The Washington PostDemocracy Dies in Darkness

Opinion Trump actually wants to make the election about health care. Good luck with that.

AP Photo/Andrew Harnik (Andrew Harnik/AP)

Back when he was a mere real estate developer, Donald Trump understood the power of claiming that something spectacular exists even when it doesn’t, which is why he added 10 imaginary floors to Trump Tower so he could say it was 68 stories high instead of its actual 58.

Although most of us would call that “lying,” it can be an effective strategy so long as people don’t check, or if they find out the truth but don’t really care.

As president it’s not so easy, because you’re dealing with matters that are vitally important to people’s lives, such as health care. And if there’s another building right next to yours (figuratively speaking) that’s obviously much taller, it gets even harder to claim that yours is the highest on the block.

In his gobsmacking interview with ABC News, President Trump — in addition to signaling that he’d welcome foreign help in 2020 — also answered a question about health care. He offered the health policy equivalent of the 10 imaginary Trump Tower floors — they exist, and they’re fantastic, believe me! — and this gives us a preview of how the discussion about this issue is going to play out in the election.

Trump claimed that he’d be announcing his new health care plan in “about two months. Maybe less.” Then George Stephanopoulos pointed out that his administration is supporting a lawsuit that would eliminate the entire Affordable Care Act, including protections for tens of millions of Americans with preexisting conditions. Then this happened:

TRUMP: Well, no. Preexisting conditions -- I was for preexisting conditions. And I still -- you know, I’m very much for preexisting conditions. But Obamacare has been a disaster. Look what --
STEPHANOPOULOS: -- get charged higher under your plan, right?
TRUMP: No, much lower. Under my plan, they’ll be much lower. You’ll see that in a month when we -- when we -- introduce it. We’re going to have a plan. That’s subject to winning the House, Senate, and presidency, which hopefully we’ll win all three. We’ll have phenomenal health care.
STEPHANOPOULOS: And so you’re definitely introducing a plan before the election?
TRUMP: Before the election, yes. We’ll be having a plan much before the election. Soon. Fairly soon. It’s almost complete.

It’ll be coming right after Jared Kushner’s Middle East peace plan. Maybe in the middle of Infrastructure Week.

Trump proclaimed the GOP will become "the party of healthcare," but a conservative replacement to Obamacare would probably look something like...Obamacare. (Video: Joshua Carroll/The Washington Post)

We can be reasonably certain that the Democratic nominee will offer a detailed, specific plan meant to address problems such as the remaining uninsured, health-care costs at the systemic and individual level, and any number of other challenges.

The president, on the other hand, will be offering the policy equivalent of vaporware, vague descriptions of a plan that doesn’t and will never exist.

So for voters, there will be two contrasts to judge. The Democrat will have a serious plan to fix what’s wrong, a plan you might or might not think is worthwhile. Trump, on the other hand, will have no plan at all.

You might recall that about three months ago, Trump claimed that he had assigned a couple of Republican senators to come up with a health-care plan, and it would be ready real soon. But there was no plan, and there was never going to be a plan. This new plan, coming in a month or two? It’s not coming, either.

Why not? Two basic reasons. First, Republicans in general and Trump in particular don’t care enough about the issue to put any energy into it. Second and more important, they know that what they’d like to do on health care is so incredibly unpopular that actually laying it out would be politically catastrophic, as they learned when they tried and failed to “repeal and replace” the ACA in 2017.

Which means that in 2020, voters are going to choose between something and nothing.

As of now, some of the Democratic candidates have released specific health-care plans, while others have endorsed existing ideas produced by think tanks or other legislators. But those who haven’t done so yet will surely come up with them as the primary process moves along. Depending on who the nominee is, their plan could be anything from shoring up the Affordable Care Act and adding a public option (Joe Biden’s position) to full-on single-payer (Bernie Sanders’s position).

Whoever that nominee is and whatever specific plan they offer, it’s going to be lengthy, detailed and serious, because the position they’re in is the opposite of the Republican one: Democrats care deeply about health care, and the things they want to do about it (such as making sure everyone has insurance and actually protecting people with preexisting conditions) are extremely popular.

The New York Times reports that many Republicans believe Trump should just avoid the issue. But, as the Times notes: “the president and his team counter that even if they cannot win on health care, it would be ridiculous to simply cede the territory if they could at least narrow the gap.”

The problem is that they can’t, because everything he can say about it only makes things worse.

So don’t be surprised to see Trump pivot every time the issue comes up. What’s your health-care plan? It’s great, it’s spectacular, I’ll be unveiling it soon, but in the meantime let me tell you how awful it is that Democrats want to force your grandmother to die so they can harvest her organs and give them to transgender illegal alien abortionists. Not on my watch!

What that means is that Trump will be defending the status quo, even as he argues that the status quo is a nightmare (“Obamacare has been a disaster”). As hard as it can be to argue for radical change, that puts the Democrats in a pretty good position to persuade voters that their approach is better.

Read more:

The Post’s View: No matter what Sanders says, there’s no Medicare-for-all without tradeoffs

Megan McArdle: Sorry, Bernie, but most Americans like their health insurance the way it is

Charles Lane: Bernie Sanders’s Medicare-for-all advocates what the U.S. already does indirectly

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

Robert J. Samuelson: A single-payer health-care system is no panacea