Republican Obamacare Replacement Bill Pulled From House Floor

A major legislative defeat for Paul Ryan, the House GOP, and President Trump.

Capitol Building Dusk

Just minutes before a vote was scheduled to take place on the American Health Care Bill, the bill was pulled from the House floor as it became apparent that another day of lobbying recalcitrant members of the conservative House Freedom Caucus had proven to be entirely fruitless and that the bill would have failed had it gone to a final vote:

House Republican leaders abruptly pulled a Republican rewrite of the nation’s health-care system from consideration on Friday, a dramatic acknowledgment that they are so far unable to repeal the Affordable Care Act.

“We just pulled it,” President Trump told the Washington Post in a telephone interview.

The decision came a day after Trump delivered an ultimatum to lawmakers — and represented multiple failures for the new president and House Speaker Paul D. Ryan (R-Wis.).

The decision means the Affordable Care Act remains in place, at least for now, and a major GOP campaign promise goes unfulfilled. It also casts doubt on the GOP’s ability to govern and to advance other high-stakes agenda items, including tax reform and infrastructure spending. Ryan is still without a signature achievement as speaker — and the defeat undermines Trump’s image as a skilled dealmaker willing to strike compromises to push his agenda forward.

“I don’t blame Paul,” Trump said, referring to Ryan.

Rep. Bradley Byrne (R-Ala.), who planned to vote for the legislation, said that Friday would have been the “first big vote in the presidency of Donald Trump. I think it’s a statement, not just about him and the administration, but about the Republican Party and where we’re headed.”

“So much about political power is about perception. And if the perception is that you can’t get your first big initiative done, then that hurts the perceptions down the road about your ability to get other big things done,” Byrne said in an interview before the decision.

The decision came hours after Ryan visited the White House to warn Trump that despite days of intense negotiations and sales pitches to skeptical members, the legislation lacked the votes to pass.

Trump had personally lobbied 120 lawmakers, either in person or on the phone, White House press secretary Sean Spicer reminded reporters on Friday. The president had “left everything on the field,” Spicer said.

Spicer said that no matter what happens, the White House did not think that defeat would slow other parts of Trump’s agenda including tax reform and immigration reform.

Vice President Pence, White House Chief of Staff Reince Priebus and Health and Human Services Secretary Tom Price also made a last-ditch attempt to win over members of the hard-line House Freedom Caucus, huddling with them at midday at the Capitol Hill Club, a GOP social hall next door to the headquarters of the Republican National Committee. All three exited the meeting quickly without taking questions.

In one stunning defection Friday, House Appropriations Committee Chairman Rodney Frelinghuysen (R-N.J.) announced at midday that the health care bill is “currently unacceptable” and that changes made late Thursday to placate conservatives “raise serious coverage and cost issues.”

Another moderate, Rep. David Joyce (R-Ohio) — who had met with Trump on Wednesday night — said he would vote against the bill. So did Rep. Barbara Comstock (R-Va.), a longtime Ryan friend and ally who represents a competitive Northern Virginia congressional district.

Rep. Paul Gosar (R-Ariz.), a Freedom Caucus member, was one of six Republicans who voted against a procedural resolution bringing the bill to the floor on Friday morning.

“You know what? I came here to do health care right,” said Gosar, a dentist. “This is one chance we that can get one-sixth of our GDP done right. It starts with here.”

At the heart of the argument made by GOP leaders to skeptical members: Keeping the Affordable Care Act is a worse outcome than passing a potentially flawed replacement.

“You want to score a touchdown, but sometimes, on the fourth down, you kick a field goal,” said Rep. Joe Barton (R-Tex.), the longest-serving member of Congress in the Freedom Caucus. “The choice is yes or no. I’m not going to vote no and keep Obamacare. That’d be a stupid damn vote.”

At the White House on Friday morning, Trump projected confidence as he answered shouted questions following an announcement of a presidential permit for the Keystone XL pipeline, a revived project that the president said would create jobs.

Asked by a reporter what he would do if the bill fails, Trump — seated at his Oval Office desk — shrugged and said: “We’ll see what happens.”

(…)

When formal debate on the bill began on Friday morning, top leaders used a procedural vote to gauge last-minute support. House Majority Whip Steve Scalise (R-La.) was seen conferring with Rep. Christopher Smith (R-N.J.), a key holdout. House Ways and Means Committee Chairman Kevin Brady (R-Tex.) sat in the row behind them cajoling Rep. Patrick Meehan (R-Pa.), another moderate who has yet to announce what he plans to do.

Rep. Mark Meadows (R-N.C.), who chairs the Freedom Caucus, did not respond to requests for comment on Friday about his plans.

Rep. Ken Buck (R-Colo), a caucus member who said before the election that minor losses in the House Republican ranks would increase conservative clout, said he remained undecided.

“I’m examining life experiences,” he said. Asked to explain what he meant, he said he was joking.

Rep. Peter King (R-N.Y.), a moderate who had expressed qualms as recently as Tuesday, when he was singled out by Trump inside a private meeting of House Republicans, said he had all but decided to vote for the bill.

“I’m not one they should worry about,” he said.

Rep. Louie Gohmert (R-Tex.), one of Trump’s most ardent congressional supporters, said he remained opposed to the legislation because it made more political sense to keep current law than to start rewriting it.

“A no vote means we save Donald Trump from a Democratic majority in 2019,” Gohmert said. “If this passes, then Obamacare stays.”

As I noted this morning, after yesterday’s difficulties in getting a majority together to pass the AHCA on the seventh anniversary of the passage of the Affordable Care Act it was obvious that putting that majority together today would be no easier. The House Freedom Caucus was demanding changes that would have been a poison pill in the Senate, for example, and the minor changes that were made to the bill in an effort to placate them ended up alienating House GOP moderates in the so-called Tuesday Morning Group, more and more of whom were joining their more conservative colleagues in announcing their opposition to the bill as the day went on. By the time Speaker Ryan took the extraordinary step of taking a sudden trip to the White House to brief the President, it was apparent that more than 30 House Republicans would vote against the bill and suggestions were that the final total would be much higher since many members would no longer feel it necessary to vote in favor of a bill that was going to die in the House anyway, meaning that there would have been a lopsided majority against the bill and even more humiliating defeat for Ryan, the House GOP, and President Trump.

Based on the initial reporting, this isn’t just a temporary setback for the AHCA, it’s basically a full-on retreat for the entire GOP from health care reform, at least for now. Paul Ryan is speaking now, and he’s referring to the effort to repeal the Affordable Care Act in the past tense, while Republican member of the House are being told that “Trump is done” with health care reform for now according to CNN Congressional Reporter Phil Mattingly. Whether that is a serious threat or just posturing is something only time will tell, but it’s hard to see how the GOP is going to be able to ‘repeal and replace’ the PPACA in the future if they were unable to do it now, at the beginning of a Republican Presidency when the GOP has solid control over both the House of Representatives and the Senate, then they aren’t going to be able to do it in the future. Indeed, if they were unable to come to an agreement on this issue it’s hard to see how they are going to be able to tackle equally complicated issues such as tax reform, entitlement reform, the debt ceiling, and other matters of importance.

