GOP, Health Care, Medicaid, Trump

The Art of the Miscalculation

“Hello, Bob. So, we just pulled it.”

        Donald J. Trump phones Washington Post reporter Robert Costa to report on the art of his failed deal.

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Congressional Republicans spent seven years – and 60-plus repeal votes in the House of Representatives – promising their most fervent supporters that if they ever got all the political power in Washington, D.C. they would wipe away the hated Obamacare on Day One.

On Day Sixty-four they ran head long into an old political reality – don’t believe your own press releases.

What could go wrong?

In the end, the collapse of the Republican plan to “repeal and replace” Barack Obama’s signature legislative accomplishment – the Affordable Care Act – was based on a huge miscalculation, a miscalculation that is now the signature reality of the Grand Old Party. The politics of opposition met the realism of substance. Given seven years to come up with a genuine alternative to what virtually everyone concedes is a flawed national health policy, Republicans, particularly the vacuous leader of their party, punted on substance.

Just consider what President-elect Trump told the Washington Post a week before taking office. “We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” People covered under the law, he said, “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.”

Perhaps even he can’t spin this one…

The Post’s Robert Costa and Amy Goldstein reported in that January interview that Trump – wait for it – declined to discuss specifics. Big surprise. There were no specifics short of a massive tax cut for the most well to do and a butchering of Medicaid.

The intellectual bankruptcy of Donald Trump’s GOP, the total triumph of puffy rhetoric over hard reality, was on full display during the Republican art of the fail. The empty suit in the Oval Office met the empty heads in Congress. Of course, Trump predictably blamed Democrats for failing to undo the legislation that they bled over and that cost the party many seats in Congress. It won’t wash. Democrats actually believe in what they have done, while Republicans now fully embrace the smoke and mirrors that surround Trump and the party he now owns, if cannot control. Not surprisingly the post mortem’s have been, and brutally so, all about Trump’s failure and that of the once and never again policy wonk Paul Ryan.

“It’s hard to overstate the magnitude of the Day 64 defeat,” wrote Axios’ Mike Allen, a D.C. access journalist who rarely misses a chance to curry favor with the powerful. “President Trump, who made repeal-and-replace a central theme of his campaign, and House Republicans, who made it the central theme of every campaign since 2010, lost in a publicly humiliating way despite controlling every branch of government and enjoying margins in the House rarely seen in the past century.”

The Miami Herald – Trump won Florida just four months ago you may recall – was just as critical. Republicans “made a huge political miscalculation,” the Herald’s editorial said. “They were vociferous. They were resolute. Ultimately, they were clueless. Well, their constituents, many getting preventive care for the first time, or prenatal care, or cancer treatments clued them in: Obamacare, for all its faults, was working for them.

“Ryan finally — finally — stated the obvious: ‘Doing big things is hard.’ (We’re suppressing a ‘Duh!’) And it’s especially difficult when you leave out preparation and inclusiveness to meet a long-touted promise.

And it hasn’t just been the “opposition” press delivering harsh judgments about the Republican debacle. Right wing websites savaged Congressional Republicans with The Drudge Report featuring a photo of the German airship Hindenburg bursting into flames over the headline: Republican Catastrophe.

Republican Catastrophe (Photo by Sam Shere/Getty Images)

Politico’s Tim Alberta relayed this little bit of color from a critical meeting Trump had last Thursday with the self-righteous egotists of the hard right House Freedom Caucus. “Forget about the little shit,” Trump told those who taught the new president his painful lesson about the art of the Washington deal. “Let’s focus on the big picture here,” the Closer-in-Chief opined. Trump’s message, of course, was that substance doesn’t matter. Don’t sweat the details. The art of the flim-flam got him elected, after all. Who would have thought governing could be so hard?

Trump’s constant use of shape shifting lies notwithstanding, Republicans own this colossal mess and for one principle reason: they have abandoned governing, which is to say substance, in favor of once again trotting out the old hackneyed rightwing clichés and policy inconsistency. Trump’s promise of “health care for all” that would lower costs was always nonsense and internally inconsistent, about as intellectually honest as a sales pitch for Trump University.

This defeat was so big and so obvious that perhaps even Donald Trump can’t spin it away. And Congressional Republicans are going to have difficulty escaping the reality that they fumed against Obamacare for seven politically productive years, but when given a real chance to change the law – or repeal it outright – the GOP quarterbacks took a knee.

Stipulate the obvious: Obamacare has problems. Premiums are too high for many working poor, some states have opted out of the Medicaid portion of the program and the whole scheme remains complicated and confusing. Blame Democrats for some of the confusion. They have never been able to articulate a consistent message about the benefits and there have been real benefits, including insurance coverage for millions of Americans who had not been covered before. Also blame Republicans for the confusion because they have repeatedly misrepresented the negatives impacts of a program that impacts less than 10% of the entire health care marketplace.

Still, Obamacare needs work just like the defense budget or Trump’s golf game needs work, but the constant GOP mantra that the Affordable Care Act is imploding or cratering the economy is just as nonsensical as the tweets from the West Wing. But having ridden the “Obamacare is killing America” hobby horse to electoral success Republicans, as the New York Times pointed out, went searching for a solution to a problem they invented. The problem was invented, of course, because of a burning desire to continue to exploit the issue politically rather than actually work to improve health care. The approach clearly worked. What was missing, as the Times noted, was a “coherent idea or shared vision of what [Republicans] want to achieve and what problem they mean to solve.”

The one and never again policy wonk. (AP Photo/J. Scott Applewhite)

As one wag noted Republicans might have had a better chance to push their plan if they could have pointed to any place in the world were their ideas about enhancing “competition” in health care is working. Americans pay more, have worse outcomes and see more of their fellow citizen’s uninsured than any other major industrialized country. And no country does health care the way we do. The Republican approach wasn’t in any way a fix for a still fractured American approach to health care, but instead would have doubled down on the only strategy the GOP has known in the last two decades: cut taxes for the wealthiest and tell the poor to get a job.

Obama, in pushing the legislation in 2009, sought to reduce the number of uninsured and encourage more preventive care. He succeeded and would have succeeded even more broadly had Republicans not spent every day of both his terms attempting to delegitimize his presidency and with it his legislation. When Republicans got their chance to show the country what they value – should I mention they have more control over the government than they have enjoyed since the 1920s – they opted to advance a plan that would have ended coverage for 24 million Americans over the next decade and gutted the Medicaid safety net for many of the same working class Americans who, against their own best interests, put Donald Trump in the White House.

To the moral bankruptcy that has accompanied the Congressional Republican embrace of the very idea of Donald Trump as their leader, now you may add the intellectual bankruptcy of treating actual governance the way Trump treats the presidency – with contempt and arrogance.

The Atlantic’s Russell Berman had one of the best summaries of the Republican health care fiasco and one of the best quotes. “I’ve been in this job eight years,” Republican Representative Tom Rooney of Florida told Berman, “and I’m wracking my brain to think of one thing our party has done that’s been something positive, that’s been something other than stopping something else from happening. We need to start having victories as a party. And if we can’t, then it’s hard to justify why we should be back here.”

Now, that is a perceptive politician.

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