His most famous line about winning, of course, is another that became a staple of his rallies. “We’re going to win with strength. We’re going to win with health. We’re going to win at so many levels,” he said last spring. “We’re going to win, win, win. You’re going to get so tired of winning.” The crowds ate it up.
On Thursday, President Trump won with health. The American Health Care Act squeaked out of the House, backed by 217 Republicans. The legislation, if passed by the Senate and signed into law, would likely mean tens of millions fewer people with health insurance by 2026, higher premiums on some portion of those with preexisting conditions and higher out-of-pocket costs for many older and poorer Americans. But a win is a win, particularly if you don’t care about what you actually won.
There have been a slew of stories about Trump’s indifference to what was in the health-care bill. What he said he wanted repeatedly on the campaign trail isn’t what was passed, but that didn’t keep Trump from telling a Rose Garden audience on Thursday afternoon that the legislation would do things that outside analysis made clear that it wouldn’t. Of all the things we should have foreseen from a Trump presidency, this, in hindsight, is among the most obvious: Trump was more consistent about his desire to win than he was about what those wins would entail. His policy specifics are generally things championed by others: immigration by Stephen K. Bannon, child-care by Ivanka Trump. The thing Trump wanted to accomplish was to win.
Consider Politico’s report on how the vote was accomplished.
“We needed to let this play out a little bit,” one Republican told reporters Rachael Bade and Josh Dawsey. “But the White House just couldn’t let this go.” The anecdote that demonstrates that involves Trump haranguing and cursing at Rep. Fred Upton (R-Mich.) after Upton balked at supporting the measure earlier this week. Upton demanded a legislative fix. “Trump did not want to talk about the merits of the legislation — he didn’t care much about those specifics,” officials told Bade and Dawsey. So Upton came up with something that he could live with, and he was a yes. That was good enough for Trump.
What’s really remarkable about the legislation is the extent to which Capitol Hill Republicans acquiesced to Trump’s win-however strategy. Our Paul Kane spoke with Capitol Hill Republicans who copped to the fact that they didn’t particularly like the bill they’d supported. “Is this bill good? No, I don’t like it,” Rep. Mario Diaz-Balart (Fla.) told Kane. He voted for it, he said, so that he could be part of the process of making it better, which seems like an odd way to craft legislation.
Other Republicans were caught in equally awkward positions. Any number of Republicans admitted they hadn’t read it. A number dodged cameras when posed with that question. Rep. Chris Collins (N.Y.), an early backer of Trump’s candidacy, admitted not only that but that he wasn’t familiar with a part of the bill that would gut a health plan for residents in his state.
So why’d the bill pass? There seems to have been a collective sense among the caucus, powered in no small part by the White House, that the win was the important thing. The New York Times reports that Chief of Staff Reince Priebus was twisting every arm in sight in an effort to secure a passing majority, so much so that his famously warm relationship with fellow Wisconsinite Paul Ryan was strained. Kane reports that the positions of the House speaker and other Republican leaders were perceived as being in jeopardy if they couldn’t close the deal. With stakes like that, 217 becomes more important than 24 million — 217 votes was a stronger motivation than the 24 million people who would be uninsured in 2026 thanks to the bill’s passage.
Trump’s entire campaign focused on appealing to his core base of support, with balking Republican voters signing up at the end in enough numbers to propel him to victory. This mirrors the strategy that brought us the amendment that revived the Republican health-care bill: Conservative members of the House Freedom Caucus insisted that if they were united in support of a measure, moderates would reluctantly join the team. They did. There may certainly be some blowback for those moderates, but for many Republican members of the House, their core Republican base will likely support the bill — or at least not want to see those representatives ousted for their votes.
It’s certainly not a coincidence that this episode occurred in a moment of unprecedented partisanship. A lot of Republicans across the country likely shared Trump’s attitude: The win was more important than what was won, especially since the win was a victory over the hated Obamacare.
The broader point can be made more simply. Why did Republicans have a Rose Garden ceremony to celebrate a bill moving out of one of the two chambers of Congress? Because the bill wasn’t the point. The passage was.