WASHINGTON ― Reporters love to call new legislative proposals “dead on arrival.” It sounds dramatic, like a cop show. The Clintons’ health care plan was “dead on arrival.” Every Social Security reform since the 1980s has been “dead on arrival.” Barack Obama’s Asian trade deal was “dead on arrival.”
Well, the new Obamacare “repeal and replace” plan, assembled by House Speaker Paul Ryan (R-Wis.) and Health and Human Services Secretary Tom Price, isn’t “dead on arrival.”
Something has to be alive before it can be declared dead.
But if we go with the idea that President Donald Trump and his circle know what they’re doing, then this is meant to be a Zombie Plan.
They’ve put forth a bare-bones proposal to provide cover for Republicans eager to “abolish Obamacare” now, but wary of being accused in the next election of weakening or eliminating health care coverage. In this scenario, the GOP will use the greased-skids procedure of reconciliation to abolish what they despise about Obamacare ― taxes and mandates ― while vowing to support some living, fleshed-out version of the new proposal later this year or next.
There is a perhaps fatal flaw in such a strategy: the new proposal’s almost total disconnect from substantive and political reality.
Substantively, it isn’t really a proposal because even Price admitted that he has no idea what it will cost. He also has no idea how to pay for it. That is for others, starting with the scorekeepers at the Congressional Budget Office, to determine. (Will they supply real facts or alternative ones?)
The plan, such as it is, will surely not “cover everybody,” as Trump promised it would, unless “everybody” means well-off people who can actually find a plan that covers their medical costs.
Nor does it actually, fully or anytime soon do what Senate Majority Leader Mitch McConnell (R-Ky.) vowed repeatedly a new plan would do: demolish Obamacare “root and branch.” It’s more a medium plowing.
As HuffPost notes elsewhere, no one believes Ryan’s claim that a refundable tax credit for non-taxpayers is anything other than a cloaked form of welfare payment.
Republicans acknowledge ― some publicly, some privately ― that politically the optics of the plan could be real bad for a party, and maybe even a president, who claim to be tribunes of the people. For example, Trump says he will muscle Big Pharma into selling medicine in bulk. It’s a sensible, long overdue move and one worthy of an actual autocratic populist. But even if he succeeds, the government’s savings on Medicare will primarily replace revenue lost by ending Obamacare’s payroll tax surcharge on high-income earners and its not-yet-implemented tax on “Cadillac” insurance plans.
In other words, the Palm Beach Populist will wring cash from Big Pharma so that he can give it to, among others, CEOS of Big Pharma.
The changes penciled in on Medicaid expansion are a political mess in all directions. The tea party wants that Washington-controlled $20-billion-a-year cash flow to the states stopped yesterday. But much of the rest of the GOP, including some otherwise quite conservative governors of red states, desperately want to keep that money coming, just with fewer strings. They’ve got sick or vulnerable people in need of help that they say they care about, and least five million could lose coverage if that Medicaid money stops.
Obamacare, however much of a mess it has been in places, has helped millions of real people. Its polling numbers are now positive enough that Republicans are getting skittish.
The Democrats aren’t about to help them. For one, if nothing happens, if no legislation passes, the status quo is ... Obamacare. In our new semi-parliamentary system of government ― in which all relevant political disagreements are intra-party ― the Democrats for now are happy to be bystanders, jeering from afar.
So what are Trump and his Merry Trumpsters up, besides the zombie strategy, and will this thing ever be alive?
Well, they had to get something ― anything ― started, if only because ending Obamacare remains an emotional issue with his core supporters. Opposing the Affordable Care Act is what got the tea party rolling. Trump’s inner circle was also in a hurry to do something that could plausibly be called real governance, not just angry early-morning Twitter rants of alternative facts and unsupported accusations.
If he doesn’t like how things progress or what the finished product becomes, he can ― and will ― blame (or let others blame) Ryan, McConnell, Price, Senate Democratic Leader Chuck Schumer (N.Y.), White House Chief of Staff Reince Priebus or Shadow President Obama.
And if you know how Trump operated in business, you know that he will not take responsibility for any deal until it is final ― and even then won’t necessarily own the deal he just made. Don’t forget: In recent years, he mostly put his name on other people’s buildings.