Jules Witcover: Republicans act in haste on replacing Obamacare
WASHINGTON — Donald Trump’s biggest promise on his way to the Oval Office was to “repeal and replace Obamacare.” He not only said he would do so, but he said he would achieve both tasks “simultaneously,” and on day one of his presidency.
But seven weeks into the Trump administration, he finds himself bogged down in the customary legislative meat grinder that is law-making in America’s bilateral process and two-party political system.
Two basic Republican objectives are involved in the current scrimmage, one represented by President Trump and the other by House Speaker Paul Ryan.
Trump’s is political, in swiftly fulfilling his campaign pledge to take action and provide window-dressing for his faithful voters. Ryan’s is policy-driven, a detailed formula designed to achieve the long-held GOP goal to rein in the scope and cost of a major safety-net program.
The Trump objective has produced a showy product devoid of the essential element of a credible price tag, as expressed in a reliable “scoring” by the Congressional Budget Office, which is yet to come.
This has left Ryan in the challenging position of selling the replacement health care package as a pig in the poke, a particularly hard proposition to make to members of his House caucus dedicated to cutting costs and demanding to see that price tag first.
Trump has already signaled his willingness to strike deals with reluctant Republicans, which always has been his business forte. But Ryan in a press conference has assured his members his plan is “a conservative wish list,” calling it “a covenant we made with the American people when we ran on a repeal-and-replace plan in 2016.” He added: “I have no doubt we’ll pass this because we’re going to keep our promises.”
But the absence of the CBO cost calculation has generated caution among congressional Republicans as well as Democrats. Rep. Lloyd Doggett (D-Texas) warned that “health care is too important, it impacts too many lives, to have a health care bill jammed through in this manner as President Trump’s immigration order. What this bill needs is some extreme vetting.”
Conservative Republican Sen. Tom Cotton of Arkansas agreed. “I want to get it right, I don’t want to get it fast,” he told MSNBC. “And the Senate certainly will not be jammed with whatever the House sends over here.”
The White House pushed back on the absence of the CBO scoring. Trump’s press secretary, Sean Spicer, sarcastically observed, “If you’re looking to the CBO for accuracy, you’re looking in the wrong place,” citing its forecasting of the cost of Obama’s Affordable Care Act, which is now on the chopping block.
White House Budget Director Mick Mulvaney also weighed in, saying the Ryan plan “is going to score points in helping on the deficit, to (spend) less money CHECK. So I hear all this talk about the CBO score. The only question about the CBO score is: Is it going to be really good or is it going to be great when the figures are out?”
But Republican Sen. Susan Collins of Maine said of the replacement bill: “I do not think that it will be well received in the Senate. I want to slow down, to take more time to sure we get this right.”
Her caution reflects the political concern among Republicans that in their rush to score points with the broad Trump constituency, the party could be at risk of alienating current Obamacare enrollees who might find themselves without coverage upon repeal.
Ironically, Trump’s new willingness to slow down the process and negotiate on details of the Ryan package could save it from unwise haste inspired by his own desire to meet what was his strongest vote-getter and loudest cheers in the 2016 campaign.
In the end, an even greater irony would be that when all the dust and furor clears, the essence of Obamacare or a reasonablc facsimile of it could wind up in place, for all the Republican rush to judgment.