Trump ObamaCare Reversal Overruled AG and HHS Secretary

The decision to hand Democrats a victory and step on the good news from the Mueller report apparently came from the very top.

Yesterday, the Trump administration surprised us by reversing course on defending ObamaCare in court. Now we’ve learned that President Trump overruled his Attorney General and HHS Secretary on the matter.

POLITICO (“White House Obamacare reversal made over Cabinet objections“):

The Trump administration’s surprising move to invalidate Obamacare on Monday came despite the opposition of two key cabinet secretaries: Health and Human Services Secretary Alex Azar and Attorney General Bill Barr.

Driving the dramatic action were the administration’s domestic policy chief, Joe Grogan, and the acting director of the Office of Management and Budget, Russ Vought, according to three sources with direct knowledge of the decision. Both are close allies of White House acting chief of staff Mick Mulvaney, who helped to engineer the move.

But Monday’s terse, two-sentence letter from the Department of Justice to a federal appeals court, which reversed the administration’s previous partial opposition to a lawsuit challenging the 2010 health care law, took many Republicans aback — in part because they see it as bringing high political risk for a party that has failed to unite behind an Obamacare alternative and which lost House seats in the 2018 midterms when Democrats made health care a focus of their attacks.

The new challenge to Obamacare follows a heated internal administration debate that began late last year and continued through yesterday’s announcement. Azar argued against backing a lawsuit seeking the full repeal of the health care law at a White House meeting in late December, citing the lack of a Republican alternative, according to two sources briefed on internal discussions, while Mulvaney said that taking a bold stance would force Congress into repealing and replacing the law.

[…]

“It’s weird. It just doesn’t make a lot of sense legally and it doesn’t make a lot of sense in terms of the way DOJ normally approaches these things. DOJ normally tries to make litigation go away and tries to defend federal statutes,” said Jonathan Adler, a professor at Case Western Reserve University School of Law who has been a vocal opponent of the Affordable Care Act. “The substantive arguments in favor of that position aren’t very strong and you can’t find very many people who think the arguments in favor of that position are strong.”

Sam Stein, Sam Brodey, and Asawin Suebsaeng focus on the politics for The Daily Beast (“WTF Is Wrong With Them’: Republicans Horrified as Trump Goes After Obamacare Again“):

Over the past 24 hours, Republican officials have watched in horror as the Trump administration once again fully embraced the repeal of Obamacare, just over a year after the issue proved toxic for the party at the ballot box.

The embrace came in two steps: with the Department of Justice siding with a lower court ruling that declared the health care law invalid in toto, and with the president tweeting that the Republican Party would become the party of health-care reform. And it quickly complicated what had been widely viewed as one of the best weeks of Trump’s presidency. Ebullient over a four-page summary of Special Counsel Robert Mueller’s investigation into Russia’s meddling—a summary that said the president was not guilty of collusion—Trump suddenly found himself back in a debate that has vexed his administration.

GOP officials couldn’t help but marvel at Trump’s inability to enjoy a rare grace period. “They are completely tone deaf,” texted one of the party’s top strategists. “How bout a few more victory laps on Mueller while you can get away with it? WTF is wrong with them?”

But seasoned Trump hands were hardly surprised at the rake Trump had placed his foot on. “And there’s something unusual about him stepping on a good message?” one former administration official said, laughing when asked about the timing of the announcement.

Some of the timing of Trump’s foray back into the health-care wars was dictated by his own Justice Department. On Monday evening, DoJ announced its support for U.S. District Court Judge Reed O’Connor’s ruling that because Obamacare’s individual mandate had been zeroed out, the entirety of the law was now constitutionally illegitimate. O’Connor’s judgement had been widely panned in legal circles and even the administration had, to that point, stopped short of saying all of Obamacare should be undone because of the mandate’s demise.

As such, the department’s new position set off alarm bells among Republicans who had spent much of the 2018 election cycle trying to alleviate voter concerns that their attempts at health care overhaul would—contrary to the likely outcomes—leave those with preexisting conditions vulnerable to the whims of private insurers. Fergus Cullen, the former chairman of the New Hampshire Republican State Committee and a critic of the party’s approach to Obamacare repeal, compared the rejoining of the debate to the famous battle-of-wits scene in The Princess Bride.

