Donald Trump has slapped his name on all kinds of things over the years, but he’s met an edifice he’s hesitating to brand, and that’s the House GOP’s Obamacare replacement. The president has sent mixed messages over the last few days about how hard he’s going to publicly sell the disastrous House bill. So far, only the Democrats are calling it “Trumpcare.”
But this is shaping up to become Trumpcare, and the neophyte president’s behind-closed-doors wheeling and dealing with the bill’s conservative critics are making sure that it either can’t pass—or if it does, that it will wallop the white working-class voters who are his base.
The image-conscious White House has vacillated on how involved the president should appear to be with the House bill. Trump hailed it with an enthusiastic tweet on Tuesday as “our wonderful new Healthcare Bill.” Several follow-up tweets defended the bill from its Republican critics, while reassuring them that all will be well. On Wednesday night, administration officials were telling reporters that Trump would “barnstorm” to win over recalcitrant Republicans—or rally their constituents against them. The Huffington Post reported he was going to ride Air Force One straight to Kentucky—home of Senator Rand Paul, the only senator who has said flat-out that he opposes the bill.
But by Thursday morning, the White House had pulled back on that claim, deciding to send Vice President Mike Pence to Kentucky, a move not likely to set Paul to shaking in his boots. Trump was back to tweeting that the media once again were lying about discord over the bill; negotiations would result in “a beautiful picture.”
Trump’s role, instead, became private lobbying. In meetings with the bill’s conservative critics—from Senator Ted Cruz and family to members of the House Freedom Caucus and Tea Party groups, Trump is said to be promising to halt expanded federal Medicaid support as soon as 2018, rather than 2020 as the bill currently does. House Speaker Paul Ryan, fresh from a lie-ridden Thursday morning PowerPoint presentation of his bill, is reported to be unhappy. The speaker looked like a menswear model pretending to do some work as he complained that under “Obamacare…young and healthy people are going to go into the market and pay for the older, sicker people.” Thus the program is a “death spiral,” he claimed. Ryan thus proved, despite his Beltway reputation as a wonk, that he doesn’t have a clue how insurance works—as the Internet let him know.
But Ryan is shrewd enough to know that if he makes the “replacement” plan any more cruel, the bill can’t pass the Senate. It already faces tough odds as it is. Rand Paul isn’t the biggest obstacle there; the bill may face more opposition from moderate Republicans like Maine’s Susan Collins, or those from states where Medicaid expansion has covered a lot of people, such as Arkansas’s Tom Cotton. So Trump’s promises to the right wing could bring Trumpcare crashing down around the GOP.
Let’s be honest: The House Republican plan is a tax cut for the rich disguised as health-care reform. Its intentions are diabolical and disastrous, but as a piece of legislation, it is an ideological and practical mess. One fact is inescapable: If you designed a plan to hurt Trump’s most loyal base—those white working-class voters in red and purple states who gave him the presidency—this is what you would design.
But so far, Trump seems not to have noticed this—or perhaps not to care. He is too busy taking credit for jobs numbers that are actually part of President Obama’s legacy (this after accusing his predecessor of “wiretapping” him). The guy who wrote The Art of the Deal (well, who slapped his name on it; Tony Schwartz wrote it) is actually a terrible deal maker when his marks have a little bit of power. Trump isn’t facing down small contractors he can fail to pay; he’s negotiating with House and Senate members whose votes are crucial to his plans. It’s harder to lie and make promises he won’t keep, though not impossible. The coming Trumpcare debacle will either expose deep rifts in the GOP, and the limits of the new president to bridge them, or it will toss an estimated 15 million Americans off their insurance plans, most of them in Trump-supporting red and purple states. And there will be an awful lot of Trump voters, like this one in North Carolina, who develop a case of buyer’s remorse that no insurance plan will cover.