The sudden sprint has encouraged reporters to bring out terms redolent of Trump’s past career: “Trump goes into dealmaking mode,” says The Washington Post. “Trump in ‘sell mode’ on health care,” adds ABC News. The best metaphor might go back to Trump’s days running casinos, though. The president is making a big bet.
One side of the wager is the idea that he has enough political capital to push through some sort of repeal bill. The problem is, as my colleague Russell Berman reports, that Congress has a narrow window in which to push through the new health plan. So what happens if Cotton proves correct, and the bill fails?
According to CNN, Trump has a contingency plan:
In an Oval Office meeting featuring leaders of conservative groups that already lining up against House Republicans' plan to repeal and replace Obamacare, President Donald Trump revealed his plan in the event the GOP effort doesn't succeed: Allow Obamacare to fail and let Democrats take the blame, sources at the gathering told CNN.
Even if that is Trump’s hedge, he’s charting a precarious path, which is premised on his own ability to separate himself from Republicans in Congress.
Actually, every path is daunting. Let’s say that Trump gets Republicans to coalesce around the replacement plans. That could be, as Democrats can well attest from their experience passing the Affordable Care Act in the first place, a dicey proposition. Millions of people, many of them Republican voters in November, would likely lose their coverage or see the price go up. For the first time in its life, Obamacare has a net favorable rating with voters, but it struggled as long as Democrats were in control. Voters seem to hate anyone messing with their health care, even when they don’t like it that much, and will penalize the party that does that.
Now, let’s say that the bill fails, and GOP leaders can’t salvage something. That would certainly be embarrassing for them. The Republican Party has spent the last seven years railing against Obamacare and promising to eliminate it at the earliest chance. Voters have now given them a chance, with unified control of the White House, House, and Senate. As Speaker Paul Ryan put it Thursday, “This is the closest we will ever get to repealing and replacing Obamacare.” How can they justify not getting it done?
One answer is to leave Obamacare in place and let it fail. That plan depends on Obamacare actually failing. While the law would struggle without the marketing the Obama administration put behind it, it’s unclear that it would collapse outright. In any case, the liberal journalist Greg Sargent sees this as an effective strategy:
If the law survives, Trump can spend the next couple of years claiming that it is collapsing all around us—or rather that it continues to collapse, since it is already collapsing as we speak. And Republican voters will of course believe that this is the case, since it is an unshakable truism for them that the law has already failed in spectacular fashion.
Accepting this requires a very cynical view of Republican voters, and of Republican members of Congress, believing that they don’t actually care about repealing the law and that, in the case of the voters, they won’t have been following the news. One lesson of the fights over the debt ceiling in the last few years is that conservative members really care about their priorities, even when misbegotten. One needn’t agree that repeal is good to believe that many Republicans sincerely want to get rid of the law. If the GOP Congress fail in its repeal effort and then just gives up and moves on, it’s reasonable to expect that some of its members will face primary challenges in 2018, and that voters will penalize some of them, though it’s tough to know how deep the impact would be.