On the campaign trail, Donald Trump promised to replace the Affordable Care Act with “something terrific.” The plan he signed onto as president was anything but — and no amount of presidential spin or salesmanship could alter that reality.
Unable to muster the votes necessary for passage, House Republican leaders pulled what was supposed to replace the ACA and strip President Obama of his crowning achievement. It was a stunning acknowledgment of failure for congressional Republicans, who spent years voting for repeal when it didn’t matter, since Barack Obama was in the White House and nothing they did would kill his signature health care law. This time, when Republicans control Congress and the White House, and it did matter, they couldn’t reach consensus.
It was a huge loss for Trump, who just recently discovered that health care policy is “an unbelievably complex subject.” There should be at least one more discovery in this failed effort to repeal and replace Obamacare: A president can’t sell a lemon to lawmakers who then have to sell it to voters back home.
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The House plan would have booted 24 million Americans off health care coverage over the next decade. That was too cruel even for some Republicans — but not cruel enough for the ultraconservative members of the House Freedom Caucus. Asked about those Republican hard-liners, House Speaker Paul Ryan said some were ready to vote yes, “but not enough.” With that, Ryan was forced to utter these words: “Obamacare is the law of the land and will remain the law of the land until it is replaced.”
What next? In defeat, Trump retreated to campaign rhetoric, saying the best thing “politically speaking” was to let the ACA implode and die. Unable to cast himself as what he is — the biggest loser in this battle — he declared Democratic leaders Nancy Pelosi and Chuck Schumer to be the real losers because “now they own Obamacare.”
The ACA needs fixes, and Republicans will be tempted to try to make things worse in every way they can, in the hope that a public perception that the law has failed will add impetus to a another repeal effort. But if the president or the GOP’s congressional wing really want to redeem themsleves and prove they can govern, the right approach is to sit down with health care experts — and yes, Democrats — and come up with a series of fixes that could help the landmark legislation work better for all Americans.
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Trump predicted Democrats would come running to him because they know Obamacare is failing. But he also said he hoped both parties “can come together and do real health care.” If that hope is real and not fake news, it would be welcome.