President Trump’s decision to relaunch the fight over the Affordable Care Act may have thrown Republican lawmakers for a loop, but the president isn’t backing down.
“The cost of ObamaCare is far too high for our great citizens,” he tweeted Monday. “The deductibles, in many cases way over $7000, make it almost worthless or unusable. Good things are going to happen!”
It’s not clear, though, what those good things might be, or how and when they might happen. Here’s why.
Congressional Republicans aren’t on board: “Republicans have no intention of heeding President Trump’s urgent demands for a new health-care plan to replace the Affordable Care Act, fearing the potential political damage that such a proposal could cause in 2020 and hoping he will soon drop the idea, according to interviews with numerous GOP lawmakers, legislative staffers and administration aides,” The Washington Post’s Seung Min Kim and Josh Dawsey reported over the weekend. “Not only is there no such health-care overhaul in the works on Capitol Hill — there are no plans to make such a plan.”
Asked whether two Senate committees overseeing health care plan to draft another Obamacare replacement plan, Senate Finance Committee Chairman Chuck Grassley (R-IA) gave the Post a flat “No,” noting that the courts won’t decide Obamacare’s fate for a long time.
Even the senators supposedly working on a plan are hedging: Trump told reporters last week that Republican Sens. John Barrasso of Wyoming, Bill Cassidy of Louisiana and Rick Scott of Florida will be coming up with a health care plan that’s “really spectacular.” The president’s tweet Monday again mentioned those three senators along with Senate Majority Leader Mitch McConnell.
But there doesn’t appear to be a working group formally tasked with devising an Obamacare replacement plan. "I think the president just listed off the names of people he's spoken to on the phone about health care," one Senate Republican aide told CNN.
And when Chuck Todd, host of NBC’s “Meet the Press” on Sunday asked Barrasso a straightforward question — “Should the American people expect an actual health care plan alternative from the Republican Party this year?” — he got a less than straightforward answer. “The American people should expect to not have to be burdened with the incredible costs that are affecting them now, as a result of the healthcare law,” Barrasso said, deflecting.
Scott, on CBS’s “Face the Nation,” seemed to indicate he expects a proposal from the White House. “I look forward to seeing what the president's going to put out,” he said. He also told the Post that, while he’s going to try to get something done, “I think it accelerates everything if the White House had a plan.”
And Scott is probably not the best person to pitch the GOP as “the party of health care”: The Florida senator on Friday unveiled legislation aimed at reducing prescription drug prices, but his background opens him and the GOP up to easy criticism. Scott was CEO of the hospital group Columbia/HCA in the 1990s. The company later agreed to plead guilty to at least 14 corporate felonies and pay the government $1.7 billion for its actions while he was in charge, in what the Justice Department at the time called the “largest health care fraud case in U.S. history.” The Washington Post’s James Downie cracks that Scott is on Trump’s health care team “because no one knows how to fix U.S. health care better than a man who took in millions while overseeing a company committing massive Medicare fraud.”
Republicans are reportedly rooting for the lawsuit challenging the ACA to fail: Republicans may not like the Obama health care law, but they know that having it wiped off the books while Congress is divided could be a recipe for chaos. “If you’re looking strictly at political outcomes, it could be argued that a lot of members don’t want to see this struck down because they don’t want to deal with the fallout,” an unnamed “senior Republican senator” told The Hill.
Trump himself doesn’t think the lawsuit challenging the ACA will succeed: “Trump has privately said he thinks the lawsuit to strike down the Affordable Care Act will probably fail in the courts, according to two sources who discussed the matter with the president last week,” Axios’s Jonathan Swan reports.
But he wants to press ahead on health care anyway: Aides tell The Post that the idea is to address what Trump sees as his biggest political vulnerability heading into the 2020 elections. “Trump's view is that Democrats are going to bash him up on health care in 2020 regardless, so ignoring the issue won’t work,” Axios’s Swan says. So Trump wants to market the GOP as “the party of health care,” and he knows that repeating the message is key to selling it: “He plans to repeat this message again and again and again,” Swan says. Plan or no plan, the president may not be easily swayed by those Republicans looking to change the subject or simply wait out the White House.
And the White House just may come up with a plan: The White House has secretly been working on a health care proposal with three right-leaning think tanks — the Heritage Foundation, the Mercatus Center and the Hoover Institute — for months, the conservative Washington Examiner reports. Policy leaders at the think tanks told the Examiner than the plan would take concepts from previous GOP health care proposals. But a conservative policy analyst indicated that it may be quite some time before there’s a concrete plan. “I don’t think there’s anything that’s fully formed,” the analyst said. “I think a lot of the devil’s in the details.”
For now, the GOP health care agenda is still mostly talk.