Sunday, March 31, 2019

Trump Going Back to Healthcare

Republicans fear a strategic mistake.  Democrats are licking their lips.  Maybe they're both wrong.

This is not as complicated as some recent articles have made it sound.  A Federal District Court in Texas has ruled that the Affordable Care Act (aka Obamacare) is unconstitutional.  Not just pieces of it, but the whole damn thing.  If you're like me, you're thinking, great!  It's about time.  But in what I would have thought were counterintuitive expectations, many thought the Trump administration would join in an appeal of that ruling to the Federal Appeals Court for the Fifth District.  That's because the District Court ruling was thought to be overly broad and decided on what some consider to be shaky grounds.  Also because the total destruction of the ACA would jettison the mandates for coverage of pre existing conditions and allowing children up to age twenty six to remain on their parents' insurance.  While decidedly anti free market measures, they have proved to be very popular, especially with the beneficiaries of those provisions.  Big surprise.  People like free stuff.

Anyway, the political consensus is that the GOP lost their multiyear long campaign to kill Obamacare completely, and the parts that remained were politically popular.  No one had much of an appetite to stir up a hornets nest on an issue that was credited, at least in part, for having led to the loss of the House in 2018.

Enter The Donald, and his uniquely Trumpian reasoning.  To the chagrin of a lot of Republican pols, Trump appears to want to put the final nail in the coffin of Obamacare.  Maybe as an expression of his animus towards Obama.  Maybe as an expression of his animus towards John McCain whose critical thumbs down led to the failure of the GOP to kill the ACA legislatively.  Or here's a weird thought.  Maybe he just wants to fulfill a campaign promise.

So what the hell is Trump thinking?  I can think of two possibilities.  Maybe he's been advised that the questionable nature of the District Court's decision makes it unlikely that the Appeals Court or even the Supreme Court will uphold it.  If true, Trump can claim to have gone the extra mile to kill Obamacare only to have been stymied once again by the courts.  Republicans won't have to answer for depriving some constituents of their goodies, but Trump can tell his base he did everything possible.

Or maybe Trump really wants to fulfill this particular promise, for all the reasons mentioned previously.  If that's true then I've got some words of caution for both Democrats and Republicans.  First of all:  Don't underestimate Trump.  The terminally smug political pundits on the left wing Sunday shows this morning were drooling over the prospect of the huge political blunder Trump is about to make.  "Trump has no idea what he's setting himself up for"  they say.  And we should believe them because they have proven so omniscient in the past on the prospects of Donald Trump's unconventional thinking.  They're the ones who told us that Trump's populist message had no appeal to average Americans.  Then he won the election.   What do the pundits understand about average Americans?  They don't know any average Americans.  Is it possible that there is a substantial constituency that would still love to see a clearing away of the wreckage of that Rube Goldberg monstrosity that is Obamacare.  Wouldn't millions of Americans love to see the ACA finally, thoroughly, and totally terminated with extreme prejudice?  I know I would.

But what about the backlash?  Trump says he wants to replace it with something better.  He wants the Republican Party to become known as the Party of Healthcare.  Democrats scoff.  Republicans, many of them at least, wink.  But what if Trump's serious?  I can easily see Trump abandoning the remnants of Obamacare and pressing for something better.  Something politically palatable to both his base, and a large number of independents and even some Democrats.  Something that perhaps some old school Republicans might choke on, but hey, Trump is a disrupter.  Is it really so difficult to believe that Donald Trump could come up with a plan?  Is it really so difficult to think that Donald Trump could come up with a new coalition for healthcare reform that skewers the sacred cows of both sides and their existing special interest constituencies?  Most, if not all of the governments in the developed world provide some form of universal coverage for their citizens.  Is it really so hard to believe that it could happen in the United States?  The cynical politicos on the right don't want it.  The smug pundits on the left think the answer is Medicare For All.  If there is a middle ground solution, it will take a guy who is a genuine disruptor to find it.  Corporate owned Republicans and mainstream media Democrats guffaw at the prospect that Trump is that guy.  Are they right to chortle so smugly?  We've seen this movie before, and it had a surprise ending early one Wednesday morning in November of 2016.  Careful what you wish for Democrats (and Republicans).  You just might get it.