The Trump administration takes a beating over healthcare. But this is much more than just a garden-variety legislative defeat. J. BROOKS SPECTOR takes a look.
In the end, the biggest crash from the failure of the Republican-sponsored American Healthcare Act to pass the House of Representatives was the myth of Donald Trump as the dealer-in-chief, the closer and the man who brought his hard-won business acumen to the table, let alone the man who brought his incisive intellect, his fierce intensity and his energy to bear on problems and then solved them. That Donald is gone.
Instead, we now know the real Donald Trump. He was that impatient, surly 10-year-old neighbour child who piled everyone else’s GI Joe action figures (except his own special ones) into a heap, poured paraffin over them and then threatened to set fire to this pyre unless everyone else played this catastrophic game with him. (Or, perhaps, to transgress political correctness a bit, he was the girl who lived in the apartment down the hallway who was poised to cut every one of everybody else’s prized Barbie senior prom dresses into ragged mini-shirts, unless everyone did things her way. Then, while the gang looked on in horror, when you demurred, she plunged her scissors into the Barbie doll’s heart – just to show it didn’t matter to her one whit.
The long-proffered promise of “repealing and replacing” that supposedly hated Obamacare health law, one of Trump’s chief election campaign mantras, repeated endlessly at rallies, in debates and televised speeches (and promised by Republicans for seven years), has, in the end, come to absolutely nothing at all. Instead, Trump now says his administration’s unguided but baleful laser-vision will now turn its attention to tax reform instead. Healthcare? Fergetaboutit. That is just so last week.
Several things conspired to break this presidential promise upon some very unfriendly coastline rocks. First of all, polling and some increasingly angry, raucous congressional constituency meetings across the nation have begun to demonstrate to many members of Congress (Republicans and Democrats alike) that Obamacare, for all its flaws, has been gaining in national popularity, especially as millions of lower- and middle-income folks have signed on to its various options for their healthcare in place of relying on charity or the trauma unit of a hospital.
Then, of course, came the Congressional Budget Office’s scoring (financial and programmatic projections and evaluations) that, fully implemented, the Republican alternative, would, in a decade’s time, force at least 24-million (!) people OFF medical insurance, in contrast to the current provisions of the Affordable Care Act. Then there was the implacable congressional maths for any measure introduced into the House of Representatives. While Republicans have a solid majority on paper, the right-wing, social conservative-style budget hawk faction, the “Freedom Caucus”, had some 30 members – more than sufficient to block passage of the new bill, even if every other Republican voted for it (and if no Democrats joined with them).
Meanwhile, a chunk of the Republican membership was leaning towards amending the measure so that its provisions would have been dubbed “Obamacare lite”. In this way, the measure would have included most of the provisions of Obamacare that citizens have come to support, even if it would still wring out the more unpopular tax mandate provision – the part that enacts a modest tax on anyone who refuses to sign on for healthcare.
As a result, the Republican Party’s leadership in the House, under Speaker Paul Ryan, was increasingly condemned to a series of escalating compromises to appease, on the one hand, the Freedom Caucus, and then moderates, all in an effort to achieve a majority of the House of Representatives, or 217 votes. Usually a majority is 218, but there is currently one vacancy in the House.
These sweeteners eventually even included amendments such as a unique, special provision designed to benefit the health needs of senior citizens in upstate New York, in an effort to appease a bloc of Republican congressmen who were increasingly trending negative on the bill. At no time, however, did the president or the House Republican leadership make any attempt to attract Democratic support (and thus a potential majority in the House without the Freedom Caucus, thus presaging a more bipartisan passage in the Senate). That would have comported with the more usual form of politics as the art of the possible, at least as it has been practised in less hyper-partisan times than those of the present.
This might have come from offering key compromises that would have kept certain key provisions of the current act in place and then offering strengthened federal support for those faltering state-by-state insurance exchanges which were designed to offer a range of plans for the heretofore uninsured. Such an effort could have brought bringing on board more moderate Democrats, even if the Freedom Caucus would have gone away, sulking in high dudgeon in response.
Eventually, the Trumpster decided to show who was boss by carrying out a campaign of phoning individual members or seeing congressmen in groups, asking them to support this measure as a signature moment in “making America great again”. Many of those lobbied by Trump, however, appear to have felt affronted by his scorched earth, “support me or face my wrath approach”, and especially words to the effect of, “we’re keeping score of who does and does not support us”.
