By Rich Lowry
Friday, October 02, 2020
‘If you want to make God laugh,” Woody Allen once
famously said, paraphrasing a Yiddish proverb, “tell him about your plans.”
That’s not an issue for President Donald Trump, at least
not on health care.
He’s been promising a health care plan since he started
running for president, often with superlative adjectives attached, and yet
never produced one. His lack of a proposal was a stumbling block in Tuesday’s
debate and plays into a broader, long-standing Republican vulnerability on
health care.
Polling tends to show that, far and away, the three most
important issues to voters are the economy, COVID-19, and health care. Trump
leads on the economy and trails on the other two. To the extent that issues
play a role in a Trump defeat in November, health care will have had some hand
in it. He has done little to inoculate himself and, in fact, has further
exposed himself.
His administration backs a lawsuit that seeks to strike
down Obamacare, including its popular protections for people with preexisting
conditions. This allows Democrats to say — and they say it all the time — that
he wants to destroy Obamacare.
Never mind that the suit is very unlikely to succeed. The
background is that in a previous case, the Supreme Court upheld the individual
mandate in Obamacare as a tax. Then, Congress zeroed out the tax. The current
case argues that the individual mandate therefore can no longer be upheld as a
tax and further — this is the real stretch — that if this now toothless mandate
is thrown out, the rest of the law has to go as well. There’s no reason to
believe that the conservative justices would undertake this legal adventure.
This makes the politics a worst-of-both-worlds scenario
for the White House. By backing the suit, it opens itself up to the attack
before the election that it will eliminate protections for preexisting
conditions, without having any realistic chance of winning when the court takes
up the case after the election.
It would help at least to have a plan, and that’s Trump’s
instinct. But his supposedly imminent health care plan has become as meaningful
as the various versions of “infrastructure week.”
Coming up with a health care plan is not like, say,
promising to create 10 million jobs, a pledge that would depend on
circumstances not fully under any president’s control. Drafting one, at bottom,
requires only a consensus among some wonks, a word-processing program, and a
printer.
No one would have bet at the outset that the
administration would have in hand two historic Middle East agreements — namely,
the United Arab Emirates and Bahrain normalizing relations with Israel — before
having one health care plan. But here we are.
It’s not as though there aren’t options (and it should be
noted that the administration has adopted worthy, piecemeal changes to the
health-care system). A plan from The Heritage Foundation is tailor-made to be
picked up by the administration. In fact, it’s been promoted in an op-ed
titled, “A
Health Plan for President Trump.”
But the administration has remained divided, with one
faction reflecting vintage Tea Party thinking that no Obamacare replacement is
necessary. In addition, health-care policy inevitably involves trade-offs that
are all politically perilous.
So the path of least resistance is to commit to nothing.
The administration has instead offered up an executive order pledging to cover
people with preexisting conditions. The president has touted this as a historic
act, even though it’s only a more official version of Trump’s prior promises.
The president is more populist, both in manner and
substance, than his Republican predecessors. But health care is an area where
his populism is insufficiently realized. Seeking to repeal Obamacare without
bothering to tell people how it’s going to be improved on is what you’d expect
from a stereotypical Republican.
God might scoff, but it’d be better to have a plan.
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