Donald Trump says his health care plan will provide “insurance for everybody.”
And that means we are about to find out what kind of Republican president he will be.
Trump’s comments to the Washington Post put him at odds with the Paul Ryan wing of the GOP, which has been waiting six years to junk Barack Obama’s signature program. And the incoming president doesn’t seem to care.
He says, in a classic Trumpism, that everyone will be “beautifully covered.”
Now I spent much of the campaign arguing that Trump, a onetime Democrat, was far from an orthodox Republican. This was clear when he repeatedly told me and other interviewers that he would not touch Medicare, despite the standard GOP position that soaring entitlement spending must be reined in. Trump appealed to working-class voters in part through a mixture of conservative and more moderate positions.
ObamaCare always contained a ticking time bomb for any future repeal effort. It’s a fact of Beltway life that it’s a zillion times harder to repeal an existing government benefit than to block a new one. With 20 million people added to the insurance rolls under the Affordable Care Act, the prospect of them losing coverage would be a PR nightmare for the Republicans.
At first the GOP seemed inclined to repeal now and promise to replace the program in a couple of years. But Trump insisted that both be done at the same time.
As for Trump’s insistence that no one lose medical insurance, here’s the warning shot: “I think we will get approval. I won’t tell you how, but we will get approval. You see what’s happened in the House in recent weeks.” That was an obvious reference to how he strong-armed the House GOP, with a single tweet, into reversing its ill-advised move to gut the congressional ethics office.
ObamaCare has lots of problems, including soaring premiums and all the people who lost their plans and access to their doctors, despite the president’s promises.
But when Trump said he wanted to keep two key elements—no ban on preexisting conditions and young people staying on parents’ policies until 26—it was clear the whole program wouldn’t be sent to the trash heap.
None of this means the Ryan Republicans won’t fight for their vision of a stripped-down vehicle, perhaps with individual health savings accounts. And Trump may learn that delivering “lower premiums,” as he told the Post, is complicated in a program with so many interlocking parts. He also said he would pressure drug companies to reduce prices, as he is doing with Boeing and the cost of the next Air Force One planes.
Whether Trump can bring a better health care program in for a landing—or it gets mired in Capitol Hill quicksand—will be an early test of whether he can turn campaign rhetoric into reality.