What Is President Trump's Health Care Plan?
Conservatism or Trumpism?
There is something to be said for the idea that excessive government is a bad thing. High taxes and burdensome regulations can hold back economic growth. Aid programs can make people dependent on government and reduce the incentive for people to work hard. As an institution that receives revenue from taxes rather than from providing goods and services that consumers actually want, the government has little reason to spend money efficiently. Unlike private businesses, the government will keep collecting revenue whether it does a good job or not.
Republicans have been successfully making this argument for decades, an argument that has put them in a dominant position at all levels of government today. Conservatives, in fact, should be thanking President Obama in particular for doing so much to help them achieve this recent success. Obamacare, after all, has come to represent the ultimate example for so many conservatives of government out of control. And President Trump, while hardly a traditional Republican candidate, spent much of his campaign decrying Obamacare as one of the ultimate evils of the universe.
Ever since the Affordable Care Act became law, conservatives complained about the new regulations that it placed on insurance companies, increased health care costs, higher government spending that resulted from Medicaid expansion and new subsidies, and the hated individual mandate that would impose penalties on people who did not get insurance. As a general rule, they prefer a health care system that is run by the private sector as much as possible, with competition between insurance companies and medical service providers (supposedly) creating more choices for consumers and driving prices down. They also question the idea that health care is some sort of a human right that government must provide rather than a service that individuals must pay for themselves.
Donald Trump the candidate made some of these traditional conservative arguments, complaining particularly about new regulations, higher health care costs, and the hated individual mandate. He did not, however, emphasize the argument that people should buy health care for themselves. Instead, he claimed that a better law would be crafted that would keep the more popular parts of Obamacare, such as guaranteeing insurance for people with preexisting conditions and allowing young people to stay on their parent's insurance until the age of 26, and would not cause anyone to lose their insurance. In fact, he even claimed that more people would get affordable insurance than under Obamacare. It would be the perfect plan. People would get more benefits with the government spending less money and imposing fewer rules. Why hadn't those stupid politicians thought of this before?
For a guy who was supposedly not a traditional politician, Donald Trump played the ultimate political game better than the seasoned politicians: promise the moon while being vague on the details of how you will get there. The only problem is that those seasoned politicians who have to write actual legislation know that the Trump "plan" is a fantasy, and it's a fantasy that they are not even interested in trying to deliver. This is why the health plan recently passed by the House will cause millions to lose their insurance. So whether you agree with the conservative ideology or not, you can at least respect House Republicans for being consistent. It is President Trump, as has often been the case during his first few months in office, who is being inconsistent. After promising that no one would lose their insurance or be denied due to preexisting conditions, he has endorsed a plan that would do both.
If something resembling the House health care bill gets through Congress and lands on the President's desk, we will find out what Donald Trump actually believes about health care. Is his priority to shrink the role of government or to provide affordable health care? And if he does go along with traditional conservatives and signs a bill that causes large numbers of people to lose their current insurance, what will his supporters think? Will they be happy simply because the hated Obamacare is gone, or will they be disappointed when they eventually realize that they were naive enough to believe in a fantasy?
My best guess is that we are not going to get a new health care bill at all. The House created a bill too conservative to get through the Senate. The Republican majority is slim in the Senate, and Senators have to think about public opinion throughout their states, not just the constituents of heavily gerrymandered districts. So when the Senate fails to come up with something that can be reconciled with the House, conservative members of the House can tell their constituents that they tried, Republican Senators can blame Democrats for standing in the way of change, and President Trump can then do what he does best: blame everyone but himself for the nation's continuing problems. The best news for President Trump and the GOP, of course, is that they will not have to deal with the wrath of millions of people who have lost their health insurance, and if conservatives are ever unhappy about any of the complex, inevitable problems associated with health care, they will still have the evil Obamacare to blame.