Counting the ways the GOP bungled the health care bill

There’s stumbling out of the gate, and then there’s what Republicans just did on health care.

They came up with a substantively indefensible bill, put it on an absurd fast track to passage, didn’t seriously try to sell it to the public, fumbled their internal negotiations over changes — and suffered a stinging defeat months after establishing unified control of government.

There has been a lot of finger-pointing after the collapse of the bill, and almost all of it is right. This was a party-wide failure.

House Speaker Paul Ryan has — faint praise — thought more about health care policy than almost any other elected Republican. He rose to prominence with thoughtful policy proposals buttressed by PowerPoint presentations. This was his moment to shine as a wonk.

Instead, with an eye to procedural constraints the legislation would face in the Senate, he wrote a mess of a bill that got failing grades from analysts across the political spectrum.

The operating theory wasn’t that the merits of the bill would get it over the top, but that speed and sheer partisan muscle would. The House wanted to pass it in three weeks, which would be a rush for a bill naming a courthouse.

Ryan gambled that he could get his fractious caucus to rally in record time because — unlike his frustrated predecessor as speaker, John Boehner — he had a president of his own party at his back. And none other than “the closer,” President Trump, whose calling card is his skill at deal-making.

But you can’t be a closer if you don’t know anything about the product. Trump knew the health care bill was wonderful and beautiful and his other characteristic boosterish adjectives. Otherwise, he was at sea.

He wasn’t knowledgeable enough to engage in meaningful negotiations. One of his interventions — to try to placate House conservatives by stripping out the so-called “essential health benefits” of ObamaCare — may have lost more moderates than it gained votes on the right.

For their part, Ryan and Trump are united in blaming the House Freedom Caucus, the recalcitrant group of conservatives that destroyed Boehner’s speakership and have made a good start at ruining Ryan’s.

The Freedom Caucus is certainly prone to self-defeating purity, but in this case, when they said the bill wouldn’t fully repeal ObamaCare or do enough to reduce premiums, they were correct. The bill shed support on both the right and the left because of its underlying weakness (it’s hard to get anyone to back a bill with a 17 percent approval rating, per a Quinnipiac poll).

Perhaps most unforgivably, the White House and congressional Republicans now have decided to move on. After seven years of promising to repeal and replace ObamaCare — with Trump thundering it at rallies and Republicans writing it into every campaign document — they’re giving up after three lackluster weeks.

Tax reform beckons. Republicans tell themselves they’ll get better results on taxes because it’s more natural terrain for the party, an implicit concession that the GOP still — even after electing a populist president — can’t bring itself to engage on kitchen-table issues that don’t involve tax cuts.

Perhaps the initial tax legislation will start in a better place, the process will be more deliberate and Trump will get immersed more readily in something — the tax code — central to his business dealings.

But tax reform is more popular in theory than it is in practice. It requires painful tradeoffs and is vulnerable to the political critique that it favors the wealthy and corporations over working people. Already there are divisions between House and Senate Republicans over the so-called border adjustment tax that Ryan and his team favor.

If tax reform is going to pass and get signed into law, Republicans will have to perform much better than in the foreshortened health care debate. On the bright side, they can’t perform much worse.

 

 

 

 

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