Reason’s Peter Suderman has some good insights on why the bill failed, and places most of the blame where it belongs, with Donald J. Trump:

The bill failed in part because it could not establish a balance between the concerns of moderate Republicans, particularly with regard to the way it treated the Medicaid expansion, and more conservative members of the House Freedom Caucus, who argued that the bill was too much like Obamacare, retaining its core scheme of subsidies and regulations.

But it also failed because Trump proved himself an ineffective negotiator and dealmaker—one whose preference for shallow political victories over substantive policy wins ultimately proved insufficient in a complex policy negotiation.

Throughout his life, Trump has portrayed himself as a master dealmaker. As far back as 1984, for example, he argued that the U.S. government should let him manage the nuclear arms negotiations with Russia. It would take an hour-and-a-half to learn everything there is to learn about missiles,” Trump, who in 2015 did not know what the nuclear tried was, toldThe Washington Post at the time. Trump has never been focused on details. The deal itself was always more important than what was in it.

As House Republicans moved towards a vote on the health care bill, GOP lawmakers characterized his role similarly. This week, in advance of meetings with Republicans who opposed the bill, Rep. Patrick McHenry (R-North Carolina) called Trump “the closer.” Final support for the bill would be won by Trump, who would use his skills as a dealmaker to push it over the finish line.

Trump repeatedly promised to repeal and replace Obamacare with “something terrific.” But he never described the policy mechanisms of the replacement he preferred. And the outcomes he described—coverage for everyone, lower premiums, no changes to Medicaid—had little or no connection to the bill that House Republicans eventually drew up.

That didn’t seem to matter to the president. As has always been the case with Trump, making a deal—any deal—was all that mattered.

In the end, though, the bill died. Trump couldn’t close the deal. And one of the biggest reasons that Trump couldn’t close the deal is that he didn’t understand or care about the details.

The ominous thing is that this seems to describe how Trump feels not just about health care policy, but how he feels about pretty much all the issues facing the nation. Throughout his campaign, his rhetoric and his campaign message was always focused on his ability to get “better deals” but always fairly empty of exactly what he thought those deals should entail. This is true whether one is talking about health care, or international trade, or immigration, or tax reform, or any of the other myriad of issues that the Congress and President are supposedly going to be dealing with over the next four years. If this two weeks or so of dealing with the American Health Care Bill is any indication, Trump is going to have a huge problem getting any of his agenda through Congress, and that’s going to be a recipe for a failed Presidency.

FILED UNDER: Congress, Healthcare Policy, US Politics, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Doug Mataconis
About Doug Mataconis
Doug Mataconis held a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010 and contributed a staggering 16,483 posts before his retirement in January 2020. He passed far too young in July 2021.

Comments

  1. Argon says:

    Don’t worry. The stupid will only continue.

    A Lawyers, Guns and Money post links to an appropriate YouTube video: http://www.lawyersgunsmoneyblog.com/2017/03/trumpcare-two-acts

  2. gVOR08 says:

    The GOP’s Obamacare Repeal Bill Is Dead Because Trump Doesn’t Republicans Don’t Understand How Health Policy Works

    I fixed Suderman’s headline for him. Anyone who talks about the free market fixing health care has no idea how health care works. Anyone who talks about healthy people not paying for sick people has no idea how insurance works. It ain’t just Trump. GOPs have been piling up lies on this stuff so deep there’s no way for them to dig back out to reality.

  3. Daryl's other brother Darryl says:

    Don the deal-maker didn’t.
    He’s a loser. Maybe some of the idiots who voted for him will see that.
    7-1/2 years they been talking about repeal and replace and they couldn’t get it done.
    Fwcking laughingstocks

  4. Electroman says:

    Without the House Freedom Caucus and the Tuesday group, the GOP does not have a majority; full stop.

  5. michael reynolds says:

    None of this really surprises me. I’ve always said Ryan was an empty suit, that GOP ‘ideas’ cannot survive contact with reality and that Trump is incapable of persuading anyone beyond his base – and even apparently people in his base. And I’ve insisted that Obamacare was the best deal anyone could have gotten at that point in time, and given that the GOP plan wasn’t just a little worse but catastrophically, extravagantly worse, I’ll take that point as proven.

  6. David M says:

    Well, the country dodged the first major bullet of the Trump era. There will be many more.

  7. Stormy Dragon says:

    @David M:

    Isn’t this the second or third bullet dodge? His Muslim bans both got smacked down too.

  8. S. Fields says:

    The ominous thing is that this seems to describe how Trump feels not just about health care policy, but how he feels about pretty much all the issues facing the nation.

    Sadly, contra Darryl above, the most ominous thing is that Trump’s sycophants still won’t see that Don the Dealmaker is a clueless sham.

  9. Mikey says:

    Trump’s on record blaming the Democrats. “We couldn’t get a single Democrat vote.” Really? HIS PARTY HAS THE MAJORITY. I’m no mathematician, but even I can figure out it’s not the minority’s fault if the majority can’t get, you know, a majority.

  10. CSK says:

    @S. Fields:

    The Trumpkins are fighting their cognitive dissonance: On the one hand, The Geriatric Mango is the greatest dealmaker in the universe. On the other hand, he’s a poor naif who was cruelly manipulated by Paul Ryan.

  11. Liberal Capitalist says:

    President Donald Trump blamed Democrats on Friday for the failure of the GOP health care bill that would have replaced the Affordable Care Act…

    “Perhaps the best thing that could happen is exactly what happened today because we’ll end up with a truly great health care bill in the future after this mess known as Obamacare explodes,” Trump said Friday afternoon, speaking from the Oval Office…

    “Whenever they’re ready, we’re ready,” Trump said, repeatedly arguing that “with no Democrat support, we couldn’t quite get there.” President Donald Trump blamed Democrats on Friday for the failure of the GOP health care bill that would have replaced the Affordable Care Act….

    (source: http://time.com/4713021/donald-trump-republican-ahca-failure-democrats )

    Something is exploding, but it’s not the ACA.

    What a maroon !

  12. Hal_10000 says:

    As far back as 1984, for example, he argued that the U.S. government should let him manage the nuclear arms negotiations with Russia.

    In an alternative universe, the US is a smoking nuclear pile of rubble and communism dominates the planet.

  13. MBunge says:

    Not to trigger anyone’s Trump Derangement Syndrome but jokers like Suderman are the real problem with the GOP and conservatism. Republicans have literally had SEVEN YEARS to prepare for this moment and it’s supposed to be Trump’s fault they failed? There will no doubt continue to be many instances where Trump’s lack of any interest in public policy will screw things up but THIS fiasco isn’t one of them.

    And Trump’s decision to drop health care reform indicates he’s figured out the House GOP is like The Terminator. It can’t be reasoned with. It can’t be bargained with. It doesn’t feel pity or remorse and it absolutely will not stop until we are all dead. And whack jobs like Suderman helped make it that way.

