Will Trump Bypass Ryan after the Failure of the Health Care Bill?
It’s a fait accompli that the American Health Care Act (AHCA) is politically dead, and it’s a popular Washington sport for Democrats and Republicans to point the fingers at each other as the cause.
Although President Trump publicly voiced his support for the AHCA, behind closed doors it’s rumored he wasn’t 100% behind the bill—he recognized that it had some weaknesses. So who’s to blame in this debacle? Certainly President Trump has some egg on his face, but the ultimate loser in this scenario is the bill’s leader, Speaker of the House Paul Ryan.
Ryan had a lot riding on AHCA passage; it was he who was charged with corralling representatives in the House together to support the bill so it had a fighting chance in the Senate. In the end, it was not to be, and now Ryan is the one with egg on his face, although different theories abound as to why the Speaker pushed a bill that seemed doomed to fail almost from the beginning.
The obvious theory is that since Ryan has taken so much money from the insurance industry, it was less of a problem for him to support “Obamacare 2.0” and to at least make an effort to get other lawmakers behind it. It’s well-known that Ryan and Trump see less than eye-to-eye on “draining the swamp” of Washington, and for this reason, Ryan is much less popular among ardent Trump supporters.
Another theory is that Ryan actually wanted the bill to fail because there was no way it could satisfy all the parties involved — least of all the American public. By having the bill fail, the Congressional Freedom Caucus — the group of conservative congressmen who opposed the AHCA — look obstructionist.
Indeed, one Republican congressman (Rep. Ted Poe of Texas) made a comment that the Caucus would have “opposed the Ten Commandments” if given a choice. In this way, Ryan can make his enemies look weaker, although there are dangerous ramifications of this strategy, one of which is that Ryan now appears to be more exposed in terms of his continued leadership prospects.
Going forward, it’s almost certain that the White House will further attempt to bypass Ryan, by talking directly to lawmakers, in trying to gain support for its legislative priorities for the rest of this year, including tax reform and budget approval, among other items. If this comes to pass, and Ryan is increasingly left out of the loop, he could find himself isolated, which would have the effect of people inside and outside Washington questioning why he’s in a leadership position.
In the meantime, despite reports, Republicans are continuing to try to salvage a replacement for Obamacare. There are some people who say that Trump may be in a stronger position now because he can either accelerate the “death spiral” of Obamacare — which the Congressional Budget Office (CBO) has claimed is actually further away than many pundits had predicted — or he could use his powers of the presidency to try to make fixes to Obamacare — possibly working with Democrats to negotiate with insurance companies and claim victory if and when Obamacare costs stabilize.
The first option may be more appealing, because Obamacare blowing up would force both Democrats and Republicans to scramble and come up with a solution that doesn’t make voters so angry they toss out members of Congress from both parties in 2018.
Health and Human Services Secretary Tom Price, who issues regulations governing Obamacare, was appointed by Trump, and therefore, it wouldn’t be hard for Price (who is known to be an opponent of Obamacare) to sabotage the system on Trump’s orders.
The Trump White House could also order an end to cost-sharing subsidies that reduce deductibles. Republicans have already challenged these subsidies in court, and the insurance companies say Obamacare couldn’t survive without them.
Of course, politically, it’s a high-stakes game, because Democrats would immediately cry foul, and if a better replacement wasn’t in place by 2020, it’s possible that Trump wouldn’t be re-elected (however, if one was in place by then, he could take much of the credit).
Trump could also order the IRS to ease up on enforcing tax penalties paid by people who choose not to buy insurance at all, perhaps counteracting some of the negative publicity in the last scenario. But one way or another, Trump likely sees all potential endgames as a win-win for him; as he said, politically, it might be wisest to simply let Obamacare become so dysfunctional that Democrats would come begging to him for a replacement.
But without tinkering, that’s unlikely to really happen by 2018 (although premium costs are certainly skyrocketing). Hardcore opposition to Obamacare replacement may yet cost Democrats in 2018 much more than it will cost Republicans. In the end, it may come down to a bitter case of who yells and accuses their opposition the loudest. Trump is a veteran of public relations battles in the press — House Speaker Ryan, not so much.