The Trump health care pivot
Posted on April 1, 2019Health care is a big deal.
It routinely ranks as the No. 1 or No. 2 issue that the American people care about most. Yes, it is even more important than the Russian collusion story.
So, President Trump was absolutely right to pivot to health care as the book closed on the Mueller investigation.
Of course, it would have been nice to tip off his friends and allies on Capitol Hill that such a pivot was coming.
Those little details are seemingly unimportant to this White House, but if the president actually wants to make progress, he needs Senate Majority Leader Mitch McConnell (R-Ky.) and House Minority Leader Kevin McCarthy (R-Calif.) on board and engaged.
Republican politicians don’t do health care that well. They don’t like to talk about it. They don’t like to get in the weeds on the complicated issues that drive health care costs up. They aren’t as cloyingly empathetic as the Democrats.
And unlike their political rivals, they don’t have an overarching thematic approach to a government-run health system. That’s because they don’t believe in socialism and they don’t trust the government to do a good job of controlling the means of health care production.
In a political world that desperately craves easy solutions, the Democrats have them in spades while the Republicans are left trying to change the subject to anything but health care.
But the issue remains a big deal and at some point, the GOP needs to come up with their own solutions.
2010 was the rare election where health care actually worked in the Republicans’ favor. They campaigned on repealing ObamaCare and they won a huge victory in the House.
Repealing ObamaCare is a simple campaign slogan, but it soon became apparent that in practice, it was going to be more complicated than just repealing the previous president’s top legislative accomplishment.
As it turned out, protecting the rights of people who have pre-existing health conditions to get affordable insurance has resonance with a lot of voters.
Indeed, the Democrats campaigned on protecting that right in the 2018 midterm elections, and that was one of the top reasons they won more seats than expected.
Republicans got tied around the pre-existing axle as the party tried to come up with alternatives in 2017, and they never came up with a sufficient way to describe what they were trying to do. That made them exceedingly vulnerable to 30-second ads, which the Democrats deployed with devastating effectiveness.
The way McConnell sees it, looking at his legislative calendar, looking at his counterpart in the House, Speaker Nancy Pelosi (D-Calif.), and then looking at the executive branch, with all of its fulsome dysfunction, he sees nothing but a huge time-suck if he follows the president down the health care rathole.
There is no way that Pelosi and Trump are going to find a way to replace ObamaCare with something better than current law, certainly nothing that the GOP caucus will be able to support.
But McConnell is smart enough to be deferential to the president. More power to him if he can make the deal of the century.
Congressional Republicans probably shouldn’t just rely on the great dealmaker to come up with a plan, though.
If the Justice Department is successful in litigating ObamaCare’s demise in the Supreme Court, the GOP might be up the proverbial creek without any paddles.
Like I said, health care is a big deal. Especially to the voters.
It might behoove the Republican leadership to bring all of the different parts of the vast health care industry together and have them come up with some ideas on how to preserve the best parts of our system while fixing the obvious holes in the system.
This issue is not going away, no matter how hard some might wish it to.