Deprive 24 million people of health insurance. Or don’t.
If you’re President Donald Trump, it would seem, either outcome is just fine.
During an interview with Financial Times that appeared over the weekend, Trump said he hadn’t given up on repealing the Affordable Care Act, even though House health care legislation fell apart last month when it didn’t have the votes to pass.
Both Trump and Speaker Paul Ryan (R-Wis.) have since put most of the blame for that failure on the House Freedom Caucus, a group of extremely conservative Republicans who rejected the bill because it left too much of Obamacare in place.
In the FT interview, Trump said he hoped Freedom Caucus members would come around. But if they don’t, Trump said, he’ll simply cut a deal with Democrats instead.
“If we don’t get what we want, we will make a deal with the Democrats and we will have in my opinion not as good a form of health care, but we are going to have a very good form of health care and it will be a bipartisan form of health care,” Trump said.
Taking Trump quotes seriously or literally is always a gamble, given how frequently he contradicts himself or makes outlandish statements. But he made the same point on Twitter Saturday, when he wrote this:
The idea that Trump could so easily toggle between appeasing the Freedom Caucus or working with Democrats is difficult to fathom, given what each side wants.
The Freedom Caucus had rejected the American Health Care Act, the GOP leadership’s bill, because it wanted even fewer guarantees of coverage ― even though that proposal would have steered insurance subsidies away from the poor and the sick, dramatically reduced funding for Medicaid, weakened regulations on what insurers cover, and ultimately increased the number of Americans without insurance by 24 million, according to the Congressional Budget Office.
Democrats, for their part, want no part of repeal. They would gladly modify the Affordable Care Act in order to shore up shaky insurance markets in states like Arizona and Tennessee, where insurers have struggled to make money and are contemplating leaving altogether. But such amendments would necessarily involve strengthening the program ― or, at the very least, trading more liberal reforms (like increasing the value of subsidies for people buying coverage) for some more conservative ones (like giving insurers more freedom to vary premiums by age).
In other words, the agendas of the Freedom Caucus and Democrats aren’t simply different. They are mutually exclusive and lie at opposite ends of the political spectrum. It’s not possible for Trump to be comfortable with both options ― unless he has no clue what any of these proposals would do, or has no interest in substance altogether.
During the March negotiations, Politico reported, Trump told Freedom Caucus members to drop their objections and “forget about the little shit,” even though they were raising serious, fundamental objections to the GOP proposal. On several occasions, according to The Washington Post, Trump had to ask own advisers, “Is this really a good bill?”
“Either doesn’t know, doesn’t care or both,” is how one Capitol Hill aide described Trump to CNN.
Of course, there’s always one other possibility. Trump could have zero interest in working with Democrats. He might simply be trying to threaten the Freedom Caucus into dropping objections ― in which case the question would be whether those Freedom Caucus members are willing to call his bluff.