    Mike

  14. S. Fields says:

    @Mikey:

    The world’s greatest deal maker can’t close the deal with a Congress his party controls on a bill his party wrote.

  15. grumpy realist says:

    @MBunge: Trump jumped aboard the Ryan train and tried to push it as much as possible. So he’s responsible for what he put his name behind.

    Whatever happened to Truman’s “The Buck Stops Here”? Instead, we have a whiny man-child who refuses to take responsibility for anything he says or does.

  16. David M says:

    @MBunge:

    Suderman is in the “Obamacare is bad, but repeal/replace is actually complicated, so the GOP should start taking the idea seriously and stop offering empty platitudes” camp, so I’m not sure what your complaint with him is. Unless you haven’t read him much over the last several years.

  17. michael reynolds says:

    @MBunge:

    The problem is the GOP. They believe in things which are not true. Their ideology is a mismatched grab bag of Ayn Rand and Ronald Reagan and Jim Crow. They don’t have the capacity to govern because at heart they are malicious, stupid, luddite, racist, misogynist and authoritarian. If you could look inside Paul Ryan’s head you’d see tumbleweeds. He and his party are a fraud.

    Now that discredited, ludicrous, backward party is led by a nasty cretin who doesn’t care about a single thing on God’s green earth but lining his own pocket and sucking up the applause he so desperately needs.

    Suderman my ass. Suderman is just one crusty neuron in a senile brain.

  18. Liberal Capitalist says:

    what ???

    … you say the mean Democrats blocked your fabulous health care bill by having the Repubs pull the bill before a vote… even though for 7 years you said you could do better?

    … thanks Obama.

    https://m.popkey.co/ba0efa/0xbGW.gif

  19. Gustopher says:

    President Trump shouldn’t feel to bad — half of all Presidents are below average, and many people are failures in their chosen professions.

    I don’t know who is more unrealistic, Donald Trump for believing he can make things happen in Washington by force of will alone with no knowledge of how things work, or the people who voted for him with the promises that he would restore jobs that aren’t coming back?

    At least the people who voted for him have desperation as an excuse.

  20. Kylopod says:

    Well, for one thing, I feel a little vindicated. I may not have predicted the rise of Donald Trump, but I did predict early on that the GOP would have a hard time repealing Obamacare even if they won in 2016. Here is what I wrote in June 2015:

    To do a full-scale repeal would mean immediately throwing millions of Americans off their health insurance, including millions of Republican voters. I simply don’t believe the GOP is stupid enough to do such a thing even if they win the trifecta in 2016. We already saw how panicked many Republican officials became when King v. Burwell was being decided. And that was only a partial repeal in roughly half of the states. And it would have happened while Obama was still president, when there was still some possibility of blaming it on Obama and getting at least some voters to agree. If they do it when a Republican is president, they’ll automatically own it in the eyes of the public.

  21. Kylopod says:

    @David M:

    Well, the country dodged the first major bullet of the Trump era

    Unfortunately for him, a lot of his “bullets” are blanks.

  22. Pch101 says:

    The bill failed in part because it could not establish a balance between the concerns of moderate Republicans

    There is no such thing as a “moderate Republican”. There are conservative Republicans and far-right Republicans. There are bombastic Republicans and polite Republicans. But there isn’t a moderate to be found in the bunch.

    This is the usual war between the establishment that tries to fix everything with tax credits and the extremists who try to fix everything by destroying it. Eventually, the two of them will work something out, i.e. the establishment will capitulate.

    Liberals should not get too comfortable — Obamacare is going to be killed off soon enough. Both wings of the Republican party are lacking in smarts — it should be clear by now that Paul Ryan is no intellectual or policy guru — so the GOP’s “solution” will solve nothing.

  23. Fredw says:

    A trap of their own devise. Lets get two thing straight about Obamacare. First it was a crappy piece of legislation right from day one for a variety of reasons. Second, despite it’s many flaws, as passed it could have sustained itself. To do so, it depended on the individual mandate and on a fund, the name of which eludes me right now, to cover early losses for the insurance companies. Without that attenuation of underwriting losses it made no economic sense for it’s primary beneficiaries, insurance companies. Republicans have actively engineered the collapse of Obamacare first by cutting the funds for the transition and second by discouraging healthy people from following the mandate. Trump has now by fiat destroyed the individual mandate which is certain to again increase premiums by driving everyone out of the exchanges. Make no mistake, the Republicans own the coming healthcare crisis 100%. It is sad that the Democrats are probably going to keep defending ACA and are too stupid to understand its collapse and to put the blame where it belongs; squarely on the Republicans.

  24. S. Fields says:

    @MBunge:

    That Republicanism is extremism paired with ineptitude and that Trump’s alleged magnificence as a deal maker in real estate doesn’t translate to politics remotely as well as the expectations set by Trump himself are not mutually exclusive positions.

  25. Moosebreath says:

    And after all of this, a Republican Congressman is honest enough to give up the game:

    “Rep. Joe Barton (R-TX) admitted as much as he left the meeting Friday. Reporters asked why, after Republicans held dozens of nearly-unanimous votes to repeal Obamacare under President Obama, they were getting cold feet now that they control the levers of power.

    “Sometimes you’re playing Fantasy Football and sometimes you’re in the real game,” he said. “We knew the president, if we could get a repeal bill to his desk, would almost certainly veto it. This time we knew if it got to the president’s desk it would be signed.””

    I don’t know about the rest of you, but I’m not tired of winning yet.

  26. Davebo says:

    @Fredw:

    Trump has now by fiat destroyed the individual mandate

    Oh really?

  27. HarvardLaw92 says:

    I can’t speak for the rest of you, but watching this ultra-far-right Bircher caucus now turn its gunfire inward towards its own party in some sort of circular firing squad just warms my heart.

    Audrey II has starting eating Seymour. You broke it, you bought it.

    I’m not sure that my freude can handle this much schaden … 🙂

  28. DrDaveT says:

    @Gustopher:

    I don’t know who is more unrealistic, Donald Trump for believing he can make things happen in Washington by force of will alone with no knowledge of how things work, or the people who voted for him with the promises that he would restore jobs that aren’t coming back?

    The NBC Nightly News has been following opinions in some small town in Ohio since before the election. They went back there today and talked to people, and the first guy they talked to was a 60-ish white guy who voted for Trump because Trump promised better health care. He’s now confused and disappointed.

    At some point you run out of facepalms.

  29. fredw says:

    @Davebo:

    He has instructed the IRS not to enforce the penalties. That effectively ends the mandate.

