Close Close

Life Health > Health Insurance > Health Insurance

Health Care Collapse Could Leave Trump Winless in First Year

Your article was successfully shared with the contacts you provided.

(Bloomberg) — President Donald Trump is now more likely than ever to end his first year in office without a single major legislative accomplishment.

His Affordable Care Act change effort collapsed Tuesday. He won’t even release the broad outlines of his tax overhaul plan until September. The last time Washington did a major tax bill, in 1986, it took more than a year. A $1 trillion infrastructure plan is little more than a talking point. Congress ignored his budget proposal. Republicans are as divided on all of these issues as they are on health care. Lawmakers haven’t even given him money to build his border wall.

(Related: Health Insurers’ Next Affordable Care Act Scare Is Just Two Days Away)

And between now and the end of the year, Congress still has to approve more than $1 trillion in federal spending, pass a veterans health care bill and navigate a debt-ceiling fight to avoid a potential default, all in the space of about a dozen working weeks. It doesn’t leave much time for legislating, even for a Republican president who came into office with a package of promises and a Republican Senate and a Republican House to boot.

The White House pledges next time will be different — preparing to launch a tax overhaul effort, complete with a coordinated strategy and travel by Trump to key states to promote the plan, something he never did in a concerted way with the Affordable Care Act change effort. The administration is asking corporate chief executives and conservative groups to pitch in with media appearances and town halls and is recruiting governors and local officials to do the same.

That still might not be enough. The failed fight over the Affordable Care Act exposed weaknesses that imperil much of Trump’s agenda: a historically unpopular and inattentive political novice in the Oval Office, an uncompromising hard-right wing on Capitol Hill, and their leadership’s inability to bridge internal philosophical divides.

Fruitless Months

The first casualty of the Affordable Care Act debate is time: six fruitless months exhausted on a subject Republican leaders had hoped to dispatch in January. And this was supposed to be the easy one. Since 2010, Republicans had promised a repeal. Trump and Republicans campaigned hard on the issue. Yet despite full control of Washington, they couldn’t get it done.

“Every Republican for the last seven years has campaigned on repealing Obamacare,” Republican Senator Ted Cruz of Texas said Tuesday. “I think the credibility of the conference is seriously undermined if we fail to deliver on that promise.”

On Wednesday, Trump said he planned to meet with Republican senators for lunch at the White House to see if they could try again to get a health care bill through the chamber. “They MUST keep their promise to America!” he tweeted. “The Republicans never discuss how good their healthcare bill is, & it will get even better at lunchtime.”

Surprised By Defections

Even by the standards of Trump’s own instincts to delegate the detail work, the president was unusually disconnected from the debate as Senate Majority Leader Mitch McConnell’s health care bill veered off course.

Last week, he traveled to Paris to participate in Bastille Day festivities with French President Emmanuel Macron. On Friday, he went directly from Paris to his club in Bedminster, New Jersey, where he spent nearly nine hours over three days on the golf course watching the U.S. Women’s Open. On Monday, he kicked off the White House’s “Made in America” week with a photo op in which he sat in a fire truck on the South Lawn, tried on a cowboy hat and hefted a baseball bat.

Two Republican senators, Mike Lee of Utah and Jerry Moran of Kansas, were meanwhile planning to publicly defect from the Obamacare legislation.

“I was very surprised when the two folks came out last night because we thought they were in fairly good shape,” he told reporters Tuesday at the White House.

Trump gamely tried to put the blame on Democrats. “We’re not going to own it,” he said “I’m not going to own it. I can tell you the Republicans are not going to own it.”

The public would disagree. Americans say they would blame Trump and Republicans for a problems in the health care system over Democrats by 59% to 30 percent, according to a Kaiser Family Foundation poll taken June 14-19.

All 52 Republican senators were invited to the White House for lunch on Wednesday to discuss health care with Trump, White House spokesman Ninio Fetalvo said.

Currency markets reacted strongly as traders concluded Trump’s overall agenda is imperiled. The dollar slid to a 14-month low against the euro.

Pivot to Taxes

The White House argues that Trump has been successful outside of legislation. He won confirmation of his nominee for the Supreme Court, Neil Gorsuch, and his administration is making steady progress on deregulation.

Congressional Republican leaders and the White House have to now figure out whether they can salvage any of their legislative agenda, particularly the promise of major tax cuts.

The Affordable Care Act change effort has weighed on the popularity of both Trump and his party. The public rejected the health care legislation they drafted mostly behind closed doors without any Democratic input. Trump’s approval rating is 4%.

The president says he’s ready to abandon health care and move on to tax cuts he believes will goose the economy.

“It will go on and we’ll win, we’re gonna win on taxes, we’re going to win on infrastructure and lots of other things that we’re doing,” Trump said.

Congressional Priorities

But the Senate isn’t quite done with health care. McConnell still plans a vote on a repeal bill early next week. And he acknowledged that if it fails the Senate may hold bipartisan hearings on legislation to stabilize the Affordable Care Act public exchange system — exactly what the Senate Democratic leader and Trump foil, Chuck Schumer of New York, has sought for months.

White House officials say they’ve learned lessons from the health care experience, and they believe Republicans, desperate for a political win after the collapse of the Affordable Care Act change bill, can rally around a compromise tax plan.

Rather than letting the House and Senate draft their own versions of the bill, as the White House did with health care, the administration plans to release a unified framework for changes to the tax code — with compromises on rates and loopholes already baked in and signed off by leaders in both chambers.

September Release

A small group of top Republican leaders — McConnell; House Speaker Paul Ryan; Senator Orrin Hatch of Utah and Rep. Kevin Brady of Texas, who chair the Senate and House tax-writing committees; Treasury Secretary Steven Mnuchin and National Economic Council Director Gary Cohn — are discussing high-level principles for an overhaul, according to one person familiar with the matter.

They aim to outline their principles by the end of the month, vet them with members of Congress in August and release a plan in September, the person said. Debate would extend through the fall.

White House Press Secretary Sean Spicer is developing a comprehensive messaging strategy, recruiting surrogates and interest groups to support the legislation even before the details are final.

Marc Short, the head of the president’s legislative affairs team, has said he recognizes that opponents of the health care bill did a better job rallying their supporters.


© 2023 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.