WASHINGTON — President Donald Trump failed to persuade enough House Republicans to vote for his American Health Care Act, leading to its withdrawal from the House floor on Friday. How did the effort to pass a replacement for Obamacare go wrong? Let me count the ways.
One. The GOP House has too many members who are like Trump was 2016, when he acted as a Caucus of One. He bucked the GOP establishment and assured the party base that the path to victory was to shout over any and all voices of moderation. When critics said Trump was crossing the line, he rarely retreated. The House GOP Freedom Caucus — a right-of-right rump with close to 30 members –followed the same playbook. On the health care bill, members acted like 30 Trumps, pitted against one Trump.
After the vote, I talked to Hoover Institution wiseman Bill Whalen, who always knows how to put these things in perspective. The problem, as Whalen sees it, is this: “How do you threaten people with political Siberia when they’re already proud of being Siberians?”
Two. The GOP actually did become the Party of No. “We were a 10-year opposition party where being against things was the easy thing to do,” Speaker Paul Ryan admitted Friday. And: “Doing big things is hard.”
Three. Democrats don’t look for the perfect today; they’re in it for the long game. In 2010, then-House Speaker Nancy Pelosi was able to corral enough Democrats to vote for President Barack Obama’s Affordable Care Act — even though it was not the single-payer plan that many Democrats preferred.
On the right, Whalen noted, many politicians have an “Ivory soap standard” — if a measure isn’t 99.44 percent pure, they’ll reject it.
Four. Once Washington gives something to people, woe to the party that tries to take it away.
Obama promised voters that he could offer health care to more people, including people with pre-existing conditions, and expand benefits – and that somehow his package would lower premiums and save American families $2,500 annually. It never ceases to amaze me how many smart people believed what shrinks rightly call magical thinking — that the public can save money paying for more services.
That unrealistic standard has become the floor to the mainstream media. One frequent meme is that Trump voters, who tend to be older, would get hit the hardest by the GOP plan. It’s true, the Trump plan would have changed the Obamacare formula that required insurers to charge older consumers no more than three times what they charge the youngest adults. The GOP package’s formula limited the ratio to 5-to-1, which would have increased premiums for older people too young for Medicare. (The GOP plan tried to soften that blow with higher tax credits for older Americans.)
Missing from reporting was reporting on how the old formula unfairly lowered premiums for older Americans — and I write this as someone in that older age bracket – by driving up premiums for young adults. And when young, healthy adults abstain from buying health care, premiums go up for everyone.
Five. Like Obama before him, Trump made the mistake of trying to pass his big health care package with votes from his party alone.
Obama succeeded. Trump failed, Whalen noted, because Trump had fewer Republicans, 237, than Obama had Democrats, 253, in 2010. With that many more Democrats, Whalen noted, Obama could “play ball.” The Trump White House made concessions to woo Freedom Caucus votes, and then more concessions were sought — those concessions chased away moderate Republicans. As White House spokesman Sean Spicer put it, negotiations devolved to the point where, to get “two members, you’re giving up 14.”
Friday afternoon, the president blamed Democrats for the bill’s demise, as not one Democrat would vote for it. But then, Trump didn’t reach out to the Democrats. Friday the president said he expects Democrats to reach out to him when Obamacare “explodes” — and that he was open to working with them.
Trump seems to have learned his lesson. He isn’t trying to woo GOP votes over the weekend. He’s done. “We learned a lot about loyalty,” the president said. Methinks the Freedom Caucus is dead to him.