  30. Tyrell says:

    They need to do something quick. Humana executive says that the government health care plan is collapsing. See Burton Report: “Managed Health Care: A good idea gone wrong”. And “Obama Care Repealing Itself: Only four exchanges remain” (Daily Caller). Obama Care is dissolving itself: a result of its faults and poor structure. It is going broke and can get a money fix only through Congress. They were counting on all these healthy young people who did not sign up. The mandate ended up being a punishment on the people who can’t afford the plan.
    What is needed is a basic, no frills plan and supplemental plans of optional coverages and deductibles. That would be attractive to everyone and get people excited. This would reduce costs and bring more money in.
    What is not needed is a one plan fits all. People should be able to choose plans that fit their different needs and wants: much like purchasing a car or home.
    “It’s just crazy” (Bill Clinton)

  31. Terrye Cravens says:

    The GOP is actually 3 parties and they are now at war with one another. They can win elections, but governing seems to be beyond them.

  32. HarvardLaw92 says:

    @fredw:

    They were barely enforceable to begin with. IRS could only offset to collect; liens & levies were disallowed.

  33. Terrye Cravens says:

    @Tyrell: According to the CBO the ACA is stable. I have been listening to people say for years that it is in a death spiral. And of course Republicans are promising to do anything they can {short of repeal and replace} to destroy it. The GOP runs the government now, if it fails, it will be on them.

  34. David M says:

    @Terrye Cravens:

    Not only are you right that it’s not in a death spiral, each state is it’s own market. If the market in Texas collapses, it will be painful for them, but it won’t affect me up in Washington State. So talk of a singular “collapse” isn’t accurate anyway.

    This doesn’t mean certain areas aren’t struggling…they very much are, and we should improve things for them.

  35. Laura Koerber says:

    I think that if the Republicans had been better at tactics, they would have quietly sabotaged the ACA until it really was not working,and then repealed it on the grounds that it was a failure.

    That seems to be the plan Trump wants to follow now and there are plenty of people stupid enough to fall for it.

    So I think we can expect more of this:

    http://www.salon.com/2017/03/22/how-republicans-quietly-sabotaged-obamacare-long-before-trump-came-into-office_partner/

    I expect more efforts by Trump to limit the enrollment period, cut advertising (to limit new enrollments each year) and more conversations with insurance CEOs in an effort to convince them to abandon the exchanges.

    Its a plan that could actually work if the goal is to get rid of the ACA while dodging the political consequences.

    The good news I see in this is that the news media is unlikely to continue fawning over Ryan. His image as a Republican who can think must be shot to hell by now.

    I \

  36. DrDaveT says:

    @Laura Koerber:

    I think that if the Republicans had been better at tactics, they would have quietly sabotaged the ACA until it really was not working,and then repealed it on the grounds that it was a failure.

    It’s a quaint, old-fashioned kind of notion, that the GOP cares what is actually true when formulating their tactics. As we’ve seen with global warming, trickle-down economics, the effect of high marginal tax rates on the rich, the relationship between guns and deaths, women’s health issues, homosexuality, and a dozen other issues, they have their own “alternative facts” and a media machine to trumpet them. They know what ought to be true, and The Big Lie is so much easier to deal with than the Inconvenient Truth.

  37. Terrye Cravens says:

    @David M: Yes, and they can also stabilize some of the state markets as well.

  38. Dumb Brit says:

    Ahhh, the “Art of Repeal”!

  39. An Interested Party says:

    ..Trump is going to have a huge problem getting any of his agenda through Congress, and that’s going to be a recipe for a failed Presidency.

    Oh come now, what fool actually believes that Trump could ever have a successful Presidency? Speaking of which…

    @MBunge: I see that the slobbering sycophantry continues…do carry on…

  40. Dumb Brit says:

    So the Closer is a poseur.

  41. Turgid Jacobian says:

    @HarvardLaw92: Careful. I think too much freude in his shaden was what did in Orin Scrivello, DDS.

  42. grumpy realist says:

    @HarvardLaw92: What I was most surprised by was how absolutely crappy Trump’s so-called “negotiating skills” have turned out to be. The only thing the idiot knows how to do is a) threaten people b) Yes! You! Must! Act! Now! Or! Never! Have! This! Chance! Again! (aka The Bahama Time-Share Gambit) c) shove so much sh*t so quickly at the other side that they get bewildered (the Baffle Them With Too Much Too Quickly), or d) pout and threaten to walk away from the table. Oh, and there’s screaming at people as well, but that doesn’t work very well if they have similar levels of power to yours.

    Hell, I did better negotiation as Project Manager getting a system designed and built for the Ministry of Police in Japan.

    Trump must just now be coming to grips with the fact that he can’t say “you’re FIRED!” to any of the House members and it must be driving him loopy.

  43. Bob@Youngstown says:

    @David M: approx 45 states have an insurance commission that regulate the healthcare insurance offerings within their respective states. For example,It is the Ohio commission that gives approval for deductibles and premiums based on applications of each carrier. It is the insurance commissioners that have the greatest impact on rates and deductibles.
    One discussion I’ve not heard too much about is the medical loss ratio. hi Many of my acquaintances seem to think that insurers are free to charge premiums at whatever the market will bear, never heard of the ACA medical loss ratio ….. and are astounded to hear that insurers have refunded over 2.4 billion to policyholders because their premiums were too high.

  44. teve tory says:

    Josh Barro‏Verified account
    @jbarro

    It’s such a waste. There are real problems to address. But Republicans instead chose to be angry, lying morons.

  45. MarkedMan says:

    Dems need to take advantage of this quickly. Obamacare has gone seven years without tweaks, unheard of for major legislation. Trump may be willing to pass a bill with most dems and a few repubs as long as he can claim “Master negotiator” title.

  46. Eric Florack says:

    In the simplest terms what we have here is the establishment GOP along with the Donald being put on notice that the conservatives will not be lightly brushed aside again.
    Trump and Ryan particularly have nobody to blame for all this but themselves. They tried lording it over everybody else and it’s not going to work. They told us for quite a while that they didn’t need the conservatives. Obviously, they found out differently… If they want anything at all they’re going to have to play ball with the conservatives. And the fact of the matter is that conservatives have far more power than either Ryan or Trump want to admit.
    Message for Little Donny… Eliminate Obamacare entirely. Don’t just dress it up. Don’t just put lipstick on the pig. Kill it. Then come back and we’ll talk. Not before.
    The lesson was taught yesterday. Was it learned?

  47. Moosebreath says:

    Ezra Klein has a good post-mortem on the failure of Republicare. His conclusion:

    “Big policy change is hard. The modern Republican Party has built itself in opposition. Paul Ryan won fame designing budgets that were never meant to pass, and by criticizing Barack Obama. Donald Trump established himself as a political force through his leadership of the crackpot birther movement. This is a party that has forgotten how to do the slow, arduous work of governing. Perhaps it’s worse than that. This is a party, in many ways, that has built its majority upon a contempt for the compromises, quarter-loaves, and tough trade-offs that governing entails. They need to learn from this defeat, or they are doomed to repeat it, and repeat it, and repeat it.

    In the interviews Trump is giving today, it is clear he has somehow convinced himself tax reform will be easier. It won’t be. And soon, Republicans will have to raise the debt ceiling, and pass their appropriations bills, and, if they’re going to hold to any of Trump’s budget proposals, find 60 votes to bust the budget caps. And they’re going to do all of that with the myth of Ryan’s policy genius and Trump’s dealmaking skill shattered.”

