Trump campaigned on repealing “all” of Obamacare. After a conversation with President Obama, however, he has indicated that he wants to keep coverage for preexisting conditions and allow adult children to stay on their parents’ plan until age 26. Right there he creates a challenge to the “repeal and dawdle” tactic. If Congress repeals the subsidies and the individual mandate (which keep young and healthy people in the exchanges), what mechanism is going to allow those with preexisting conditions to afford coverage? Well, we don’t and won’t know until the House passes a replacement bill. That’s small comfort to those about to lose subsidies and be priced out of the insurance market.
Moreover, if the House thinks universal access will be an acceptable replacement, it might want to check with Trump. Kellyanne Conway said very clearly on “Morning Joe” today that “we don’t want anyone who currently has insurance to not have insurance.” That’s not access; that’s coverage. She also started hedging on the prospect of repealing Obamacare with no ready alternative, saying it was “ideal” to do this simultaneously.
Republicans should be very wary about taking a controversial, highly unpopular leap into the unknown — repeal with no alternative — so long as the president is not explicitly and completely on board. And with Trump’s propensity to reverse himself and leave open multiple interpretations of his utterances, House Republicans could very well act, thinking that Trump is with them. Then the hue and cry begins (especially as insurers bail out of the exchanges, people lose subsidies, etc.) and Trump declares he is shocked — shocked! — to see how the House ripped insurance away from his Rust Belt, working-class voters. Indeed, it would seem obvious that Trump will renounce whatever the House does that proves to be unpopular.
The only way to prevent this from happening is to repeal Obamacare and replace it at the same time. Even then, if Republicans put forth their own replacement — one that without the individual mandate only provides access to insurance — there is no guarantee that Trump will sign it. Republicans may have worked strenuously to pass something that — like all bills of this magnitude — is controversial and creates substantial criticism. Why should he take the heat if he sees public support plummeting? Truth be told, unless Trump signs a bill, Republicans can never be sure that he will defend it.
He did exactly this today, in criticizing the House GOP for its move to cut the ethics office. “With all that Congress has to work on, do they really have to make the weakening of the Independent Ethics Watchdog, as unfair as it … may be, their number one act and priority,” he tweeted. So much for the House Republicans’ claim that they had not weakened their ethics investigator.
With a normal president, the White House sends up legislation, in essence putting the president on record as to what he wants. With Trump, there is no indication that he is going to do that — and hence no guarantee that he will support what the House and Senate come up with. Again, a normal president would not hang his own party out to dry on such a critical matter. Trump, however, has demonstrated that he has no loyalty to the GOP per se and continues to show resentment toward Republicans who did not support him or did so only grudgingly.
House Republicans would be wise to force the president to show his hand — in writing — before risking their necks on an ill-conceived and potentially very unpopular scheme to repeal Obamacare and dawdle until it can pass something new. By the way, exactly what replacement bill is going to get 60 votes?