Trump Now Owns the AHCA Healthcare Plan
In President Trump’s 2020 Campaign Speech in Kentucky last night, he took ownership of the American Health Care Act (AHCA) by fully backing its passing in the House two days from now, on Thursday. This morning, he met with the House Freedom caucus, and threatened the re-election of any Republican Representative who voted against the AHCA. It wasn’t clear if they would just be in trouble with Trump voters, or if Trump might send a nasty tweet about them, or actively campaign for a hand-picked and loyal primary challenger. That is total ownership.
The AHCA cuts 24 million people in ten years, and 14 million in the first year. Many of them are Trump supporters. The House has put on a rider of an additional 75 billion dollars to support Medicaid and almost seniors in age, who will be subject to the 5 to 1 cost ratio to young people, from the present 3 to 1. The use of this money is not yet specified. It seems too much for each year, and is probably over 10 years. The AHCA is supposed to save 334 million dollars over 10 years.
Trump said that he could not present tax cuts until the AHCA was passed. This makes it pretty clear that the AHCA savings were not going to deficit reduction, as they are presented, but to tax cuts, and undoubtedly weighted to the rich.
In Trump’s Kentucky speech, he railed against President Obama and the Congress passing the Affordable Healthcare Act (AHA, alias Obamacare) both without transparency and in a rush. Only a few sentences later, he urged Representatives and Kentucky Senator Rand Paul to pass the ACHA in three days and without resolving the Medicaid and almost Senior problems. There is no use wasting internet electrons calling this hypocrisy, since that word applies to almost everything that Trump does.
Finally, Trump repeated his slogans, including “Make America Safe Again”. Again, cutting 24 million from health care does not make America safer. Nor does the 18% cut in the NIH for future medical care advances.
Trump’s threatening the re-election of his fellow (?) Republicans is a very serious threat, which Trump seems easily capable of insuring. Considering a primary threat, that could make any Republican nervous. Most Republicans are in safe gerrymandered districts or in red states, where there is no real Democratic threat. This new Trumpian threat is akin to the Tea Party havoc of a decade ago. It wasn’t present in the 2016 election, since nobody knew that Trump would win, or continue in the political scene.
There are some caveats to the Trump threat, however. First of all, it loses President Trump a lot of potential Republican friends, especially if they have to accede to his threat. It also endangers their reputation in their districts if they cannot stand up for their special projects that will be decimated by the steep domestic budget cuts. It also increases Democratic opposition and anger, and encourages Democratic financial support, if they are in close districts. Trump’s current approval rating is about 39%, and it has generally been sinking. The Trump-directed controversies have increased in number and depth, rather than getting fewer and subsiding. Even in the 2016 campaign, Wisconsin’s Paul Ryan skipped rallies where he would have to appear with Trump.
There are 237 Republicans in the House, plus 4 Republican vacancies where they have joined the Trump administration. That is a lot of Republicans to campaign against, if they wanted to revolt en masse on some issues. Even 30 in the Freedom Caucus is a lot to oppose en masse, and a lot of them are demographically backed in their districts.
Clearly, the AHCA has become an important issue this week for Trump. But its catastrophic effects as analyzed by the CBO was only known for a week, and Trump was lukewarm about the House Ryan plan before. We all know that Trump hates to lose. But sometimes, not winning on obtaining a very bad investment is a good deal. So happy.