Given this White House’s staff’s inexperience in Washington, Trump’s declining popularity and trustworthiness in the opinion polls, and his naturally hectoring personality, the clear implication left in many minds was that the Trump administration felt that fealty to the cause was required by fiat, rather than the more usual method of encouraging and buttering up members of Congress. Supporting this legislation had now the possibility of harming their respective electoral chances in 2018. “Meh” on the automatic loyalty front as a result.
In the end, however, the Republican leadership couldn’t reach sufficient supporters for the proposed bill to pass the House of Representatives and so they pulled the measure from facing a final embarrassing vote. Thus there would be zero impetus for the measure to be supported in the Senate. Or, at the minimum, there was not going to be enough support so that an eventual compromise between the two chambers could be worked out in the end, thereby allowing the president to ostensibly claim a victory of sorts in carrying out his campaign pledge.
Now that the measure has been consigned to the dustbin, the recriminations are beginning. President John F Kennedy’s remonstrance after the Bay of Pigs catastrophe, “Success has a thousand fathers, failure is an orphan”, is now gaining a kind of new Trumpian corollary: “Failure also generates another thousand or so paternity suits.”
Donald Trump, of course, is blaming everyone for this embarrassing defeat, save his own hubris and ineptitude. Besides snarling at those horrible Democrats who failed to support a measure that would, after all, have gutted their own previous president’s signature law, if they had voted for the new bill, high on the list for some finger-pointing is Speaker Paul Ryan. Despite White House comments that there is still love aplenty between president and speaker, Ryan is being blamed for failing to shepherd the measure through Congress as well as for failing to figure out a legislative formula that would minimise the rebellions on the left and right of his party in the chamber.
Right up there, too, among others, has been a grudging recognition of the ineffectiveness of the White House’s legislative affairs office for being unable to bring dissenting Republican members back on board. Some Republicans are also starting to mutter – very quietly – that the president did himself very few favours by seeming to be disengaged from the battle until things had largely solidified into pro/con camps. And, when he did finally join in, his evident lack of a real grasp of the details of the measure or its impacts in his meetings – as well as his imperiousness and belligerence towards waverers among Republicans – may even have strengthened opposition to the bill.
There is also a dawning understanding among some Republicans that – wow, golly, gee, or using Trump’s words, “who knew healthcare policy was so complex!” – a three-week legislative effort was not nearly enough time and energy to put into effect something as complex as a root-and-branch revision of national healthcare policy, let alone convince a divided nation that this new measure was the right approach. The healthcare sector is approximately one-sixth of the nation’s economy, and in the seven years since the passage of Obamacare, most major insurance companies, healthcare enterprises like hospital groups, and ordinary consumers have all made their accommodations and adjustments to the provisions in the Affordable Care Act.
Importantly, nearly two years of the Obama presidency had taken place before the earlier law had been passed. There had been innumerable public forums, much vigorous legislative debate, multiple congressional hearings, public campaigns, and much angst before its final passage. And still, key provisions remained hotly contested and debated for many for years to come.
In essence, the question must be asked: What fools thought this could all be done, this time around, in less than three weeks, and without a clear explanation in public as to what it all meant, or how it would work in reality? Serves ‘em right for their hubris, you could easily say of this effort. At the minimum, this embarrassing fight should have been an intensely public lesson for the new kid of what it really takes to govern, as opposed to shouting at your real estate and bankruptcy lawyers to browbeat opponents in the property game.
Now that the new Republican healthcare bill has been tossed into the congressional file 13, Trump has announced that, well, too bad. He’ll just turn his attention now to tax reform instead. Of course, if there is one thing that is MORE complex and MORE politically fraught than healthcare, it must surely be the US tax code – every damned chapter of it.
Every single interest group in the nation (and nearly every citizen as well, by virtue of such long-established tax breaks as the income tax deduction for home loan interest) has an ox in any potential fight over the entire tax code, if for no other reason than every single provision of the tax code benefits some while disadvantaging others. A wholesale revision opens the whole thing up for bloody, fraught, all-out renegotiation. This will almost certainly not be completed in the time allotted to it in between now and the autumn recess for Congress. The Trump White House should be steeling itself for yet another protracted, painful struggle – and the almost certain political trench warfare of attrition, one subsection at a time, that will ensue.
