It’s a typically hot and sticky July in Washington, but in some ways it feels just like late March all over again. A health-care bill backed by President Trump has collapsed in dramatic fashion, and Trump knows just who to blame: anyone but himself.
The latest failures, first of a Senate Republican bill to repeal and replace the Affordable Care Act and then the expected defeat of a subsequent, last-ditch effort to simply repeal the law and worry about a replacement later on, offer a vivid picture of Trump’s leadership style, his strategic and tactical missteps, and why he can’t seem to push any of his priorities through in Washington, despite holding majorities in both the House and Senate.
For one thing, Trump has been almost entirely absent from the process with this bill. He’s recently been traveling—first to Poland and the G20, and then another trip to France—and dealing with the increasingly toxic Russia situation, including the revelation that his son met with a Russian lawyer in hopes of getting dirt on Hillary Clinton. He’s largely been disengaged from the process of twisting arms and changing hearts on the health bill.
“I am sitting in the Oval Office with a pen in hand, waiting for our senators to give it to me,” he told Pat Robertson in an interview last week. But that was part of the problem. While he sat passively, Senate Republicans were fighting over what to include in the bill. Trump’s involvement might never have made a difference; perhaps the distance between what Rand Paul wanted and what Susan Collins wanted was always too big to bridge. But the president has never demonstrated any serious understanding of health-care policy, and by surrendering the chance to lay out parameters, he allowed the GOP caucus to spin off in several conflicting directions.
By the time Trump finally got involved, hosting rank-and-file members at a White House dinner Monday night, it was too late. As they supped, Senators Jerry Moran and Mike Lee announced they opposed the repeal-and-replace bill, dooming it.
That set Trump’s short fuse alight, producing a string of tweets that has continued ever since. First, he criticized congressional Republicans for trying to repeal and replace Obamacare simultaneously:
Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in!— Donald J. Trump (@realDonaldTrump) July 18, 2017
It’s an interesting idea. It’s also one that some Republicans wanted to pursue back at the beginning of the Trump administration, when the president labeled repeal his top priority. GOP leaders knew that it would be difficult, and perhaps impossible, to write a bill that would achieve all that Trump, and members, wanted to do—to drive drown premiums, reduce costs, and leave entitlements in place, all while repealing the individual mandate. Repeal alone would allow a moral victory and push the difficult reckoning off into the future.
But Trump wouldn’t have any of it. He pressured congressional leaders to do both repeal and replacement at the same time, and they acquiesced. GOP leaders must have read his tweet demanding pure repeal with bitter humor. But Senator Majority Leader Mitch McConnell gamely announced he’d move forward with a pure repeal bill, only for three members of his caucus to announce their opposition—too many for the bill to move forward.
Trump scolded Republicans during his conversation with Robertson last week.
“For years, they've been talking about repeal-replace, repeal-replace,” he said. “I think they passed it 61 times, repeal and replace, but that didn't mean anything because you had the minority, the Republicans, they didn't have the majority so it wasn't going to get to the president, but if it ever did, Obama wasn't going to sign it.”
Trump is on to something here. GOP leaders played a cynical game with voters for years after the Affordable Care Act passed, repeatedly holding votes to repeal Obamacare, knowing that they didn’t have anything resembling a plan that could actually replace the law, achieve what they said it would, and garner enough votes. Once in power, they were suddenly confronted with that failure.
In an unusually frank moment, but one that was damning about the way he and his colleagues had acted in past years, Senator Pat Toomey of Pennsylvania said, “Look, I didn’t expect Donald Trump to win. I think most of my colleagues didn’t, so we didn’t expect to be in this situation.”
One might expect a candidate for president to have realized that before July, but Trump had even less interest in the health-care nitty gritty than most GOP senators. As it turned out, however, repeal alone does not appear to have enough votes among Senate Republicans to proceed either, despite Trump’s urging.
