Ultimately it was was not supposed to happen; the Affordable Care Act - the legacy of America’s first black president, Barack Obama, was to be demolished. Evan as he outlasted the desire by Republican leaders to be a one term president, the GOP was determined to maligne, trash and dismiss the derisively labelled, Obamacare, that helped over 21 million people obtain health coverage, unto the rubbish heap of partisan defeat.
After 67 failed attempts to defeat it, and after another, of the equally despised Hillary Clinton, for president, then the election of Donald Trump would do it. With braggadocio, falsehoods, snickering, and snideness, it would die, seven days, to the day, that it was signed into law, by a gleeful, Paul Ryan, the speaker of the house, the Iago of this drama.
Then the unexpected happened this Friday, when Ryan had to tell the new president that there were not enough votes and that the bill had to be pulled. No joy in Mudville, and a bellwether for the self-designated populist as he faced his second defeat, after the thinly disguised travel ban to keep Muslims out of the country failed. Now, on the simmering embers of defeat, Trump has to face not only that campaigning is far different than governing (as every president has discovered) but that despite claims to possessing the art of the deal, he may not have it, in the top job.
The Affordable Care Health Act, as the bill came to be known, was flawed from the beginning by switching the Obama tax credits from low-income Americans to younger ones, by increasing premiums for them, and by sending prescription costs even higher, but then as Ryan stated, it was never about health insurance, it was about cost containment.
Then the Congressional Budget Office, a bipartisan, and independent financial assessor gave the bad news: 14 million Americans would lose their coverage, next year, and by 2026, 52 million, with projected cost savings of $337 billion over 10 years, by cutting Medicaid, and eliminating subsidies, from the Obama plan, including some pre-natal plans.
What were they thinking? As observers have noted Trump’s near obsession with removing every piece of Obama’s legislative legacy was a major flaw; but, the other was not realizing (but, then he’s not a politician as Vice-President Pence reminds us) the factionalism within his own party -- those radicals that wanted to make far deeper cuts in the replacement of the ACA, with no concession to even mild attainments -- such as the pre-existing condition, or allowing young people to stay on their parent’s insurance to age 26.
Then there were the moderates who had to face, “the folks back home”, their constituents, who, many of whom for the first time, had real health coverage, and could even cover prenatal and maternity care. Those constituents had made their opposition to the new bill clear, in noisy rebuke, at town halls, and in letters to the local dailies.
To add insult to injury the GOP, as appeasement to the radicals, was ready to sacrifice over 7 million American veterans, by deleting their access to tax credits if they could not use VA hospitals.
There seemed to be no middle course, and any cooperation with the equally despised Democrats was tantamount to apostasy. Could he, as The New York Times said, be “improbably blamed for his party’s shortcomings?”
“It’s really a problem in our own party, and that’s something he’ll need to deal with moving forward,” said Representative Tom Cole of Oklahoma, an ally of the center-right Tuesday Group, which stuck with Mr. Trump in the health care fight and earned the president’s praise in the hours after the bill’s defeat.”
Cole later admitted that past presidents -- such as the iconic Ronald Reagan -- had to work with Democrats. So, the tide seems to turn -- or is reality beckoning? One thing is certain, rolling back, “a major established social welfare program, [is a fact] that is almost unheard of.”
For 10 years, the Republicans were the party of “no” and so concentrated were they in saying “no” especially to President Obama, that they were left without a plan, so busy were they saying, no. So, now it’s no to their plan, and perhaps a resounding nyet from St. Petersburg on further help from Vladimir Putin. Who supports a loser?
The result, for now, is that the ACA remains, left as Trump said, as an option in his first few weeks in office, to self implode. But that implosion might very well echo off the walls of the Oval Office.
If early efforts at loosening the insurance requirement are left to the wolves, then consider that the insurance requirement is vital in maintaining healthy markets, “because it encourages healthier people to sign up for coverage. And healthier people offset the cost of sicker people. And that in turn keeps premiums in check,” noted the Chicago Tribune.
If it is loosened then premium costs would skyrocket, and increase even more than they did in some area, for some that bought insurance on the marketplace exchanges, put in place by Obamacare. And, as we saw the tax credit benefit for younger people versus older, in the Trump plan, did just that.
In the end, the image conscious Trump who gave half-hearted endorsement to the bill, (and was told to abandon it by his son-in-law Jared Kushner), blamed the Democrats, a move that even his ardent supporters told him not to do, in the face of his refusal to accept the Democrats offer to work, and fill the holes of the ACA, and put it on firmer foundation.
Behind the scenes he blamed Ryan and Reince Priebus, for their failure to shepherd the bill through, now creating even more tension between two men, whose help he now desperately needs.
His next chance is a tax plan, but the early soundings seem to be as top heavy as his executive orders -- missing an ideology, and hell bent on raising defence from an already near $7 million high. And, then take away from Meals on Wheels, cut the Coast Guard, delete monies from Great Lakes Conservation, and decimate the Environmental Protection Agency? One again, he seems to not even grasp the basics of crafting legislation, as critics have noted.
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