Politics & Policy

Who Killed Obamacare Repeal? Blame Trump.

(Reuters photo: Kevin Lamarque)
There are a lot of reasons the GOP failed, but the most important was the lack of a president who knew what he was doing.

The dismal saga of the Republican party’s effort to repeal Obamacare reached what appeared to be the end of the line this week when the Senate voted down a partial-repeal plan 51–49. There are a lot of reasons for the failure. But the person who bears the most responsibility is the one least likely to shoulder any of the blame: President Donald Trump.

The difficulties involved in repeal and replace were formidable and would have challenged the talents of any president. But if a more conventional president had been in charge — one with extensive political experience and policy knowledge, as well as the temperament needed to work closely with Congress — this result would have been unthinkable.

To be sure, Trump is far from alone on the list of those who have ensured that Obamacare is here to stay. Leaving aside the efforts of President Obama and the Democrats, who acted against public opinion to cram the bill down the throats of the country in 2010 on a partisan vote, there is no shortage of conservative villains here.

If Chief Justice John Roberts had not voted to uphold the individual mandate, apparently out of a conviction that the Supreme Court must not bear responsibility for sinking the law, the legal campaign to reverse Obamacare would have succeeded long before the Republicans had the power to repeal it. But Roberts abandoned the other conservatives on the Court, who believed it was unconstitutional to compel citizens to buy insurance.

Much of the problem also has to do with the dysfunctional nature of a GOP that has struggled to transition from opposition to governing. The GOP wasn’t just unprepared to make good on seven years of promises when it arrived in Washington this past January with control of both ends of Pennsylvania Avenue; it badly underestimated how hard it would be to do something that no party has ever been able to accomplish: roll back an entitlement that helped millions of Americans even if it hurt millions of others.

Therefore, House Speaker Paul Ryan, Senate Majority Leader Mitch McConnell, and other congressional leaders must shoulder their share of the blame. So long as President Obama was in the White House, they were free to posture on the issue, vowing that they would repeal it as soon as they got the chance. The same is true of rank-and-file conservative members who supported the grandstanding of Senator Ted Cruz and others who pushed the party into a government shutdown that hinged on a futile effort to defund the health-care law.

Their tentative efforts to plan for the day when they could do more than posture about it were perfunctory. Ryan devoted more thought to this problem than most Republicans did, but he was never able to bring enough of his members around to any of his ideas.

When they unexpectedly found themselves with the ability to make good on their promises, Republicans were hopelessly divided between those who wanted a clean repeal and those who wanted to preserve the entitlement that Obama promulgated, albeit in a manner that was less reliant on the federal government. As with previous generations of Republicans who feared to reverse liberal entitlements, some in the GOP proved to lack the courage of their convictions.

But still, this failure was not inevitable. The gap between the House Freedom Caucus and Senate moderates such as Susan Collins is large, but the idea that it was unbridgeable was more a function of a lack of leadership than of anything else.

The history of initiatives of this sort teaches us that a president armed with control of both houses of Congress who decides on a legislative priority usually gets his way. Such efforts involve painful compromises, payoffs to recalcitrant members and their constituents, and the inevitable arm-twisting and threats — as well as the ability to go over the heads of representatives and senators and speak to the country directly, an essential element of any president’s political arsenal.

Barack Obama had little respect for Congress or interest in the normal forms of friendly persuasion that involve entertaining and back-scratching. But he proved a president could have neither the charm of Ronald Reagan nor the penchant for raw political thuggery of Lyndon Johnson and still have the ability to force dysfunctional congressional majorities to give him what he wanted. A president who punts responsibility for managing Congress as Trump has done, however, will never get his way.

The problem with the Trump White House is not just that it is a political circus that revolves around the whims and mood swings of a president without a normal filter. It’s that it is led by someone whose lack of policy knowledge is matched only by his lack of interest in doing the normal spadework of presidential leadership.

Trump has some impressive political gifts, as his unexpected win last November proved. But governing requires him to do things that don’t involve speaking to adoring audiences or burning foes and friends alike on social media.

The chief architect of the worst disaster of his administration is the man in the mirror.

A more conventional president would have concentrated the West Wing’s efforts on repeal and replace and spent all of his first-term political capital on forcing Congress to give it to him in a form that he could present as a triumph, even if (as was the case with Obama’s health-care law) a lot of the details would have had to be worked out later.

But while Trump occasionally gave lip service to this effort, it never captured his full attention. Worse that that, distracted as it was by the civil wars Trump encouraged, his chaotic staff never devoted enough of its time or effort to accomplish what the president couldn’t be bothered to do.

Trump’s loyalists may argue that a conventional politician could never have led the Republicans to victory in 2016. We’ll never know how any of Trump’s defeated rivals would have fared against the lackluster Hillary Clinton campaign. But the characteristics that endeared Trump to disillusioned voters — his lack of concern for how the system works and shallow knowledge of policy questions — have come back to bite him with a vengeance.

Trump assumed that he could pass off the normal political responsibilities of a president to either his staff or the House and Senate leadership and still get the results he wanted. He was wrong about that, and to make matters worse, his predilection for sowing chaos and distracting the country from his legislative agenda made their work even harder than it might have been. An unpresidential temperament may be what elected Donald Trump, but it was also what ensured that a powerless Democratic minority and a few stray Republican dissidents thwarted the chief GOP policy goal of the last seven years.

Trump can blame a lot of people for this failure, and many of them will deserve it. But the chief architect of the worst disaster of his administration is the man in the mirror.


Editorial: The Republican Health-Care Fiasco

How Republicans Went Wrong on Health Care

Obamacare Repeal and Replace, R.I.P.

— Jonathan S. Tobin is opinion editor of JNS.org and a contributor to National Review Online.

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