It’s hard to know what “Trumpcare” is, but whether it’s “repeal” or “repeal and replace with something terrific,” it was and is going to fail. It was either going to fail to be enacted by Congress, or if it was enacted, it was going to set off such a bipartisan backlash it would be repealed, either by a chastened Republican Congress or a new Democratic Congress and president.
The reason Trumpcare was doomed was that health care is not like global warming or police shootings or use of military force in foreign countries: It is an issue a large majority of Americans agree on, and it is an issue voters can assess with their own eyes in their own kitchens.
Republican voters are almost identical to Democratic voters in what they want in a health care system. They want comprehensive coverage, low out-of- pocket costs and affordable premiums, freedom to choose their own doctors (they could care less about freedom to choose between Aetna and Humana), and freedom from interference by bureaucrats (be they public or private). Obamacare became a liability for Democrats because the public clearly perceived that the ACA could not meet those requirement for millions of Americans. The public now clearly perceives Republicans want to enact legislation that would be even worse than the ACA.
These facts — Americans want the same thing in a health care system regardless of party, and it’s difficult for politicians to fool the public about the success or failure of a health care bill — were obvious to thinking people even before the new Republican-controlled Congress began writing their “repeal and replace” legislation. But it was not obvious to Trump and most congressional Republicans. For some reason they thought they could remove 20-30 million people from the ranks of the insured, hand most of the savings over to the rich, and the public wouldn’t mind.
Now they know. The public has a little problem with that.
The good news is that Trump and the Republicans learned before enacting their dreadful “repeal and replace” bill that the public doesn’t like it. The bad news is that Trump is the president, he has the power to accomplish repeal by sabotage, he doesn’t seem to care what happens to the Republican Party now that they elected him king, and he might well force the country to undergo a rough equivalent of repeal without the formal consent of Congress. In that event, we will have to watch Trumpcare die AFTER it harms millions of people who have insurance now, and after it inflicts much damage on the GOP.
Trumpcare was and is doomed. The only question before us is how it will die.