getting rid of community rating that it nearly derailed the bill. Only after the conference added an amendment allowing states to apply for waivers from community rating did the most conservative members finally came on board.

..every American remembers two particular provisions of the law—pre-existing conditions and coverage for children up to 26. These policies are simple and sound good. And they have become over the years a new standard in most people’s minds.
..Conservatives will argue their side just needs to do a better job explaining how these mandates drive up costs for everyone, or lower the quality of care.
..conservatives face a choice. They can work with their colleagues to minimize the costs of the mandates (there are innovative ways to do this) and build in different free-market reforms to lower premiums.

On Health Care, a Promise, Not a Threat

McConnell warns GOP senators they may end up having to work with the Democrats. They should.

The failure so far of Senate Republicans to agree on a health-care bill provides an opening. Whatever happens the next few days, moderates and centrists on both sides can and should rise, name themselves, and start storming through.
.. The party is undergoing a populist realignment, with party donors, think-tankers and ideologues seeing things more or less one way, and the Trump base, including many Democrats, seeing them another.
.. He has impulses and sentiments but is not, as the French used to say, a serious man.

.. Many Republican senators see that the American people are not in the mood for tax cuts to the comfortable and coverage limits on the distressed. Democratic senators, on the other hand, are increasingly aware that ObamaCare is not viable, and in some respects is on the verge of collapse.This gives both parties motives to join together and make things better.

.. Republicans believe they must repeal ObamaCare because they’ve long promised to do so. Keeping promises, especially in our untrusting political climate, is a good thing. But polling suggests America isn’t eager that promise be wholly kept

.. Republican Shelley Moore Capito of West Virginia said on Fox News Wednesday night: “I’m ready to roll up my sleeves and work with the Democrats.” Republican Ron Johnson of Wisconsin says it’s a ‘mistake’ to attempt a partisan fix. Democrat Joe Manchin, also of West Virginia, says he’s “ready” for a bipartisan effort. The New York Times reports senators from both parties met privately weeks ago to discuss core issues. Mr. Manchin was there along with Democrats Joe Donnelly of Indiana and Heidi Heitkamp of North Dakota. Among the Republicans were Sens. Capito and Collins, Bill Cassidy of Louisiana and Lindsey Graham of South Carolina.

.. Every president until Barack Obama knew this. He bullied through ObamaCare with no Republican support, and he did it devilishly, too, in that he created a bill so deal-laden, so intricate, so embedding-of-its-tentacles into the insurance and health systems, that it would be almost impossible to undo. He was maximalist.

.. Here is a thing that would help: a little humility from the Democrats, and a little humanity.

.. ObamaCare has big flaws—always did. It was an imperfect piece of legislation and it’s done some things my party said wouldn’t happen, such as lost coverage and hiked deductibles.

.. The Democratic Party made this mess. It’s on them to help dig out of it. If they show some humility, Republicans would look pretty poor in not responding with their own olive branch.

.. When it’s over, use whatever words you want: “We forced Democrats to admit the bill was flawed and dying.” “We forced Republicans to back down.”

McConnell’s Calculation May Be That He Still Wins by Losing

When it comes to managing Republicans’ best interests, Senator Mitch McConnell of Kentucky, the majority leader, rarely loses. So it is possible that Mr. McConnell views the potential failure of a hastily written health care bill as an eventual boon.

.. As Democrats immediately took to the Senate floor to excoriate the bill and the secretive process in which it was put together, few Republicans, even those involved in crafting it, came to defend it.

.. Four others went further. Senators

  1. Ted Cruz of Texas,
  2. Ron Johnson of Wisconsin,
  3. Mike Lee of Utah and
  4. Rand Paul of Kentucky

all said they would not vote for the bill as currently proposed.

.. Mr. McConnell and many of his aides are also eager to get to the business of changing the tax code, which they view as less difficult than health care, and have been working with the White House behind the scenes to get that effort started. For Mr. McConnell, cutting taxes is a much higher priority than health care