  48. Hal_10000 says:

    @Moosebreath:

    Tax reform will run into the same problems the Obamacare overhaul did: you have competing interests who are in tension with each other. Anti-trade Republicans who want the border adjustment tax and pro-trade Republicans who don’t. Deficit hawks and deluded “supply siders” who think the Laffer Curve means that tax cuts “pay for themselves” (the Laffer Curve is real; the inference from it is baloney). You’ll have the Fair Tax idiots. You’ll have the VAT people. Hell, you may even have a carbon tax supporter in there.

    Reconciling all these interests is possible but it will take LOT of work and a LOT of persuasion and Trump has shown he can’t do either. He worked “as hard as he could” on AHCA according to his sock puppet Hannity — which included two vacations and starting a feud with Snoop Dogg. According to reports, AHCA lost support after he visited Capital Hill. Unless Ryan pulls his head out of his butt and takes over this process the way Speakers used to, tax reform is already dead.

    I said before that Trump was engaged in that wish fulfillment that many people have about being President where they give speeches and glorious successful agendas just appear. Once he sees how tedious and difficult and groveling crafting legislation is, he’ll get bored. Took a whole two months, but here we are.

  49. Hal_10000 says:

    One last thought: Obama, a Democrat, was able to get better “deals” out of a hostile GOP Congress than supposed uber-deadler Trump has been able to get (so far) out a friendly GOP Congress.

  50. teve tory says:

    Message for Little Donny… Eliminate Obamacare entirely.

    You and the ‘conservatives’ demanded everything, so you’ll get nothing.

    Sorry, it’s over.

  51. teve tory says:

    This is a party, in many ways, that has built its majority upon a contempt for the compromises, quarter-loaves, and tough trade-offs that governing entails. They need to learn from this defeat, or they are doomed to repeat it, and repeat it, and repeat it.

    read erik florack’s comment above, then come back and read this bit again.

  52. grumpy realist says:

    Wow. And you thought that the left can make nasty noises about Trump….just wait until you see what people on the right are saying….

  53. Moosebreath says:

    @Hal_10000:

    Generally correct, though you left out the overriding goal of tax reform to Republicans — it needs to include a large tax cut for the rich.

  54. DrDaveT says:

    @Moosebreath:

    Generally correct, though you left out the overriding goal of tax reform to Republicans — it needs to include a large tax cut for the rich.

    Let’s be more precise — what GOP donors (and thus GOP Congressmen) want in general is to remove the brakes on the natural processes that cause wealth to concentrate at the top.

    In a pure unregulated market, eventually a handful of people own everything. Since that’s Very Bad For Society, we have developed a few mechanisms to counter that trend — progressive taxation, inheritance taxes, transfer payments, subsidies, mandatory public education, public ownership of certain infrastructure, etc. Most ‘conservatives’ are startled to learn that Adam Smith knew this, and wrote at length about the need for government regulation of markets in The Wealth of Nations.

    GOP donors hate all of these things. For some, it’s simple greed — they want to keep more of ‘their’ money. For others, it’s a religious belief that property is sacred. In the end, it doesn’t matter — they want that Gini index as high as possible, and will purchase Congressbeings to that end.

  55. Moosebreath says:

    Another good post-mortem from Jon Chait:

    “The right’s insoluble problem is that people who have insurance like it. Employer-sponsored insurance is popular. Medicare is popular. Medicaid is popular. To the extent that the exchanges in the ACA are not that popular, it is because they are less like those forms of insurance and more like the kind of insurance conservatives prefer — they have higher deductibles, more price discrimination between old and young, and more market competition. Any employer-sponsored insurance plan is going to cover essential health benefits. It’s going to charge the same price to the young and the old alike. In other words, it is going to spread the risk of needing medical care throughout the population it covers.”

  56. grumpy realist says:

    @Hal_10000: There’s a point that Ezra Klein makes that I thought was quite telling:

    Throughout the AHCA’s short life, the limits of Donald Trump’s attention span were on sharp display. He never bothered to learn enough about the AHCA to make a persuasive case for it, which is part of the reason it failed. But perhaps more tellingly, he seemed exhausted by what was, in ordinary political terms, an incredibly fast legislative process. The bill is less than 20 days old, but Trump is already telling reporters, “It’s enough already.” That’s what you say after working on health reform for years, not days.

    We’re not going to get a tax thingamajig.

  57. grumpy realist says:

    @DrDaveT: I keep telling people that progressive taxation is a kind of insurance that keeps rich people from being hanged from lampposts. Ditto for all of the other regulating mechanisms you mentioned.

    Someone should hand them a book on the French Revolution.

  58. Tyrell says:

    @MarkedMan: That has been my thinking too. Fix the Obama Care problems: high rates, high deductibles, subsidy income requirements, doctors not on the plan, young people not signing up, and the “mandate” (tax penalty)*. They need to get as many companies in as possible. At one time I had an HMO from my employer: there were a lot of companies to choose from. It was cheap at first, and people flocked to the doctor like it was a candy store, but then costs started going way up, companies left until we had only one: BCBS. There was a lesson there.
    Then offer a basic, no frills Medicare plan to who ever wants it, some options and supplemental plans. The goal should have been to create a broad cafeteria type program to get as many people as possible to sign up. Maybe they could not have started out of the gate like that, but they should have added more options by now. A plan like that would be too attractive and exciting to ignore! Then Trump and the Republicans can call it anything they want ( I prefer “Dream Care”)
    * “Don’t mess with the IRS. They’re garnishing wages, seizing bank accounts, taking
    property !” I hear chatter that the mandate is now void. My tax preparer said there are about 20 ways around that thing anyway.

  59. HarvardLaw92 says:

    @Eric Florack:

    This, ladies and gentlemen – this is exactly why the GOP will go down in flames over the next few years.

    Thank G-d I remembered to pick up popcorn.

  60. teve tory says:

    and why it went down on friday.

  61. gVOR08 says:

    @grumpy realist: Rick Wilson, at your link, says:

    How could my party’s policy class fail so badly?

    The short answer is, they didn’t fail. The Republican policy class came up with a plan years ago. It passed. It’s mostly working. It’s Obamacare.

  62. gVOR08 says:

    @Tyrell:

    A plan like that would be too attractive and exciting to ignore! Then Trump and the Republicans can call it anything they want ( I prefer “Dream Care”)

    Yup. If the Republicans weren’t stupid, they’d simply make a few tweaks to Obamacare and claim they completely changed and reformed it. They could easily get enough Dem votes for improved ACA to make up for loss of the Freedom (sic) Caucus. They could call it Trumpcare or Ryancare or Freedomcare or GOPcare or Wonder Bread and get on with life with an easy, popular win.

    But they are stupid.

  63. teve tory says:

    I think at some point the House Freedumb Caucus may push it so far that GOP leadership says, you know what, fuck these assholes, let’s moderate a bit and talk to the dems and compromise, like happened for 80% of our country’s history.

