President Donald Trump has already rendered a verdict on his own skills as a legislative negotiator — in a pathetically premature Rose Garden celebration of a House vote to repeal and replace Obamacare. The full picture is not quite so rosy.
As a policy leader, Trump is unique among recent presidents. He doesn’t lead on policy. Normally a president who wants action on health care would try to unite the caucus by putting forth his own substantive ideas and getting legislators to support them. Trump never had a substantive proposal and never showed any command of the details involved, so he could not play that role. He forcefully pushed House Republicans to vote on something, anything, but he didn’t help resolve differences among them.
The system is adapting to the vacuum at its heart. Before the first, aborted health care vote, Trump complicated Speaker Paul Ryan’s life. He bullied and offended key congressmen, and showed discrediting ignorance of important policy details. Before the second vote, Trump made some calls to Republican legislators, but it was Vice President Pence who took the legislative lead. And it was Ryan who won the day, addressing the concerns and objections of wavering Republicans one by one, concession by concession.
The result is not pretty — a bill that seriously underfunds Medicaid and leaves a large gap of coverage between Medicaid eligibility and a useful tax credit to purchase insurance. The bill also employs the threat of higher premiums to ensure that people keep continuous coverage, replacing a mandate with a disincentive. But those premiums are not capped — essentially allowing insurers to deny coverage to people with pre-existing conditions who haven’t kept continuous coverage. That is political poison.
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Republicans are generally hoping that the Senate will inject some rationality and compassion into the process — adequately funding Medicaid, making the tax credit means-tested and more generous to those at the bottom, and encouraging continuous coverage in some other way. But this is all occurring with very little guidance from the top. The Senate process led by Sen. Lamar Alexander seems, so far, to be designed to function without presidential input.
Trump is giving an entirely new meaning to a “Rose Garden strategy.” His goal is successful votes and Rose Garden ceremonies, with the content of those victories subcontracted. Trump, no doubt, views this as a strong executive focusing on the big picture. But this is not the result of management theory. It is the only possible choice for a chief executive who is being introduced to substantive issues and debates for the first time and seems to find them tedious. “Nobody knew health care could be so complicated,” Trump said at one point, in a statement more fitting to a congressional intern.
It is useful, even necessary, for outsiders to arrive in periodic political waves. It is part of the way that democracies renew themselves without coups and violence. But this kind of outsider perspective is precisely what Trump is not providing.
Some of the reason is just the swift, merciless education provided by reality. Yes, Middle East peace is just as “difficult as people thought.” No, building a wall across a continent isn’t really possible. Yes, health care policy is complicated.
Trump, more than most, is severed from the people and priorities he ran on. What he said during the campaign about the struggles of the working class is important. But it has almost no relationship to his governing agenda. Trump’s budget director produced a budget to please the House Freedom Caucus, not to deal with the downsides of globalization. Republicans in the House cobbled together a health care bill that has something for almost everyone — except the struggling working class that doesn’t qualify for Medicaid.
This is the price of Trump’s emptiness. On major economic issues, he has not produced policy that tilts toward the needs of the working class. He has not rallied his party to address these problems in practical ways. Instead, he has outsourced his policy priorities, and thus outsourced his political uniqueness.
During the presidential election, we heard, time and time again, that Trump is not a politician and would do what he said he’d do. The two points are actually in tension. Because Trump knows little about governing and less about policy, he can’t do what he said he’d do. And this only adds to the sum of American cynicism.