A new Post-ABC News poll finds that 61 percent of Americans now favor keeping and improving the Affordable Care Act, while only 37 percent favor repealing and replacing it. Crucially, it also finds that huge majorities reject the ideas at the core of the latest version of the GOP replacement that Trump is championing.
Only 33 percent support allowing states to decide whether to require insurers to cover Essential Health Benefits (EHBs), such as doctors’ visits and emergency room visits, while 62 percent say it should be required in all states (as the ACA does). And only 26 percent support allowing states to decide whether insurers are banned from jacking up prices for people with preexisting conditions, compared with 70 percent who say it should be required in all states. Both of these state-waiver provisions are in the latest GOP plan.
What’s even more striking, though, is that many voters who backed Trump are rejecting the GOP solutions. According to the poll’s crosstabs, Trump voters are split on the Essential Health Benefits provision, with 45 percent saying all states should require them and 49 percent saying states should decide. Trump voters are also split on the ban on insurers hiking premiums on preexisting conditions: 51 percent of Trump voters support that ban, while 45 percent favor allowing states to decide (as Trumpcare would do). Republican respondents say this by a striking 55-39.
While Trump voters do overwhelmingly favor repeal-and-replace in the abstract, there is not much support among them for the ideas at the core of the concrete replacement Trump is championing. This suggests that a key piece of conventional wisdom about this debate — that Trump will badly disappoint his base if this plan doesn’t go through — perhaps deserves more skepticism.
The new poll also shows that Trump’s bluster about sabotaging the ACA to force Democrats to the table is a non-starter with the public, including with his supporters. Americans overall say that during this debate, Trump and Republicans should make the law work as well as possible by 79 percent, while 13 percent want to make the current law fail as soon as possible. Even Trump voters say this, 58-28.
One of the big stories of the 2017 health-care debate has been this: When voters were finally presented with a choice between the unpopular ACA and a massively regressive GOP alternative that would slash spending and regulations and roll back the ACA’s historic coverage expansion for the poor and sick, they decided they preferred the former, and rejected the latter. Perhaps because of this, a nontrivial number of moderate GOP lawmakers appear privately okay with the ACA’s general spending and regulatory architecture, though they can’t say it that way out loud.
To be sure, the future of the ACA exchanges is hardly assured, and it’s still possible that the GOP could succeed in repealing and replacing the law. Trump and Republicans continue to try to push a solution that includes the above deregulatory provisions, to win over conservatives. But the unpopularity of those provisions suggests that continuing down this path invites a backlash in the 2018 elections. Indeed, our poll finds that independents oppose the EHB provision, 67-28; and they oppose the preexisting conditions provision, 71-27. Will vulnerable Republicans really want to vote for those?
Trump strongly suggested during the campaign that he represented an ideological break from Paul Ryan and House Republicans when it comes to government’s role in covering poor and sick people. He then embraced Ryan’s plan, because it turned out (shockingly) that he just wanted the “win” of crushing Obamcare, with zero concern for the details or human toll the Ryan replacement would impose on millions. The public has rejected the wildly regressive Ryan vision, and this route forward only carries further political peril.
Trump does, of course, have another option: He can drop repeal, revert to his promise of ideological heterodoxy and make a deal with Democrats to improve the ACA. This might plausibly make him more popular. Indeed, our poll finds that only 26 percent of Americans think Trump should continue working with conservative Republicans in trying to change the law — people have perhaps figured out that the GOP has nothing on this issue — while 43 percent say he should work with Democrats.
Republicans familiar with the leadership’s thinking … cautioned that passing such legislation would be complicated and likely necessitate other tax hikes or spending cuts. They expected the leadership, however, to agree with the broad points and spirit of Trump’s plan this week even as details and a path to passage remain unclear.
There are also great shows of concern about how something that balloons the deficit this much can pass Congress, but Republicans won’t care about that in the end, since the president is a Republican.
* WHITE HOUSE DELIVERS ‘MIXED MESSAGES’ ON HEALTH CARE: Over the weekend, Trump and White House advisers projected confidence that another repeal-and-replace bill was set to move forward in Congress. But CNN reports:
Privately, senior administration officials … said the pressure to rush for a vote on health care had subsided and that the White House’s priorities were realigning with those on Capitol Hill: to pass a budget bill and keep the government open.
Oh. Maybe we should, you know, learn from this the next time the White House confidently states that repeal-and-replace is about to happen.
* KEEP AN EYE ON VULNERABLE REPUBLICANS IN THE SHUTDOWN FIGHT: A government shutdown over Trump’s insistence on funding for his wall is still possible, but note what vulnerable Rep. Mike Coffman (R-Colo.) has to say about this:
“It is a divisive issue. I certainly support securing the border but I also support keeping the government open and I think this would cause the kind of showdown that would lead to a shutdown.”
If a shutdown looks likely later in the week, you’ll hear more swing-district House Republicans balking.
* PUBLIC SUPPORTS IMMIGRATION, CLIMATE REGULATIONS: A new NBC-WSJ poll finds that a striking 50 percent of Americans have little to no confidence in the GOP repeal-and-replace effort. And:
Sixty percent of the public think that immigration helps more than it hurts — up six points from September 2016. And a combined 67 percent of respondents believe that either immediate action should be taken to combat global climate change (39 percent), or that some action should be taken (28 percent).
Two more issues on which Trump is adamantly on the wrong side.
Grassroots activism and organizing is surging. Irate Democrats are flooding GOP town halls even in conservative states like Idaho and South Carolina. Small-dollar fundraising is also on fire … Trump’s attempts to push an Obamacare repeal, a border wall, and various iterations of his travel ban have also motivated a drove of new candidates to jump into the fray ahead of 2018’s elections, including in a handful of deep-red states…
The challenge for the party is to channel that energy and enthusiasm without trampling on it. But that’s a good challenge to have.
* TRUMP’S INCONSISTENCY ABOUT THE 100-DAY MARK: Trump continues to play down the 100-day mark while claiming that his start was historically awesome and frantically scrambling to produce something that he can call a major accomplishment. As historian Robert Dalleck puts it:
“As with so much else, Trump is a study in inconsistency. One minute he says his 100 days have been the best of any president, and the next minute he decries the idea of measuring a president by the 100 days.”
The media — and cable news, especially — love a good round-numbered milestone, and Trump is a voracious consumer of cable news. So Trump’s aides are contributing to a spectacle that they simultaneously dismiss as meaningless, knowing it is a priority for their boss as he juggles bold campaign pledges against the difficulty of heading the vast U.S. government.
It’s good to see that the Trump White House is focused like a laser on what is good for the American people.