If the Republican and Democratic senators had been working on a plan to preserve federal subsidies for health care insurance premiums – which were ordered ended by President Trump – here’s what they would have done:
They’d have gone behind closed doors, furrowed their brows for a few days, engaged in public fussing and feuding and name-calling. Then they would have come forward with an exact duplicate of the Affordable Care Act. Only they’d have fine-tuned some things: lowering drug prices and mandating that all Americans sign up, and expanding Medicaid for all, which would save some small hospitals along with the lives of hundreds of thousands if not millions of Americans.
And when they produced it, they would have said, “Now, after great compromise, we present the Donald J. Trump Heath Care Act for America, which will fulfill the president’s promise of a “beautiful, better” plan than that dastardly Obamacare.” Trump would sign it immediately, take a couple of swings at Obama, whose legacy and success obsess him, and then go on a nationwide tour taking bows for his genius.
The so-called compromise crafted by Sens. Lamar Alexander of Tennessee, a Republican, and Patty Murray of Washington, a Democrat, doesn’t do that, of course, but it is a move to undo a horrendous Trump mistake in ending health care insurance subsidies from the federal government that enabled millions of people to afford insurance. Trump likely has never read the ACA and probably doesn’t know any of the details. He also likely wouldn’t care if the United States had a single-payer, national health care system.
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What he does care about is undoing all that President Obama did, whether it was to install more reasonable immigration rules or to establish a health care system to serve all Americans. But he couldn’t care less about details, just as he has shown he also doesn’t worry about the effects of policies on people.
For now, Alexander and Murray have taken a good step. Basically, it’s a delaying action that preserves the subsidies for a couple of years, which will help insurance companies hold down premiums, at least a little. Absent those subsidies, premiums were set to skyrocket for many Americans. States will get a little flexibility in working the rules on health care, which probably won’t be good in many states where Republicans rule. But at least some people will be protected from the knee-jerk, explosive action from Trump.
And for his part, the president can claim credit for taking a step to end “Obamacare,” which he wrongly characterizes as a “disaster” even though its popularity has grown as millions of Americans have attained insurance thanks to the ACA.
The president’s attention span is short, and he’s going to be preoccupied in the coming months with the the “Russia probe” related to the 2016 campaign, so perhaps he’ll go on to other ideological battles and leave health care alone for a while.