Paul Waldman does the same for WaPo (“The Trump administration just handed Democrats their best 2020 issue“):

Why would the administration do something that is both so substantively horrifying and so politically bonkers? I have a theory, one rooted in President Trump’s unusual approach to both ideology and politics.

[…]

When he ran for president, Trump made lots of noises that suggested he was something of a moderate, at least on a few issues. He’d claim that he’d protect Medicare and Social Security, and even promised that he’d provide “insurance for everybody.” But no one really took those statements seriously, because it was obvious that outside of trade and immigration, Trump has no particular beliefs about any issues, much less a coherent ideology that guides him.

But instead of producing moderation, Trump’s ideological blurriness led to a more conservative set of administration policies. His own beliefs provide no borders within which his aides are required to work. And since he is so corrupt and personally despicable, many of the more sensible Republican policy wonks who would have staffed a different Republican administration chose to stay away, leaving the administration to be filled either by people who shared Trump’s penchant for self-dealing or by extremist ideologues who correctly surmised that a president who didn’t care about policy would give them free rein to indulge their wildest fantasies.

Now add in the fact that unlike other Republican presidents, Trump sees no political advantage in expanding his support. He firmly believes that his political survival depends only on keeping his most ardent supporters satisfied with what he’s doing while also keeping them agitated and angry at his opponents. So there is never a moment when Trump will say, “Hold on, that’s going too far — moderate and independent voters will be angry if we do that.”

When you combine these two factors — Trump’s indifference to policy, and his desire to play to his base and only his base — the result is an administration that is in many ways more conservative than any in modern history.

For them, the thought of taking away health coverage from tens of millions of Americans and removing vital protections from tens of millions more isn’t an unfortunate consequence of their effort to destroy the Affordable Care Act; it’s the whole point. That’s what victory looks like to them.

I suppose it’s as good an explanation as any. But it still starts with the unproven assumption that Trump has a strategy rather than simply acting on impulse.

FILED UNDER: Health, Law and the Courts, US Politics
James Joyner
About James Joyner
James Joyner is a Security Studies professor at Marine Corps University's Command and Staff College and a nonresident senior fellow at the Scowcroft Center for Strategy and Security at the Atlantic Council. He's a former Army officer and Desert Storm vet. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. An Interested Party says:

    For them, the thought of taking away health coverage from tens of millions of Americans and removing vital protections from tens of millions more isn’t an unfortunate consequence of their effort to destroy the Affordable Care Act; it’s the whole point. That’s what victory looks like to them.

    Hehe…did someone say something about a Mueller report? What was that? By the way, how would you feel if Mr. Make America Great Again took away your health care…

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  2. A very stable genius, dontcha know.

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  3. Hal_10000 says:

    the result is an administration that is in many ways more conservative than any in modern history.

    I would disagree that characterization. Radical would be a better description. This is no way represents something like Burkean conservatism or even Reagan conservatism. Whatever you think of Obamacare — and I think it has problems — it’s constitutional. It’s not the job of SCOTUS to repeal law Republicans can’t repeal themselves.

    And for Trump and his minions, I don’t even think it goes that deep. If people lose insurance, they just don’t care. What matters to them is that Obama was for it, so they’re against it. The animating spirit of the Republican Party right now is to try to destroy as much of Obama’s legacy as possible — good or bad. If Obama had cured cancer, they’d be trying to abolish it.

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  4. Moosebreath says:

    Trump is trying hard to ensure everyone thinks about him when they think about their health insurance.

  5. @Hal_10000: Indeed. If a hallmark of conservatism (at least of the Burkean or even Kirkian varieties) is slow, steady change and a concern over the possibility of unintended consequences of massive policy shifts, this administration is not conservative.

    (As I keep saying, it is more reactionary than it is anything else, and recklessly so).

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  6. OzarkHillbilly says:

    But it still starts with the unproven assumption that Trump has a strategy rather than simply acting on impulse.

    trump has a strategy James, it was dictated to him by Mulvaney. Just like his strategy on Iran was dictated by Bolton. Waldman hit the nail on the head,

    leaving the administration to be filled either by people who shared Trump’s penchant for self-dealing or by extremist ideologues who correctly surmised that a president who didn’t care about policy would give them free rein to indulge their wildest fantasies.

