(Alex Brandon/Associated Press)
Opinion writer


Ever since the GOP repeal-and-replace bill crashed, President Trump has confidently vowed that it’s only a matter of time until Democrats come groveling to him on their knees, begging for a deal that will save them from the collapse of the Affordable Care Act. In other words, Trump and Republicans needn’t take any steps to shore up the ACA’s exchanges, because they have all the leverage in the battle over its future — indeed, they have suggested, the ACA’s implosion is inevitable, ongoing and already nearly complete.

But Trump just blinked. And in so doing, he inadvertently revealed that despite the bluster coming from him and Republicans, the politics of the battle over the ACA’s future tilt against them.

The Trump administration has now quietly announced that it will refrain from taking an important step that could have pushed the ACA’s individual markets toward collapse. Specifically, The Post and the New York Times report that the administration will keep on paying so-called “cost-sharing reductions” to insurance companies to cover their reimbursement of out-of-pocket costs for about 7 million lower-income customers.

If Trump stopped the payments on his own, it could cause insurers to flee the exchanges, which would melt them down, potentially leaving at least 10 million people without coverage. Trump could do this right now. Here’s how: House Republicans had sued the Obama administration to block the payments, and last year a federal judge ruled that they are invalid but kept them going, pending the former administration’s appeal. Trump could drop that appeal, which would cause the payments to stop. But the Trump administration has decided not to do this — at least for now — and to keep the payments going.

“The withdrawal of the cost-sharing reductions would essentially torch the exchanges in most states,” Nicholas Bagley, a law professor and health policy expert at the University of Michigan, told me. “The Trump administration must think that it would be blamed for that. They’re admitting the politics are against them, at least with respect to something that has the potential to devastate the exchanges in a hot minute.”

Instead, by keeping up the payments, the administration has sent a signal to insurers that they should not exit the exchanges, at least for now. The administration does deserve credit for doing the right thing and averting the human toll that pushing the exchanges into collapse would have unleashed. But in pure political terms, this amounts to a concession of weakness.

Remember, Trump has said that, despite the failure of the GOP health bill, the ACA is currently in a state of catastrophic collapse — and thus that GOP efforts to repeal it will continue. This argument was badly undercut by the Congressional Budget Office’s finding that the exchanges will likely remain stable, and by a recent Standard & Poor’s report finding that there’s no “death spiral” and that the markets could soon become profitable for insurers.

But it’s unthinkable for Trump and Republicans to concede that the law is working, if imperfectly; or that it can be made to work over time if they don’t actively undermine it; or that the American people are not currently crying out for liberation from its darkness and oppression. Republicans cannot acknowledge that their own effort collapsed in part because the American people were faced with a stark choice between the ACA and the GOP’s massively regressive rollback of its historic coverage expansion — and clearly chose the ACA. But the Trump administration’s decision concedes that any active efforts to undermine that expansion of coverage could play against them politically — and that the status quo is not as disastrous for the American people (or as politically disastrous for Democrats) as he and Republicans claim.

All of this sets up a dilemma for the administration and Republicans over what comes next. Thanks to the House GOP’s ongoing lawsuit, the cost-sharing reductions could still end up getting invalidated in the future. Congressional Republicans now have to decide whether to appropriate the money for them, thus helping keep the exchanges going. The Times reports that some House Republicans, such as Reps. Tom Cole and Greg Walden, want to do just that, in order to avoid destabilizing the markets and hurting those who depend on them.

This could form the basis of a deal between Republicans and Democrats that could keep the exchanges going for now. There’s no telling whether House Republicans will actually agree to this, so the future of the individual markets is still precarious. But it’s now clear that the politics of the battle over the ACA’s future don’t necessarily favor the GOP. Says Bagley: “The cost-sharing move reflects the political calculation that we might be moving into a world where you can no longer play chicken with the threat to rip insurance away from people who might otherwise be able to afford it.”


* WHITE HOUSE’S DOCTRINE IS CONSTANTLY SHIFTING: The New York Times tries to track the Trump administration’s constantly shifting criteria for when it will use force abroad, which are all over the place as it seeks to explain the reason for the Syria strike:

As various officials have described it, the United States will intervene only when chemical weapons are used — or any time innocents are killed. It will push for the ouster of President Bashar al-Assad of Syria — or pursue that only after defeating the Islamic State. America’s national interest in Syria is to fight terrorism. Or to ease the humanitarian crisis there. Or to restore stability.