  64. Mikey says:

    @gVOR08: They are generally stupid, but that’s not really why they can’t come up with a few tweaks to improve the ACA.

    Because all the tweaks that would improve it would move it further toward single payer, and to them that’s like a garlic mouthwash to vampires.

    They have literally nowhere to go on this that even so-called moderate Republicans would accept.

  65. DrDaveT says:

    @Tyrell: OK, I have to agree with PC101 — this has to be performance art. It is simply not possible to be that uninformed that articulately, consistently, across multiple issues.

    For the record:

    1. Other than the mandate, the problems you cite are not problems with Obamacare, they are problems with health insurance. All of them are better under Obamacare than they would be without it.
    2. The mandate is why Obamacare (or any other plan) works. If you don’t make healthy people participate, the plan goes broke. Repeat this to yourself at night until it sinks in.
    3. Nobody is garnishing anything with respect to the mandate; that’s why it’s unenforceable. You are being lied to, and you are eagerly, willingly gullible. As Yogi Berra said,

    You could look it up.

  66. Bob@Youngstown says:

    @Tyrell:

    no frills Medicare plan to who ever wants it, some options

    Do you even know anything about Medicare? Could you please explain to me how to sign up for the “frill” plan in Medicare?

    The goal should have been to create a broad cafeteria type program

    It’s the cafeteria mentality that is problematic. IMO many Americans think that an healthcare insurance program works best when it is individualized to their specific (and perceived) needs.
    Taken to the extreme, you would have to price every type of coverage, potentially ending up with millions of unique policies. (” I demand coverage for my lower dentures, but I don’t want coverage for uppers !”)

  67. DrDaveT says:

    @grumpy realist:

    I keep telling people that progressive taxation is a kind of insurance that keeps rich people from being hanged from lampposts.

    Republicans think that’s what the police and the National Guard are for. I don’t think they’ve actually done the comparison shopping on the relative costs.

  68. Tyrell says:

    @Bob@Youngstown: Those are good thoughts. I was not leaning toward a huge amount of options. Something more along the lines of the supplemental plans that go under Medicare. And dental – vision coverage options that would go from basic to broad. More families today are looking at orthodontics. Some have coverage for that through employer plans that they pay extra for.

  69. Just 'nutha ig'nint cracker says:

    @Kylopod: Good call in 2015 still…” I simply don’t believe the GOP is stupid enough to do such a thing even if they win the trifecta in 2016.”

    No, but they were stupid enough to try, and that’s the problem. They may have only been lucky on this one and there are plenty of stupid things on their To Do list. Programs to abolish, wars to fight, Trees of Liberty to plant, etc.

  70. Just 'nutha ig'nint cracker says:

    @Pch101: You guys keep talking as though the GOP wants to “solve” something. Where are you getting that from. Even from the days of Reagan’s “over a hundred wasteful government programs” list, not only did the GOP never act on a single one of the items on the list, but also Reagan himself never asked Congress for a single cut, only challenged them to make some.

  71. Just 'nutha ig'nint cracker says:

    @Eric Florack: So you’re basically in favor of no one having access to affordable health care unless they get it from their employer or market forces can compel doctors and hospitals to lower their fees, profit margins, and incomes. Got it!

    But you are correct; that is the classical conservative position on the matter. It’s part of the reason there are so few classical conservatives; it only works for the wealthy (and maybe not even for them, truth be told).

  72. Pch101 says:

    @Just ‘nutha ig’nint cracker:

    As I said above, “This is the usual war between the establishment that tries to fix everything with tax credits and the extremists who try to fix everything by destroying it.”

    The GOP establishment loves tax credits. Establishment Republicans regard themselves as insightful intellectual giants whenever they babble about tax credits, even when they make little sense, because tax credits are central to their ideology.

    The hard right loves to break s**t. They are reactionary nihilists to the core.

    You may not consider either of those approaches to be solutions to anything — I know that I don’t — but they do. And many of their “solutions” are for problems that don’t exist.

  73. Just 'nutha ig'nint cracker says:

    @grumpy realist: No, but we will get an additional tax cut and an increase on the debt ceiling. Either that, or I’ll be trying to by 10 or so acres of arable land and a bag of seed potatoes–the new standard of wealth after the economic “game over” when the dollar collapses..

  74. DrDaveT says:

    @Pch101:

    Establishment Republicans regard themselves as insightful intellectual giants whenever they babble about tax credits, even when they make little sense, because tax credits are central to their ideology.

    In a recent thread elseblog, I asked for some suggestions about where to find genuine Conservative thought, in order to evaluate it on its merits. You provided some helpful suggestions, and noted that Conservatism is basically about valuing tradition.

    I’m now reading Too Dumb to Fail by Matt K. Lewis, which has the advantages of (1) being by an actual Reagan Conservative who thinks his party has been hijacked, and (2) attempting to explicitly establish the historical and intellectual foundations of Conservatism (and their obvious superiority to the alternatives).

    It’s worse than I thought.

    It’s one thing to believe that progress is best achieved when it is slow and incremental, as Edmund Burke did. It’s another thing entirely to explicitly tie this to Aristotelian (and mediaeval Christian) notions that the social order we have is natural and proper. I can’t yet tell whether that’s Lewis’s evangelical Christian beliefs peeking through, or a genuine part of Conservative thought, but it’s scary either way. (It also makes it hard to see how a Conservative could ever want to abolish slavery…)

    Then there’s the fundamental tension between Burkean notions that the status quo was crowdsourced from the smartest people in history*, versus Lockean/Libertarian notions that the natural state of man is liberty and that there are intrinsic human rights. Lewis handwaves this one away, but it is fundamental — the purpose of government and the proper goals of those in power are radically different under those two different axioms.

    I’m barely into the book, and already the intellectual argument is a mess.

    *Burke apparently never considered the fact that all of the systems we currently have, including the Western model, were devised by the powerful for their own benefit. There’s also the question of what is special about Western civilization, among all of the other crowdsourced solutions still out there. Maybe someday I’ll get some statement of what the goal is, but Lewis has not yet defined what ‘progress’ means to him.

  75. teve tory says:

    @teve tory:

    Holy Cow! I called it!

    Rebecca Berg‏Verified account @rebeccagberg 3 minutes ago
    More
    Rep. Kinzinger tells RCP: it’s time to forsake Freedom Caucus & work w centrist Dems. “I think that’s going to have to be the new coalition”

    The House Freedumb Caucus refused to compromise, and they may wind up just ignored while policy goes in a more moderate direction. Good work idiots!

  76. teve tory says:

    The HFC is literally 17% of the GOP Reps, and they insisted on getting everything they wanted cause they’re DUUUUUUUUUUUMB and they don’t know how shit works.

  77. Pch101 says:

    @DrDaveT:

    Change is inevitable, and modernity speeds up the rate at which things change. Conservatism can’t adapt to this ever-evolving paradigm, so the movement stumbles and fails time and again.

    Peter Drucker noted that companies had to reinvent themselves periodically because the alternative to adaptation was death — the world keeps turning, whether or not you want it to. This same principle can be applied to political systems, which need to be flexible enough to cope.

