Healthcare

Trump must keep healthcare a priority to keep base intact

Much has been made in recent weeks about whether President Trump has been going too far by demoting Steve Bannon from the National Security Council or launching airstrikes in Syria and Afghanistan. 

There remains a question whether actions like these will irreparably offend his “America First” fanbase, but early opinion polls suggest the country generally approves.

Still, the response from many of his earliest and strongest supporters shows that he may be alienating the very same people who put him in office, with everyone from Ann Coulter to Nigel Farage expressing disappointment. 

Trump’s foreign policy shift capped off a month of unrest at home, where a President who promised repeatedly that he would swiftly repeal and replace Obamacare found himself instead at the center of a legislative mess that culminated in the American Healthcare Act (AHCA) unraveling before it even came to a vote.

To hear President Trump and Republican leadership right after this happened, that first attempt was the only chance they would ever have at healthcare reform, with lawmakers now forced to move on to tax reform.

{mosads}But in a move reminiscent of his old friend George Steinbrenner rehiring Billy Martin as manager of the Yankees, Trump announced this week that he is putting tax reform on the backburner and refocusing his attention on healthcare.

 

As difficult a fight as this promises to be, the move should be good news for all Americans, but especially for Republicans seeking progress on their broad agenda.

For one, most Americans want something to be done — especially the Republican base who elected Trump. While it remains fuzzy just what the President’s supporters favor on foreign policy, there is little doubt that they want swift relief from the Affordable Care Act.

The overwhelming majority of Republicans (89 percent in a recent Utah poll) want to repeal the law, while even solid chunks of the voting base at large want to see changes. Only 20 percent of Americans support keeping things as they are.

Contrary to the popular narrative, the failure of the terrifically unpopular AHCA does not mean the status quo is working or that leaving it unchanged is wise. Despite loud pockets of anger seen at townhalls nationwide, most people are unhappy with Obamacare for a simple reason — the system just isn’t working for the majority of Americans.

Rising premiums, growing strain on insurance markets — these are bipartisan problems, even if they currently seem to lack a bipartisan solution.

However, as Trump and Republican leadership are quickly learning, the divide between “doing something” and doing something that pleases a majority is wide. Forty-three percent of Americans want to fully repeal or scale back the law.

Most people hate the individual mandate but want to keep pre-existing conditions coverage and allow young adults to stay on their parents’ insurance. Bridging that gap will not be easy.

But abandoning the goal altogether is not just politically questionable, it also would threaten the success of all future endeavors for a very straightforward reason: In order to pass tax reform via the reconciliation process, Congress cannot make changes that run up the deficit.

Taking Obamacare off the table makes that goal much harder to achieve, even if Speaker Ryan and others manage to force through a controversial border adjustment tax. Put more simply, if President Trump thinks keeping his base happy is difficult now after the initial struggles repealing Obamacare, it’s hard to imagine how difficult it will be if tax reform also fizzles.

Cobbling together a coalition broad enough to pass anything is often a Herculean task, and the responsibility for failing to do so ought not rest only on conservatives baffled that Republicans can’t pass what they already did numerous times under President Obama.

But all wings of the party — and especially the president — reasonably concerned with holding power and passing a conservative, small government agenda should be wary of what happens next with healthcare, as so many of their future goals depend on it.

No doubt President Trump, and those surrounding him, have the political instincts to realize that dealing with healthcare is not only good for the county, but good for them electorally. All that remains to be seen now is whether they are savvy enough to recognize the true opportunity and risks that they are facing.

 

Jonathan Bydlak is the founder and president of the Coalition to Reduce Spending, a non-profit, non-partisan advocate for reduced federal spending and balanced budgets.


The views expressed by contributors are their own and not the views of The Hill.