As if that were not sufficient to make things awkward for the GOP and the president, suddenly emboldened Senate Democrats are now threatening to filibuster the confirmation vote of Judge Neil Gorsuch to fill the vacant seat on the Supreme Court. And with 48 of 100 Senate votes, they might well be able to forestall such a vote, since breaking their filibuster would require 60 votes, rather than just a bare majority of the Senate. There is much more to come on this front for Trump as well.
His comments that healthcare under the Affordable Care Act will just have to implode or explode on their own and that he’s not going to help sort things out in the meantime should at least trigger discussion as to whether such nonchalance over the enforcement of the law could constitute a dereliction of his constitutional obligation, per Article II, Section 3. That provision of the president’s job is that he must take care that the laws of the nation are faithfully executed – not that he can pick and choose those he likes.
Could some clever constitutional lawyer begin thinking about a bill of impeachment if it actually comes to Trump failing to enforce the provisions of the Affordable Care Act? A legal friend in Washington, in response to just this question, guffawed and wrote that if Trump actually caused the government to renege on the expanded Medicare or other benefits under the Affordable Care Act, impeachment probably wouldn’t be required. The president would almost certainly be flayed alive by outraged citizens – long before any articles of impeachment actually could be drawn up and brought before the House of Representatives.
Of course, the president didn’t just suffer a major embarrassment over healthcare this past week. The congressional hearing with the FBI director and the head of the National Security Agency confirmed that the FBI has been conducting an ongoing investigation since last July into Russian computer hacking during the recent election, with an eye towards skewing the election towards the Republicans. This included the possibility that Trump campaign operatives had had inappropriate contact with Russian institutions, agencies and individuals during that campaign. The testimony and related comments denied there was any basis for all those ugly, snarling tweets about Trump Tower’s wiretapping and British surveillance of The Donald on behalf of the former president. Instead, this was all just so much baloney, or “malarkey”, as former Vice President Joe Biden would have loved to have had a chance to say. Such charges were the real “fake news”.
Then the Republican chair of the House Intelligence Oversight Committee also rushed to the White House, breathless with the news that some Trump operatives may have been mentioned in transcripts of intel intercepts of Russian conversations. While not surprising, given the information already out in the open, Congressman Devin Nunes’ behaviour helped blot his copybook with his fellow committee members, and the public at large, eventually prompting a kind of grudging apology from him for his lapdogish behaviour.
But all this seems to have prompted several former Trump campaign figures such as Paul Manafort to volunteer to testify in open hearings, presumably to clear their names, even though they have already been tied to various lobbying and political efforts on behalf Russia-supporting Ukrainians – and others. It did not help the White House’s credibility for Spokesman Sean Spicer to try to dismiss Manafort as a kind of barely noticeable, marginal figure. After all, Manafort had been Trump’s campaign manager for some months, right up to the nominating convention.
Anyway, there is a more sinister possible interpretation of these offers to testify, rather than simply a process of the clearing of their respective names. If they know they’ve danced around the law, now they may want to get into position so they can negotiate themselves away from serious charges and time in the big house or massive fines. Such might come into play over things like failure to register as agents of foreign powers, income tax evasion, or even violations of the Foreign Corrupt Practices Act or – gasp – espionage and treason, by pointing fingers upward at others still higher up. We shall see.
Meanwhile, lest readers think this shambolic style of governing in America is solely America’s and Americans’ problem and Trump’s public embarrassment, it is crucial to keep in mind everyone, worldwide, is watching how this affects Donald Trump’s ability and skill at governing. Needless to say, they are watching inside the Kremlin, in the Forbidden City in Beijing, in some underground, fortified bunker in Pyongyang, in offices in Tehran, and in a camouflaged headquarters in Raqqa. And in Tel Aviv, London, Paris and Berlin as well. DM
Photo: US President Donald J. Trump gets in the driver’s seat of an 18-wheeler while meeting with truck drivers and trucking CEOs on the South Portico prior to their meeting to discuss healthcare at the White House in Washington, DC, USA, 23 March 2017. EPA/JIM LO SCALZO
While we have your attention...
An increasingly rare commodity, quality independent journalism costs money - though not nearly as much as its absence.
Every article, every day, is our contribution to Defending Truth in South Africa. If you would like to join us on this mission, you could do much worse than support Daily Maverick's quest by becoming a Maverick Insider.
Click here to become a Maverick Insider and get a closer look at the Truth.
Burger King is called "Hungry Jack's" in Australia. This is due to one restaurant in Adelaide having already claimed the named Burger King.