Trumpcare Is Dead

We just learned via The Washington Post‘s Robert Costa that President Trump asked the congressional Republicans and Speaker Paul Ryan to cancel the vote on Trumpcare, aka. “The American Health Care Act Fuck Yeah!” 

In other words, the GOP’s highly ballyhooed repeal and replace process is dead. For now. It’s entirely possible they’re revisit at another time, but healthcare reform has never been attempted twice by the same administration. And besides, their tiny little GOP hearts were never really into it in the first place, leading me to believe once it’s dead, it’s dead. 

Costa also reported that, during a phone call with Trump, the president noted that when the Affordable Care Act collapses — an event the CBO says won’t happen anytime soon — the Democrats will come begging for a bipartisan healthcare bill. Another indication that Trump knows nothing about how political and governmental negotiations work. Shocker about that — that a “Washington outsider” with zero expertise in politics or the basic operating rules of the federal government (how a bill becomes a law, for example) would have a skewed sense of how the sausage gets made.

There’s actually a valuable lesson here. On some level, Trump probably thinks that you start a negotiation by asking for more than what your opponents, or your allies, will allow. Then, as the process moves forward, the matter gets negotiated down to something not as strong, but which has a better chance of passing. The end result is more than starting from a compromised position. 

But, no, it doesn’t always work like that. Many anti-Obamacare liberals (yes, they exist) wanted President Obama to start his 2009 healthcare reform process with single-payer, then, as the strategy went, they’d allow it to get whittled down to something weaker than single-payer, but stronger than the ACA ended up being. Contrarily, though, there was a significant risk of terrified conservative-leaning Democratic legislators abandoning single-payer and thus healthcare reform out of the gate, killing the legislation early on — just like what happened to Trumpcare.

Put another way: the basic rules of negotiation don’t always work in American politics. There are too many moving parts for a simplistic, primer-level negotiation tactic. In the case of Trumpcare, Ryan was too beholden to the hothead in the Freedom Caucus, making his AHCA bill way too conservative, effectively crafting a bill that was nothing more than a tax cut and a gigantic fuck you to the middle class and poor people. This is one of the top-shelf reasons why the GOP can’t do healthcare reform: they’re too indentured to the hotheads, and healthcare reform isn’t a hothead issue. It’s an issue for moderates and liberals, and Ryan couldn’t build a coalition around an alternative that made sense, so we got this shoddy legislation that’s nothing more than a minor collection of several failed attempts at conservative reform.

Now, the administration will apparently move on to tax reform. However, it’s more than fair to assume that it, too, will be stymied by Trump’s devastating incompetence, not to mention the ever-worsening war being waged by Russia.

Meanwhile, it’s colossally important that Democratic Party activists keep an eye on future amendments to other bills that might act as poison pills to clandestinely undermine the efficacy of the ACA. Make no mistake, this was a gigantic victory, but the war for affordable, comprehensive healthcare continues. A public option and an eventual plan to pass Medicare-for-all have to be next on the list. If the Democrats can seize the initiative with a winning focus on 2018 and 2020, it’s possible to expand the ACA as originally planned — to make it better. For now, pop open the champagne, but know that it’s a school night. Back to work tomorrow, defending our healthcare.

One last thing. The town hall protesters deserve massive credit for the death of Trumpcare. Watch this.

Bob Cesca is the host of the Bob Cesca Show podcast, a twice weekly political talk show. He’s also a contributor to Salon.com. Follow him on Twitter and on Facebook.

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