    Liberals may be wrong about change being virtuous unto itself, but the liberal position is better positioned to deal with change because it embraces change instead of resisting it. To deny change is to deny reality, which explains all of the fake news that comes from the right: the real world and the opposition to change that is inherent to conservatism simply don’t mix.

  78. Bob@Youngstown says:

    @Tyrell: You are not comprehending the notion that individualism is inconsistant with healthcare insurance!

    When I was covered by my employers group plan I could elect dental coverage or vision coverage – for an additional premium payment. HOWEVER…. there were separate policies with separate insurers. Sure, to me it appeared as one premium, but there were actually 3 premiums and three policies.

    What I hear those complaining about Obamacare policies is that they are too broad, and incorporate too many coverages that they don’t want or need. They want to pick exactly what they think they need and no more.

    Cafeteria style insurance, at the granular level that some want, will only make the admistrative costs of insurance greater.

    Ok, you don’t want pediatric dental on your policy… That would reduce your premium by what? less than a dollar I’d guess. But because your policy (writing out that coverage) is now atypical it costs more to administer so your “savings” are offset by additional costs. (At some point it’s just cheaper to leave the spare tire in the new car than to have another person needed to remove it.)

    Lindsey Graham doesn’t like that he has maternity coverage. I’d bet he has no idea how much that coverage adds to his premiums, or has ever tried to find out. Because that’s not the point, he doesn’t want it on principle.

  79. David M says:

    HFC didn’t kill the bill, the GOP was nowhere close to passing this. There were at least as many other GOP reps that were not voting for a bill that would kill the Medicaid expansion and take health insurance away from 24 million people.

    It was a crap bill because the GOP can’t/won’t do complicated policy anymore. That’s why it died.

  80. Pch101 says:

    @Bob@Youngstown:

    “Tyrell” is either a performance artist or an idiot. His internet persona spews the same stuff ad nauseum, no matter what anyone says. Don’t waste your time.

  81. JohnMcC says:

    @DrDaveT: I asked my TeaParty sister (a PhD in biology BTW) for some reading to explain her “conservative” ideology. She recommended something by Mark Levin. Have you ever read Mark Levin? Don’t.

    Some time ago on this blog I communicated with someone (was it you?) about Russell Kirk who I had somewhat idolized when I was in my twenties. That led me to re-visit Kirk. He’s miles and miles better than Levin but has nothing to offer to explain what now-a-days is called “conservative”.

  82. Just 'nutha ign'int cracker says:

    @DrDaveT: I may be misreading Locke (which would be intriguing to me because I have sat lectures and given lectures on Locke on 3 separate occasions), but as I read him, he is not as much a “the natural state of man is liberty” guy as much as “in the natural state, liberty yields anarchy and chaos” sort. The anarchy and chaos lead us to enter into contracts in which we trade freedoms that are less valuable for reliefs from anarchy and chaos that are, at least in theory, more valuable. (Hobbes seems to inform some of Locke’s theories, too.)

    I think the most critically important element in Locke’s Two Treatises is the notion (somewhere in the third section IIRC) that the fact that a contract is established will not automatically yield a just or moral social system. That morality and justice get affirmed only to the extent that the majority tempers their desires to protect the interests of the minority. Locke can be used to explain Burkean theories as well as any theories.

    How Libertarians reconcile their belief that they are heirs to Locke–considering that he is considered a father of liberalism–is beyond me. But then again, I don’t get how Mark Levin equates “small government Conservatism” with “True Federalism” either. Constructed reality is a wondrous thing.

  83. Just 'nutha ign'int cracker says:

    @JohnMcC: I listen to Mark Levin on the radio coming home from teaching some days. Sometimes, I can listen for as many as 3 or 4 minutes before he says something so mind-numbingly stupid that I almost lose control of the car from laughing so hard.

  84. DrDaveT says:

    @Pch101:
    Thanks for the reply.

    Change is inevitable, and modernity speeds up the rate at which things change. Conservatism can’t adapt to this ever-evolving paradigm, so the movement stumbles and fails time and again.

    I keep coming back to the fact that no conservative will ever explicitly state what the goal is. Edmund Burke believed that history showed steady progress and improvement in the social order. Progress toward what? Improvement measured by what standard? You have to have a metric before you can compare two things and say that A is better than or worse than B.

    Liberals have a pretty straightforward metric: people should be happy and healthy and productive, increasingly into the future. They can brangle about the best way to bring that about, or about the right trade between current and future happiness, but those are quibbles about means, not the goal. And personal liberty is (on this theory) a means, not and end in itself — it’s good to the extent that it makes people happy and healthy and productive, but unhelpful if taken to extremes. (Insert obligatory Somalia quote here.)

    I keep looking for a conservative principle that, in 1500 or 1700 or 1800, would induce a conservative to fight to end slavery. I haven’t found one yet. It’s pretty clear that Abraham Lincoln was not a conservative (though, ironically, FDR was).

    Liberals may be wrong about change being virtuous unto itself, but the liberal position is better positioned to deal with change because it embraces change instead of resisting it.

    I think it’s a caricature of liberalism to say that it values change for its own sake. As noted above, liberalism values change that promotes the goal, and abhors change that moves away from it. They can be wrong about what is going to work, or whether a particular change will turn out for the best. To cite Lewis’s favorite example, the French Revolution was not bad because it eliminated the French aristocracy; it was bad because it was the wrong way to go about it, and led to new problems at least as bad as the old ones, at least for a time.

  85. gVOR08 says:

    @DrDaveT:

    Burke apparently never considered the fact that all of the systems we currently have, including the Western model, were devised by the powerful for their own benefit.

    I’ve not read more than bits and snatched of Burke, but many conservatives would regard this as a feature, not a bug.

  86. DrDaveT says:

    @Just ‘nutha ign’int cracker:

    I may be misreading Locke (which would be intriguing to me because I have sat lectures and given lectures on Locke on 3 separate occasions), but as I read him, he is not as much a “the natural state of man is liberty” guy as much as “in the natural state, liberty yields anarchy and chaos” sort.

    No, that sounds right to me. It was Lewis who seemed to be lumping Locke into that group. Let me see if I can find the quote… Ah, here it is. Lewis is actually quoting Craig Shirley and Don Devine, writing in the Washington Post:

    Modern American conservatism has roots in the ideas of philosopher John Locke, the founding fathers, and the notion that humans’ natural state is freedom.

    (Aside: in a book that claims to be re-establishing intellectual cred, you cite the WaPo for key points?)

    I suppose that could be read to mean “…the notion that…” in addition to Locke and the founding fathers, but that’s not the most likely reading to me.

    How Libertarians reconcile their belief that they are heirs to Locke–considering that he is considered a father of liberalism–is beyond me.

