Why Trump Punted on Obamacare Replacement Until After 2020 Elections
Health Care

Why Trump Punted on Obamacare Replacement Until After 2020 Elections


In a flurry of tweets Monday night, President Trump continued to criticize the Affordable Care Act but indicated that any new vote on a Republican plan to replace the law would wait until after the 2020 elections, essentially punting on a hot-button political issue he had resurrected just last week to the consternation of many Republicans.

The Trump administration argued in a court filing last week that the entire Obama health care law should be ruled unconstitutional. Trump followed up on that filing by declaring that the GOP would soon be known as “the party of health care,” but his fellow Republicans were surprised by Trump’s push and generally wary of reengaging in a fight that helped Democrats retake control of the House in the 2018 elections. And the ensuing scramble made clear that the party still doesn’t have an Obamacare alternative that it can coalesce behind, even as Trump announced that GOP lawmakers would “come up with something really spectacular.”

Senate Majority Leader Mitch McConnell (R-KY) told reporters on Tuesday that he spoke with the president Monday and made clear that the Senate will not be taking up comprehensive health care legislation before the 2020 election. Trump’s tweets came after that conversation.

White House Press Secretary Sarah Sanders said Tuesday that the president "wants to work with Congress to come up with the right health care plan." She added that Trump is focused on protecting patients with preexisting medical conditions, making care more affordable and giving patients a say in the care that they receive.

Why it matters: Trump appears to have accepted GOP calls that he hold off on a new Obamacare replacement effort and instead focus his reelection strategy on attacking Democratic Medicare-for-all proposals. That likely makes political sense, for now, especially since Republicans don’t have a plan — and even if they did have one, it wouldn’t have a chance of passing a divided Congress. It’s much easier to attack the Democratic plans, promise Americans will get “great health care” and leave the thorny details aside.

Trump’s decision ensures that health care will be front and center in the 2020 elections, though it alleviates some of the immediate pressure on Republicans to produce a plan. In the meantime, though, the Trump administration continues to support a lawsuit that could result in the Affordable Care Act being struck down — and 20 million Americans losing coverage — without providing an alternative. “In short,” writes Bloomberg columnist Max Nisen, “the GOP is gambling with the stability of the U.S. health-care system because its best health policy ideas can’t pass on their own merits.”

The bottom line: The problem for Trump, New York magazine’s left-leaning columnist Jonathan Chait says, is that “the Republican party is structurally and endemically incapable of devising a health-care program that is remotely acceptable to the public. The reason, which has been amply demonstrated over the last decade, is that most people think ‘great’ health insurance gives everybody access to medical care. But paying for that care requires some combination of taxes and regulations on insurance, both of which violate conservative dogma.”