Obamacare lives! The gang that can’t shoot straight blows it bigly

“The Art of the Deal,” updated:

“So my terrific advice is this. Pick an issue, a real beaut, that’s too complicated to bother learning anything about. Nobody knew it was so complicated, believe me. Then go bully the people who have to decide the issue, tell them you need a big beautiful Win, give them whatever they need so that you get the Win. If that gets you nowhere, go hop in a Mack truck, toot the horn, scowl like a man, and drive nowhere. Then go on Twitter and bully those people again, tell them to give you a Win. Then just say the hell with the whole thing.”

Now I understand why he went bankrupt so many times.

Remember when Trump promised his credulous naifs that he’d kill Obamacare with his magical powers? Remember last year when he promised to “immediately repeal and replace Obamacare – and nobody can do that like me”? Remember when he said it was “moving fast” and would happen “very quickly”? Remember when he said “we’re gonna win with health care…we’re gonna win so much you may even get tired of winning”?

So much for that. Turns out, on his first major presidential test, he’s a loser. Bigly. Late today, his House Republican compadres pulled the Trump-touted kill-Obamacare bill because, despite their hefty GOP majority, they couldn’t even corral enough votes.

Actually, it’s hard to tell who’s more mendaciously incompetent: the policy-ignorant promise-busting poseur in the White House, or the people in his party who just couldn’t agree on how best to wreak havoc on tens of millions of Americans. This is what passes for “Republican governance,” an oxymoron for the ages.

What happened today in the House of Representatives was proof that Trump and the Republicans were dysfunctional partners in a blundered elitist scheme to ruin lives. I know that sounds hyperbolic, but center-right columnist David Brooks agreed when he wrote this morning that the House Republican plan to replace Obamacare “would increase suffering, morbidity, and death among the middle class and poor in order to provide tax cuts for the rich.”

The public caught on to the con. The latest national poll says that the House Republican plan – to eradicate a major social entitlement program – had the support of a very modest share of Americans. Like, 17 percent. That is not a typographical error. Which means that a president with a 37 percent approval rating demanded a vote on a bill with 17 percent support. I guess that’s a brilliant example of running America like a business.

He owns this farce. He knows nothing about health care to begin with. He definitely knows what golf club to use when his ball is 90 yards from the green, and he definitely has opinions about breast curvature, but he’s predictably clueless about how health policy affects the average Joe. So he ceded all the kill-Obamacare details to Paul Ryan and his band of ideologues – and what a fine mess they made.

Trump promised his fans that he’d replace Obamacare with “insurance for everybody” while protecting health care access via Medicaid, but the House Republican plan hiked the ranks of the uninsured by 24 million over the next 10 years (according to the nonpartisan Congressional Budget Office), and it sought to slash Medicaid. Trump said he was fine with that. And yet, the GOP’s right-wing extremist lobby, the hilariously named House Freedom Caucus, still wasn’t happy. It insisted that the bill should have a lot more Freedom.

And so, because Trump wanted a win (any win will do), and because he couldn’t boast of a win unless he corraled sufficient Freedom Caucus votes, he agreed to gut federal provisions that require insurers to offer basic benefits – like maternity care, substance addiction treatment,  and mental health visits. The Freedom Caucus also insisted on gutting popular Obamacare features – like the one that allows young adults to stay on their parents’ plans until age 26; like the one that bars insurers from setting different rates for men and women; like the one that bars insurers from discriminating against people with pre-existing health conditions.

But every additional draconian sweetener that wooed the Freedom faction was a deal-breaker for moderate Republicans who are attuned to the needs of their constituents. As Pennsylvania congressman Charlie Dent said the other day, the bill Trump wanted “will lead to the loss of coverage, and make insurance unaffordable for too many Americans, particularly for low-to-moderate income and older individuals.” His view was shared by many Republicans in the Senate; even if the House bill had somehow passed, it would’ve been put through the Senate meat grinder.

Bottom line: It’s one thing to rail against Obamacare for eight years – rhetoric is easy – but actual governing is hard. The guy in the White House doesn’t know anything, and Republicans are sundered from within. This is the gang that can’t shoot straight. On health care, these people can’t find their own butts with a map of the human anatomy.

They have a huge House majority, yet the Trumpcare vote was set to be a cliffhanger. Why? Because the fence-sitters coildn’t decide which outcome would be worse for them in the ’18 midterm elections. If they failed to deliver on their longstanding promise to kill Obamacare, the Obamacare-hating right-wing voters could scream betrayal and stay home en masse in ’18. (With today’s debacle, that scenario is now more plausible.) On the other hand, if Republicans try again and somehow manage to pass a replacement law that causes tens of millions of people to lose their coverage, mobilized liberals and newly uninsured Trumpkins could boost the Democrats in ’18.

“For the past seven years,” says conservative commentator Rich Lowry, “the party benefited from its powerlessness, which usefull maximized its ability to criticize Obamacare and minimized its responsibilty to do anything about it. Now, with unified control of government, the party will pay the piper…Republicans should get used to it. Their agony on health care is just beginning.”

So Obamacare lives. And I fully expect a weekend Trump tweet that’s drenched in denial. Something like:

“I win again. I said all along that the health care bill would get pulled because I’m very instinctual.”

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