    Indeed. The one thing this book really is helping me understand is the unnatural cyborg that is modern conservatism. It wants to claim Aristotle, Aquinas, St. Paul, Burke, Adam Smith, Locke, the founding fathers, Ayn Rand, and the Chicago school as core thinkers — but those writers make fundamentally incompatible assumptions about reality, morality, and the purpose of government. No three of them can be simultaneously right. (Lewis comes close to admitting this once or twice, but then yells “squirrel!” and heads off on a different tack…)

  87. anjin-san says:

    For all Trump’s flaws – and there are a great many of them – he does undeniably have an oddly effective skill set that has taken him far.

    That being said, he reminds me of a talented athlete who lacks focus, discipline, and a capacity for hard work. You see these guys all the time. They ride their talent a long way, but when they get to the big leagues, they lack the other tools needed for success at that level.

    I’ve talked to some of the most successful athletes in the country about this, and they all say roughly the same thing – if you want to be a winner in the big leagues, talent alone won’t take you far. You need to work hard, consistently. You need to understand that the people around you have talent too, you need to be able to work with the team. You need to be very, very disciplined.

    Trump is just not built for success at this level. He’s Johnny Manziel.

  88. DrDaveT says:

    @JohnMcC:

    Some time ago on this blog I communicated with someone (was it you?) about Russell Kirk who I had somewhat idolized when I was in my twenties.

    Yes, it was me. (My mother the English teacher just shuddered, and has no idea why.)

    Matt K. Lewis loves him some Kirk, too. The lists at the back of the book look like this…

    Important Conservative Books:

    The Conservative Mind by Dr. Russell Kirk [NB: I guess the ‘Dr.’ part is important for cred]
    Politics by Aristotle
    The Conscience of a Conservative by F. A. Hayek [NB: his doctorate doesn’t count?]
    Reflections on the Revolution in France by Edmund Burke

  89. Kylopod says:

    @Just ‘nutha ig’nint cracker:

    No, but they were stupid enough to try, and that’s the problem.

    I never denied it. The question wasn’t whether a Republican president would make a high-profile push to do something he called “repealing Obamacare.” That was virtually inevitable, even as far back as 2012 if Romney had won. The question was whether such a president could get Congress on board. It’s like what happened to Bush’s efforts at Social Security privatization in 2005. Politicians can talk a big talk, but Congress members are usually a pretty good weathervane as to what their constituents are saying.

    A savvier president might have made a few minor tweaks to the law and called the result “Obamacare repeal.” It’s something I could easily see Romney having done, and it was something I always thought Trump might have done. (One thing both Trump and Romney have in common is that they’re both lying phonies whose past reveals they have no particular animus toward the idea of universal health care.) But it would have gone against Trump’s instincts as the right-wing id fueled, in large measure, by racist spite toward Obama. Meanwhile, it would have contradicted Ryan’s own ambitions on creating the Ayn Rand state.

  90. Kylopod says:

    @An Interested Party:

    Oh come now, what fool actually believes that Trump could ever have a successful Presidency?

    Depends what you mean by “successful.” It is possible for a president to do a lot of damage and still be a political success. Reagan is one example. Andrew Jackson’s presidency was quickly followed by the third-worst depression in US history, but because it didn’t happen directly on his watch, he was largely remembered as a great president until the recent attention toward policies like the, um, Indian Removal Act. Even Bush Jr. managed to win a second term.

    There are some parallels between Trump and Jimmy Carter. Not in terms of the two men’s personalities (there’s a fair distance from “committed adultery in my heart” to “grab ’em by the p*ssy”), but in terms of the fact that they were both outsiders who came more or less out of nowhere to win their party’s nomination by barreling their way though the primaries, and they both maintained a poor relationship with their party’s traditional factions. Partly as a result, Carter’s presidency was characterized by a notable lack of legislative achievements at a time when his party had more Congressional representation than any president since has enjoyed.

    Still, it’s important to keep in mind that this factor is not the reason Carter is remembered today as a one-term failure. Inflation and the Iran Hostage Crisis figure larger in most people’s memories. The public seems to reward and punish presidents for whatever happens during their tenure, regardless of its relationship to their actual performance. They’ll usually give the president a pass if things aren’t going too badly at the moment.

    We’re entitled to our bit of Schadenfreude now, and certainly I’m happy about the current outcome in terms of its consequences for health care in this country. But from a purely political perspective the GOP would be in a worse position if they’d actually passed this turd.

    What we really need to be prepared for is when Trump is forced to handle a major crisis, which will happen sooner or later. It’s a virtual certainty he’ll muck it up. But that does not fill my heart with joy.

  91. DrDaveT says:

    @Kylopod:

    What we really need to be prepared for is when Trump is forced to handle a major crisis

    I expect the Kremlin is preparing one as we speak. It’s Christmas every day for them, for as long as Trump is still “in charge”.

  92. Steve V says:

    @JohnMcC: Have you read Dahlia Lithwick’s review of Levin’s book about the Supreme Court? It’s hilarious.

  93. Bob@Youngstown says:

    @Pch101: yes, second time I’ve been suckered into engaging Tyrell. Perhaps he is a Russian blogbot !

  94. gVOR08 says:

    @JohnMcC:

    That led me to re-visit Kirk. He’s miles and miles better than Levin but has nothing to offer to explain what now-a-days is called “conservative”.

    I disagree, Kirk is quite instructive on modern conservatism, just not in any way Kirk intended. First, although he avoids saying so, it’s clear that religion is central to Kirk’s conservatism. It’s also clear between the lines that it’s important that the right people be in charge, people like Kirk. But the clearest lesson is what I dubbed “the Kirk Fallacy”, the belief that all change a conservative disapproves of was caused by political liberals. Kirk explicitly blamed liberals for urbanization and industrialization. A Trumpskyite is not sure why the auto industry left Flint, but he’s sure it’s Obama’s fault.

    It’s impossible to take seriously a book with a chapter on conservative thought in the ante bellum south that starts by saying he’ll ignore slavery because it’s complicated.

    If you wish to understand conservatives, I’ll recommend Corey Robin, The Reactionary Mind.

  95. DrDaveT says:

    @gVOR08:

    First, although he avoids saying so, it’s clear that religion is central to Kirk’s conservatism.

    This comes through loud and clear in Too Dumb to Fail, as well. Lewis is more up-front about the link, and indeed spends a chapter here and there talking about evangelical Christianity’s role in political history.

    Like most such authors, he makes the basic mistake of thinking that the only intellectual alternative to “my particular flavor of Christianity’s notion of morality, as revealed by God” is “all morality is relative”. He repeatedly characterizes liberalism as decadent, libertine, and unprincipled, unlike ‘moral’ conservatism. (He seems to have completely missed the fact that the hippy movement was driven by moral outrage at the warmongering and greed of conservatism.)

  96. JohnMcC says:

    @gVOR08: A ‘thumbs up’ regarding all you said about Kirk (I made the connection between Chesterton and Calvin – how the presently dominant coalition is always God’s choice – and expanded it to be foundational to essentially all ACTUAL true conservatism.)

    And thanx for the tip by someone who’s name I forgot. I’ll look up Dahlia Lithwick, book review, Mark Levin.