Is Donald Trump Intentionally Sowing Health Care Chaos?

Predictably, the promised Obamacare “repeal and replace” legislation has thrown all of Washington into a tizzy. The reason it was predictable is that if the Republicans had been able to put together a serious alternative to Obamacare’s market-friendly, hybrid health care program, they would have done it long ago and run on it. The fact that they didn’t should have been a hint that whatever they did was going to be politically unpopular. Instead, they demagogued the program for years, turning it into an easy symbol of Obama hatred to motivate their base. Now they are like dogs who finally caught the car they’ve been chasing and have no idea what to do with it.

Since Paul Ryan and company dropped their plan and the House speaker took to the airwaves with his sleeves rolled up to give the country a riveting PowerPoint presentation, it’s been obvious that their plan is in big trouble. When the Congressional Budget Office released its analysis on Monday showing that 24 million people stood to lose their insurance and costs would rise insanely high for older people, all to give the wealthy yet another tax cut, the bottom fell out. Headlines like this one, from the Augusta Chronicle in Georgia, were seen all over the country on Tuesday morning:

That certainly didn’t make Ryan’s job any easier but he carried on gamely, appearing on Fox News to say that he was “encouraged” by the news, prompting Bret Baier to ask him,  “If you’re encouraged by this CBO report, what’s a CBO report you’re discouraged by?”

The Republicans are all over the place with this at the moment. Nobody knows if there’s a strategy or if they’re just running around in circles trying to figure find a way out and bumping into each other in the process. At this point, the Tea Partyers of the House Freedom Caucus are upset that the plan isn’t harsh enough and are demanding that all the cutbacks happen immediately. The rest of the caucus is either backing Ryan or trying desperately to come up with a good reason not to.

They’re all getting an earful from their districts and are feeling unsure why they should walk the plank on an unpopular bill when it’s pretty clear the Senate is having none of it. There, the revolt is mainly among a handful of moderates who see the Ryan bill as going way too far rather than not far enough. At least that was the state of play until Tuesday, when Ted Cruz stepped forward to criticize the plan for the projected premium increases.

Even Arkansas Sen. Tom Cotton, whom nobody would call a moderate, came out swinging, saying the House should tear up the Ryan bill and start over. The governor of Arkansas, Asa Hutchinson, is also rebelling as are a number of other Republican governors who will have to deal directly with the havoc this plan will wreak.

Every faction of the Republican party is at odds with at least one other faction of the party, sometimes with all of them. When that happens, one would expect that a president of the same party would be the mediator. In this case, expectations are exceptionally high since the president has sold himself as the greatest negotiator in the world, a man who will single-handedly bring peace to the Middle East and personally renegotiate all global trade agreements over lunch at Mar-a-Lago.

Publicly, the White House is backing Ryan’s plan. Press secretary Sean Spicer said on Tuesday that the administration rejects the CBO projections because they don’t account for the “three-pronged” strategy, which he was unable to coherently explain. But Trump had said something different to conservative activists who call Ryan’s plan “Obamacare-lite,” promising to endorse their demands and punish those who disagreed.

Meanwhile, Breitbart has suddenly become an important player in the debate. The site has returned to bashing Ryan on a level that hasn’t been seen since late 2015, when Trump adviser Steve Bannon was the editor and wrote in an email to the site’s Washington editor that his “long game” was for Ryan to be “gone by spring.” This has people wondering if Bannon is trying to send a message to Trump through the media, since that’s rumored to be one of the tactics by which the courtiers seek to influence the king. But that’s assuming that Bannon needs to do that and that he still has great influence at Breitbart. (He went out of his way to distance himself from Breitbart over a different matter recently, but nobody knows whether that was a feint or not.) Bannon or not, Breitbart is pro-Trump, and whatever the site’s editors are doing, they believe they’re doing it on his behalf.

So what does Trump want? He’s been all over the map, promising the moon and having no idea how to deliver it, repeatedly assuring everyone that health care reform would be “easy” and “fast,” until he was informed that it was very complicated. Since then it’s been obvious what his preference really is and he’s been open about it. As I mentioned in this piece from earlier in the week, he wants the bill to fail, at which point he will sabotage the existing program and then blame it on the Democrats.

When Trump met with that group of conservative activists and promised to support their even harsher version of the bill, he described this as his fallback position. But he has signaled this numerous times since the election. In his press conference on Jan. 11, he tipped his hand: 

We don’t wanna own it, we don’t wanna own it politically. They own it right now. So the easiest thing would be to let it implode in ’17 and believe me, we’d get pretty much whatever we wanted, but it would take a long time.

Trump considers “blame” an important aspect of politics and thinks it would be useful for him to have Obamacare to kick around for a while. But Republicans have been promising to repeal Obamacare for years. They know that if they don’t get it done when they control all three branches of government, their voters will logically blame them for whatever happens to their health care, not the Democrats.

Trump probably understands that and just doesn’t care. His motto when it comes to politics is “ask not what your country can do for you, but what you can do for me.” It’s all about him. The Republicans are on their own.

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