    Ooooh, that’s a bingo!

  7. gVOR08 says:

    @Hal_10000: “Radical” is indeed a better description. And always has been.

    I’ve taken to putting “conservative” in quotes as a caution that it’s a slippery word without clear definition. I had failed to find any definition that matches reality. Slow steady progress certainly doesn’t get at it. A Russian conservative in 1917 supported the Czar, in the 90s, the Communist Party. The definition in other usage does not fit the political usage of the word. IIRC the psych people have solved the absence of any particular constant policy orientation by accepting that it’s a personality trait.

    However, I may be finding a good definition. I have been reading Corey Robin’s new edition (as in complete rewrite) of The Reactionary Mind. He has studied “conservatism” through history and realized it is always radical. And always, as with Trumpism, populist. This is because it is, indeed, reaction. The constant is refusal to allow equality, for Burke equality of candle makers and hairdressers. It really always has been being against whatever liberals are for, updated weekly. Short, therefore unfair, summary. Recommend the book for your consideration.

  8. Pete S says:

    @Hal_10000: I think it goes beyond hating Obama although that is a big part of it. I believe that a lot of Trumps minions will happily forego health insurance as long as someone they don’t like down the street loses their insurance as well.

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  9. Daryl and his brother Darryl says:

    @Pete S:

    I think it goes beyond hating Obama

    I agree. I think the entire issue is that Dennison’s base, as well as Dennison himself, are all just too stupid to understand the issue.
    Just last night I saw a Republican on CNN talking about how rates in his state are up. When it was explained to him that, yes, rates are up, but not as much as they would be absent the ACA…he just could not comprehend it. The concept of bending the rate increase curve down is beyond them.

    All I can say is that I hope Republicans stay on this path.

  10. Daryl and his brother Darryl says:

    So Dennison promised big beautiful health care for everyone…and is now trying to throw millions off health care.
    This just out…he lied about tax reform too.
    He promised the tax reform bill would lead to $4T in repatriated offshore profits.
    He missed by over 80%.
    https://www.bloomberg.com/news/articles/2019-03-27/trump-s-offshore-cash-promise-falters-as-665-billion-returns?srnd=premium
    So much winning…

  11. James Pearce says:

    And since he is so corrupt and personally despicable, many of the more sensible Republican policy wonks who would have staffed a different Republican administration chose to stay away, leaving the administration to be filled either by people who shared Trump’s penchant for self-dealing or by extremist ideologues who correctly surmised that a president who didn’t care about policy would give them free rein to indulge their wildest fantasies.

    You read so much anti-Trump booolshit that it’s actually refreshing to read something that seems to really get him.

  12. Gustopher says:

    I sort of wonder if there was a plan to do this after the Mueller Report dropped if it indicated wrongdoing, to try to steer the news cycle away, and give the base a reason to rally behind their president.

    Then the Mueller Report drops, we get the Barr letter characterizing it as “Good news, everyone! The Trump campaign did not illegally coordinate directly with the Russian government!”, and they just go with the Don’t Defend ObamaCare plan anyway.

    Because they are good with details like that.

  13. reid says:

    A random headline: “Trump vows to have a health plan ‘far better than Obamacare'”. Who believes this BS anymore? The fact that this isn’t roundly laughed at is what’s wrong in this country.

  14. @reid: Come now! There have been a whole lot of alternative plans put forward. Last time I checked there were at least zero.

  15. reid says:

    @Steven L. Taylor: Heh. A future McConnell speech: “We have quite clearly put forward more than -1 proposals that would completely solve the health care crisis in this country, but the Democrats only care about witch hunts and marching this country towards socialism a la Venezuela, which would bankrupt the country.”

    That’s too close to possible for my comfort.

  16. @reid: Indeed.

  17. SC_Birdflyte says:

    @Steven L. Taylor: Dr. Taylor, I would go further than that. It’s not reactionary, it’s gone beyond that into the land of radicalism. With the President’s reptilian instincts, this is hardly surprising.

