The Washington PostDemocracy Dies in Darkness

Opinion Trump just realized his mistake on health care. But it’s too late.

Democratic lawmakers introduced legislation on April 2 to fight the Justice Department's push to repeal the Affordable Care Act through the courts. (Video: Reuters)

Just last week, President Trump promised that any minute now, Republicans were going to produce a plan to solve all the problems in the health-care system, one that would be, and I quote, “spectacular.” In response, I argued he was putting his party in an uncomfortable position by forcing Republicans to talk about an issue they would much prefer to avoid altogether.

Now Trump seems to have realized his mistake:

President Trump signaled Monday night that he will not press for a vote on a bill to replace the Affordable Care Act until after next year’s elections, apparently heeding warnings from fellow Republicans about the perils of such a fight during campaign season.
In a series of late-night tweets, Trump continued to bash President Barack Obama’s signature health-care law but said a vote on a replacement would not occur until after the elections — suggesting that he believes he would still be in the White House and that Republicans would control both chambers of Congress at that point.
“Vote will be taken right after the Election when Republicans hold the Senate & win back the House,” Trump wrote. “It will be truly great HealthCare that will work for America.”

It’ll be truly great. In two years or so.

We’ve seen this pattern before: Trump blurts out a promise he thinks everyone will like, but it turns out his party has no interest in pursuing it, and eventually it just disappears. This can apply to both the general and the specific; in this case, Trump promised that the GOP would be “the party of health care” and also said that Republicans “will take care of preexisting conditions better than they’re taken care of now.” But Republicans would like to talk about health care as little as possible, and the last thing they want to bring up is preexisting conditions.

That’s because the guarantee that people with preexisting conditions can get health coverage exists only because of the Affordable Care Act, and if Republicans succeed in any of their attempts to destroy the ACA — most recently with the lawsuit the administration is supporting that would tear out the ACA root and branch — that protection would be eliminated. They can swear up and down that they’ll figure out some way to restore the protection, but they know that voters don’t really believe them.

If you watch the administration representatives talking to the media today, it all seems a bit jumbled. They insist that they’re working on a plan like busy little bees, and the vice president’s chief of staff says “the president will be putting forward plans this year” — plural! — but no one is contradicting Trump on his assertion that the phantom plan will not become a legislative reality until 2021.

You might say, well, of course not — Democrats control the House, and they won’t approve of any Republican health-care plan. But that’s only half true. Democrats would be happy with a plan that did all the “spectacular” things Trump regularly claims — protecting preexisting conditions, insuring everybody, doing it all for much less than we pay now.

What Democrats won’t agree to is the actual things Republicans want to do on health care, which involve taking away coverage from millions of people, removing the protections the ACA provides and making the system much crueler than it is now. Any plan that adheres to conservative principles on health care will be abhorrent to Democrats and hugely unpopular with the public.

Republicans may be hoping that this is their best strategy to make the health-care issue get as quiet as possible between now and next November: Just say you’ll have a plan eventually but remind everyone it can’t be passed until 2021 anyway, so there’s no reason to be too concerned with it, and throw in some fear-mongering about Medicare-for-all aimed at skittish seniors. The trouble with that is that Democrats don’t need a specific Republican plan to attack.

That’s because there’s a lengthy and clear record over the past few years of what Republicans want to do on health care, laid out in the occasional legislative proposal, the actions of the Trump administration and a never-ending series of lawsuits. They want to roll back the expansion of Medicaid. They want to remove protections for people with preexisting conditions. They want to take away the ability of young people to stay on their parents’ insurance until age 26. They want to let insurers offer junk insurance that covers almost nothing.

When confronted about that, their answer amounts to, “Well yes, but then after we do that, we’ll restore all those things about the ACA that you like. Trust us, it’ll be great.” But they know that the public doesn’t trust them, and with good reason.

So their best hope is to persuade voters to think about something else. But after Democrats had such enormous success running on health care in 2018, they’ll be doing their best to make sure the issue is front and center in 2020.

Read more:

James Downie: Republicans’ missing health-care plan

Catherine Rampell: If the GOP built their ideal health-care system . . . it’d be Obamacare

Greg Sargent: There’s widespread support for overhauling health care in a more progressive direction

Paul Waldman: Democrats have figured out where they’re going on health care