Come on, weenie journalists. Consistency would prevent Trump from wielding the element of surprise. Plus, it’s for weaklings.

* REPUBLICANS RUSH IN TO SAVE SEAT IN KANSAS: Today is the special election for a Kansas House seat, and while Republicans will likely win, Dave Weigel takes stock of how panicked they are that it could even be close:

In the final days before Tuesday’s special election, Republicans reacted to weak polling and turnout data by rushing resources to southern Kansas. A GOP super PAC rolled out robo-calls over the weekend from Vice President Pence, and on Monday from President Trump … Republicans also dispatched Sen. Ted Cruz (Tex.) for a fly-in, where he urged Kansans to vote “if you’re fed up with the stagnation under the Obama economy.”

Making this race a referendum on “the Obama economy” seems pretty creative.

* KEY FACTOR IN KANSAS RACE: MEDICAID EXPANSION? One other tidbit from Dave Weigel’s story on the Kansas race: It may partly be a referendum on the performance of conservative governor Sam Brownback:

Republicans, who are still favored to win Tuesday, have strained to make the election a referendum on liberalism. Brownback, invisible on the trail, didn’t help matters by vetoing a bipartisan Medicaid expansion bill last month; his most favorable polling puts his job-approval rating below 25 percent, even in the 4th District.

It would be interesting if the refusal to accept hated Obamacare money to cover poor people ended up being one reason this seat was at risk for the GOP.

* WHAT TILLERSON HOPES TO ACCOMPLISH IN RUSSIA: Secretary of State Rex Tillerson is in Russia today, and CNN raises the curtain:

The secretary of state is seeking to leverage both international condemnation over the Syrian regime’s alleged use of Sarin gas against civilians and … Trump’s recent display of American military might to weaken Russia’s support for President Bashar al-Assad … Tillerson’s strategy for the trip is to highlight Russia’s responsibility and culpability for Assad’s actions in an effort to shame Putin into doing more to end the conflict and drive a wedge between Moscow and Damascus.

One wonders whether this newly aggressive posture toward Russia means Trump will now support a full, independent probe into Russia meddling in the 2016 election.

* TRUMP’S INFRASTRUCTURE PLAN COULD BE IN TROUBLE: Trump and his advisers have been vowing to push forward with a big new infrastructure plan, but Politico reports on the competing forces that might doom the effort:

Trump’s plan, expected to be released as early as May, has already faced months of skepticism from some conservative deficit hawks — even though it’s likely to call for far less direct federal spending than its eye-popping price tag implies. Meanwhile, Democrats are crying foul at suggestions that the blueprint will include hefty tax breaks for private investors and a shredding of permit requirements.

Trump may have to choose between a major public expenditure (which could pass with Democrats’ help) and a tax break and privatization scheme (probably the only thing Republicans could unite behind).

* UNIONS WORRY TRUMP WILL SELL OUT WORKERS: McClatchy reports that union leaders are worried that Trump will call for the repeal of the Davis-Bacon Act, which requires contractors hired by the federal government to pay prevailing wages:

Unions are anxious to protect Davis-Bacon, and ensure its wage protections are enshrined in Trump’s promised trillion-dollar infrastructure plan. Any move by the president that threatens the law could jeopardize their support for a Trump infrastructure bill, and thwart its prospects for winning votes from congressional Democrats, the unions’ traditional allies.

Many members of unions representing construction workers — who are deeply invested in keeping Davis-Bacon — voted for Trump. It would be shocking if they ended up getting shafted.

* AND TAXPAYERS FOOT BILL FOR MAR-A-LAGO TRIPS — BIGLY: CNN tallies up the number of trips Trump has taken to Mar-a-Lago as president, and their cost to taxpayers:

To date, Trump has spent six weekends — and a total of 21 days — at Mar-A-Lago, his private Palm Beach club. The total estimated costs for those trips are around $21.6 million. [President Barack] Obama, by contrast, spent just under $97 million on travel in his eight years as president, according to documents reviewed by Judicial Watch, a conservative government watchdog.

Trump is already on track to spending much more than what Obama did during his entire presidency — and these trips use the White House to promote memberships at a resort that Trump owns, steering more cash into his pockets.