Not that the president was ready to accept any blame. Just as he did after the House’s first attempt at repeal failed in March, Trump blamed Democrats:
We were let down by all of the Democrats and a few Republicans. Most Republicans were loyal, terrific & worked really hard. We will return!— Donald J. Trump (@realDonaldTrump) July 18, 2017
This makes no more sense than it did in March. Democrats are a minority in the Senate, and both the repeal-and-replace and the clean-repeal plans failed because the Republican caucus couldn’t unify. The Democrats were never a factor in the debate. That’s not surprising: Why would any Democrat work to repeal the party’s signature policy achievement of the last decade in order to replace it with a plan that would leave tens of millions of people uninsured and increase premiums for many? The broadside against Dems came only about 10 hours after promising that they would work together to replace Obamacare—and an a hour and a half before Trump called for the Senate to invoke the nuclear option and totally eliminate the filibuster.
Meanwhile, Trump wants credit for almost not failing. “Essentially, the vote would have been pretty close to—if you look at it—48-4. That's a pretty impressive vote by any standard,” the president said at the White House on Tuesday, referring to the basic standard of reaching a bare majority of votes required for all legislation as “impressive,” a bravura act of bar-lowering. (Indeed, most bills these days require 60 votes, and it was only thanks to the reconciliation process that this bill needed only 50.)
Trump has the answer: He needs voters to send him a supermajority in the Senate:
With only a very small majority, the Republicans in the House & Senate need more victories next year since Dems totally obstruct, no votes!— Donald J. Trump (@realDonaldTrump) July 18, 2017
The bad news for Trump is that presidents typically lose seats in Congress during their first midterm election. That rule holds even for presidents who are not as historically unpopular as Trump is (a situation his failure to deliver repeal is unlikely to help); some forecasters believe 2018 could produce a Democratic wave.
The president has one more idea. “Let Obamacare fail,” he said Tuesday. “It will be a lot easier. And I think we’re probably in that position where we’ll just let Obamacare fail. We’re not going to own it. I’m not going to own it. I can tell you, the Republicans are not going to own it.”
Perhaps he is right, but it wouldn’t be surprising if he were wrong. Given unified control of the House, Senate, White House, and Supreme Court, as well as several failed attempts at repeal, the Republican Party will have a hard time convincing voters it doesn’t own the bill. (Don’t ask me, though. Ask Donald Trump, who in September 2013 tweeted, “NO GAMES! HOUSE @GOP MUST DEFUND OBAMACARE! IF THEY DON’T, THEN THEY OWN IT!”)
Although the collapse of the Senate bill echoes the March collapse of the House’s health-care bill closely, Trump doesn’t seem to have learned much from it. Perhaps the successful resuscitation of the House bill convinced the White House that the hands-off strategy worked well. The demise of the Senate bill shows, just as President Obama before him learned, that there are dangers in deference.
One notable difference this time was that no one expected Trump to contribute meaningfully to passing the bill. As the climax of the House bill neared in March, members of the House leadership team took to talking about Trump as “the ultimate closer.” There was no such talk from Senate leaders this time around.
As I wrote when the bill collapsed, Trump seemed to be overestimating his ability to bounce back from defeat. The president didn’t bring policy experience, or governing know-how, to Washington. What he brought was a reputation as an effective dealmaker. Once squandered, that reputation is difficult to reclaim, and his irrelevance to the Senate repeal-and-replace effort demonstrates that. One can understand, given Trump’s shaky salesmanship so far, why congressional Republicans would be reluctant to let Obamacare collapse and trust that Trump would successfully pin that on Democrats.
In the business world, Trump could quietly walk away from a deal, even if it meant taking a loss of millions of dollars. In New York real-estate, a few big losses were survivable, even if it meant lighting money on fire. Politics doesn’t work that way.
It is possible that McConnell, whose reputation for wiliness is bruised but not broken by the health-care collapse, will find some way to revive repeal, but Trump’s failures of marketing, strategy, and tactics on Obamacare repeal are the equivalent to lighting political capital on fire. If that was unwise in March, it’s foolhardy now, when Trump’s position is, thanks to the Russia matter, weaker than ever.
Six months into his presidency, the president has squandered his reputation as a dealmaker and spent away whatever political capital he had at the start of his presidency. Even worse, he has no major legislation to show for it.