The Washington PostDemocracy Dies in Darkness

Trump tweets about the health-care bill a lot. He just doesn’t really make the case for it.

President Donald Trump (C) gathers with congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Health Care Act. (REUTERS/Carlos Barria)
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Update: On Wednesday morning, Trump complained on Twitter that “Republicans never discuss how good their healthcare bill is.” As we pointed out earlier this week, neither does he.

President Trump’s tweets about legislation don’t get as much attention as his tweets about, say, the “fake news” media. There are two obvious reasons for this. The first is that politicians are expected to tweet about policy. The second is that the president foments weird social-media feuds specifically to attract attention.

So it may surprise you to learn that, since House Republicans introduced their bill to overhaul Obamacare, titled the American Health Care Act, Trump has actually mentioned health care or health care legislation in more tweets than he has used the term “fake news.” He’s even tweeted about health care more than he’s tweeted about “Russia” or “leaks.”

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We went through all 750 tweets during that time period and counted. Here’s the distribution.

Notice that the health-care tweets come in clusters: At the introduction of the AHCA, when it passed the House and when the Senate introduced the Better Care Reconciliation Act last month. Trump will tweet about health-care legislation — or disparage Obamacare — a lot over a short period of time.

But what we’d like to draw your attention to is that second column. Trump has, by our count, on only five occasions tweeted anything resembling a specific of the policies his party has put forward. Those tweets, in order, are:

• This tweet responding to a comment on “Fox and Friends,” in which he discusses coverage portability.

• This tweet, in which he discusses drug prices.

• This tweet, in which he argues that the plan will yield lower premiums and deductibles and defend preexisting conditions.

• This retweet, which argues that the CBO’s coverage estimates have been wrong in the past.

• This tweet, when he argues that Medicaid spending will go up under the BCRA.

That’s it. Every other tweet refers to health care and a health-care bill in only the broadest strokes. For example:

… or …

There’s no case made for a Republican bill in those tweets, just a direct appeal to trusting his leadership.

This isn’t a surprise, of course: Trump’s been dodgy on policy details from the outset of his campaign, trusting instead that people would simply defer to his will and ability to craft a deal. He has, at times, seemed distinctly uninterested in the details of the legislation he wants to sign, and has offered hints that he doesn’t know even rudimentary components, like how the Republican replacement would affect taxes.

But the problem with this strategy is that it depends on people having confidence in Trump as the salesman — and most Americans don’t. Only about a quarter of the country consistently backs Trump’s efforts, leaving a majority skeptical of what he plans to do. If Trump’s sales pitch on health care boils down to ‘trust me,’ most Americans have already made it clear that they don’t.

What’s more, close followers of the health-care debate will notice something about the five tweets in which Trump actually champions the bill. They’re all misleading, incorrect or false.

  1. There is no articulated “phase 2″ of the health-care bill and there wasn’t at the time he tweeted that.
  2. Drug pricing isn’t included in the health-care bill, but the Senate bill does include tax breaks for drug companies. Changes to coverage guarantees could also mean that drug costs are covered in fewer plans.
  3. The Congressional Budget Office predicts that both the House and Senate bills will increase premium costs substantially over the short term, until enough sick and older people opt out of coverage to bring those costs back down.
  4. The CBO was not off by 100 percent.
  5. The Senate bill very much does cut Medicaid.

Trump has repeatedly insisted that his Twitter account is his way of speaking directly to the American people, outside the filter of articles like this. He’s welcome to do so. So far, though, he hasn’t spent a whole lot of time on social media making a real case for what it is he says he wants to achieve.