  18. Mikey says:

    @Pete S:

    I believe that a lot of Trumps minions will happily forego health insurance as long as someone they don’t like down the street loses their insurance as well.

    About 10 years ago, a guy with the nom de plume Davis X. Machina wrote this in a comment at Balloon Juice. It’s as true today as it has ever been.

    “The salient fact of American politics is that there are fifty to seventy million voters each of whom will volunteer to live, with his family, in a cardboard box under an overpass, and cook sparrows on an old curtain rod, if someone would only guarantee that the black, gay, Hispanic, liberal, whatever, in the next box over doesn’t even have a curtain rod, or a sparrow to put on it.”

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  19. @SC_Birdflyte: Radical, to me, would imply rapid change towards something new, while reactionary means rapid retrogressive change.

    He wants to go back to an imaginary (this word is important) past filled with beautiful coal and steel and when American companies dictated the terms of global trade, and so forth (and when, whites and dudes were in control). MAGA! is inherently reactionary.

  20. MikeSJ says:

    Two points here: Firstly I think one of the key drivers of the right wing/trump people is just straight up Sadism. I know that sounds a little bit over the top but sadism does seems to explain an awful lot of why Trumps people do what they do. DeVos cutting all funding for Special Olympics? Why in the world would this even be proposed? Answer: hurting people is the goal, the fact those hurt are special needs children is just a bonus for them. Throwing out the ACA with zero plans to replace it? How else to explain it?

    The second point: A national plan for health reform is vulnerable to attack & sabotage from those who oppose health reform, in other words the red states.

    A safer, stronger option would have been states organizing their own plans e.g. A Pacific plan for states on the west coast and an Atlantic plan for east coast states. I realize lots of people outside these areas would suffer but as they vote over and over for people who oppose health care for them I simply don’t know what can be done for them (see Utah for a perfect example of this.)

  21. Sleeping Dog says:

    The contemporary Republican Party is no longer conservative in any meaningful sense but has slipped into revanchism, there whole goal is to return the US as to what it was at the time of the first golden age. The plutocrats rule, workers are chattel and minorities are subject to Jim Crow.

  22. Monala says:

    @MikeSJ: Utah might be better off than most red states. The Mormons have a long-standing tradition of taking care of their own.

  23. Gustopher says:

    @Steven L. Taylor: Revanchist is the word that comes to mind for me.

    It’s usually about losing territory, but I would argue that they feel they lost territory in the War of Northern Aggression.

    It fits in with the rhetoric of wanting to take their country back, and Real Americans, and protecting the border and their precious bodily fluids from infiltration.

  24. @Gustopher: I can see the usage. I think what you are describing fits into what I am describing with reactionary.

  25. Teve says:

    @MikeSJ:

    DeVos cutting all funding for Special Olympics? Why in the world would this even be proposed?

    Jim Wright’s take on that:

    Seriously, it’s like they were sitting around the Cabinet table and Trump was all, “I know we are incredibly shitty, but are we shitty ENOUGH?”

    And Betsy raised her hand, “I have an idea…”

  26. Kathy says:

    Keep it up, and in a few years we’ll build a wall to keep Americans out.

    And Trump will pay for it 😀

  27. dazedandconfused says:

    It may be Trump’s main goal here is to reinforce his standing with the “base”, that 2-3% of the population that bothers to vote in R primaries. Hatred of anything Obama reigns supreme there still.

    Trump is shrewd in certain ways, particularly in the area of maintaining power through fear. He may be aware his control of the party stems largely from fear of him organizing a primary against them. Highly effective on the weak of spine. Lindsey’s curious transformation from outraged critic to FDAU springs to mind.

  28. An Interested Party says:

    You read so much anti-Trump booolshit that it’s actually refreshing to read something that seems to really get him.

    It’s pretty obvious to anyone who is paying any attention that this idiot doesn’t care about policy…self-aggrandizement is the altar he worships at…

  29. SC_Birdflyte says:

    @Steven L. Taylor: You make a good point, but the question is: When does trying to go back to some mythical golden age turn into trying to smash the sand castle because someone did most of the work on it? I confess I have no good answer.