Sunday, October 15, 2017

Playing with Fire

Trump's moves against the ACA are not astounding--nor even surprising--but they are risky. How so (other than the obvious?).

1. The Obvious

The obvious issue with what the president is doing is the "law" that whichever party "owns" health care "loses." This is a way of saying that every attempt to make anything other than minor adjustments to health care will be either a huge "net loss" or, at least, a very, very potential net-loss with voters.

In other words: with the best intentions and the clearest plans, going into this mess is super risky.

Does Trump sound like a guy with clear intentions or any sort of plan?

2. The First Problem: What Does Trump Want?

The view from The Omnivore's window is that Trump wants to get rid of Obama's administration by any means necessary. There's a fair argument that his base expects him to do this and approves--and that Republicans in general expect this and approve.

However, if we're talking about just "keeping his campaign promises" he did pledge to replace Obamacare with something better--for, like, everyone. Assuming that he will eventually put something better together is, to put it mildly, a hell of a stretch right now.

So what does he expect this to do, exactly? The charitable answer is that hacking up the ACA will "force congress to move." Move where? Move to what? No one is sure. But this is still the charitable take.

Now, it's charitable--but it's also stupid. Trump's party controls congress. If congress is to "move" it has to be done by the Republicans. Where do they want to go? No one can agree--just damaging what's there won't necessarily make the "repeal everything" guys side with the "keep some aspects" guys and vice versa.

It's the worst of both worlds.

Ahh--but what if what he wants to do is get the Democrats to sign on to a repeal-most-of-the-ACA plan in order to keep some recipients covered?

Then--maybe it would be smart--right?

3. Wrong. It Would Be Catastrophically Stupid

The idea that Trump is going to force bipartisan agreement on health care with the wave of his pen is, perhaps, one of the worse ideas going. If there is bipartisan agreement on health care it will be either on Democratic terms--or because a very, very risky bet paid off.

Why? Well, for one thing, The Democrats are pretty willing to have a big messy health care fight in the middle of the GOP trying to do Tax reform and deal with Iran, and so on. If you benefit from the other guys looking like more of a mess then you applaud the bigger mess.

The second thing is that in order for this to work properly it has to be a This-for-That. That is: Trump gets something he wants--the Wall funded? And the Democrats get something they want--Americans with real coverage.

But this poses the question: Does that mean that Republicans don't care if people have coverage? Well, yes--that was the point. They did agree that "something" should be done with health care--but no one agreed on what that would/could be. Certainly their voters want to keep some of the protections--yes? And while the GOP would like to repeal O-Care's 880MM taxes on the rich, if they come out and say "Yes, we care more about that than poor people going to the doctor," that's going to be a disaster.

So they have to say that what Trump is doing will improve health care--that it's a step in the right direction--and that the Democrats are stopping it from going further.

That's why this is a bad bet: There are arguments to be made (that the CSR payments are illegal since the bill does not appropriate the money--it just spends it)--that the restrictions saying care has to be pretty darn solid limit options--especially for the healthy who want only catastrophic care--if even that.

But no one is prepared to really make these arguments outside of op-ed pages. The fact is that Trump just took credit for collapse and chaos and it will be hard to get any other message past the Mainstream Media. As a result--and this was the same with the Government Shutdown--the participants on the GOP side have their story to tell--but they are relying on the Mainstream Media carrying a lot of that water for them (less today than in the past--but still).

That isn't going to happen when POTUS is undermining it daily.

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