Saturday, March 25, 2017

The Three Stooges meet healthcare reform

The collapse of the Trump/Ryan attempt to destroy Obamacare was one of Washington's more fascinating train crashes. What's wondrous is not that some things went wrong, but that pretty much everything went wrong in completely predictable ways, and that multiple parties, all Republican, were involved in the takedown. If you could have planned the destruction of the replacement legislation, the ACHA, you would have planned for things to play out exactly as they did.

They played out like a Three Stooges movie, with the Stooges played by Paul Ryan, Donald Trump, and, collectively, the Freedom Caucus. And the process is such a mess that it's not even clear whether Ryan or Trump is Moe in this scenario.

Let's look at the destructive power of the Republican Stooges:

Paul Ryan

Ryan was the key architect of the ACHA, and my god, what a mess. For years, the Republicans have insisted Obamacare was a disaster but have refused to present an alternative, and now we see why. ACHA had no real philosophy of healthcare, instead focussing entirely on giving billionaires tax cuts and cutting services for the poor.

At the same time, the bill kept a lot of the most popular parts of the ACA, because Republicans were terrified that taking all the benefits of Obamacare away at once would lead to election losses.

The result was strange, because after 7 years of  Republicans saying they would get rid of Obamacare, Ryan's bill really didn't. Instead, it kept many of the key ingredients but made them all worse. Ryan's bill was set to take insurance away from every single person who had gained it under ACA while only having a minor effect on the deficit.

The bill had been created in secret and Ryan attempted to rush it through before people could figure out what was in it. He failed. He seems to have written the bill with little input from anyone - not healthcare experts, not other factions of his own party, and certainly not Democrats - and he wound up with a bill that even he probably didn't like that much.

When the criticisms started to rush in, Ryan decided to make the bill even worse in hopes of pulling in recalcitrant conservatives even at the risk of losing recalcitrant moderates. He piled failure on top of failure like a master Jenga player.

It turned out that the only quiver in Ryan's arrow is the one that lessens the taxes of billionaires. That was the only part of his bill that looked like it would work the way it was supposed to. While Ryan has managed to cultivate a reputation as a smart policy wonk, the ACHA is wildly supportive of Paul Krugman's portrayal of Ryan as a fake and a habitual liar.

The Freedom Caucus

For Obama's entire time in office, the GOP was the "party of no." The Tea Party wing represented by the Freedom Caucus functioned as party of no within a party of no. Essentially anti-government anarchists, the Caucus simply doesn't want government to work, and believes that compromise is the ultimate evil.

For them, Ryan's bill, as awful as it was, wasn't nearly awful enough. While many Republicans just cynically used Obamacare hatred to fuel voter disenchantment, the FC contains the true believers whose passionate hatred for all government programs is unfeigned and wildly destructive.

For many in the FC the only acceptable option was to roll back Obamacare in its entirety. Crippling it or even fatally wounding it was not enough; it had to be a clean head shot or nothing.

Basically,  the party of no's inner party of no proved incapable of saying yes.

To some extent, this could be politics. The FC is full of people from hardcore conservative districts where there is a constant threat of challenges from the right funded by rich extremists. So making stupid decisions that play to the base make electoral sense. And after 7 years of saying Obamacare was the Hitler of American politics, they had painted themselves into a bit of a corner.

Still, insisting on everything or nothing in politics is the best possible way to get nothing. And the FC got nothing of what they wanted, with little chance to get it any time in the near future.

But from what I've read, the FC sees this not as a disaster but as proof of their power. Which means they are likely to stick to their path of purity politics during every subsequent legislative fight. And that could mean that the Republicans basically get nothing done for their entire time in power (fingers crossed).

Donald Trump

Everything his opponents predicted about Trump was on display during the ACHA clusterfuck. After promising an amazing healthcare bill with better coverage and lower premiums for all, he simply turned over the creation of a new healthcare system to Paul Ryan, who had no interest in any of those promises. Trump didn't understand the bill, and in lobbying for it he apparently didn't even try to make a case for any of its policies (because, of course, he didn't understand them). All Trump could do was try to charm and threaten Republicans (he didn't even bother reaching out to Democrats, which didn't stop him from complaining that none of them was willing to vote for ACHA). It turned out that he was not charming or threatening enough to get a majority to vote for a turd.

When support for the bill proved hard to come by, Trump was completely flummoxed, finally tossing out an ultimatum that failed dismally.

It's unlikely that Trump even really cared about the ACA. For him, Obamacare hatred was a campaign weapon, and he no more wanted to end a working healthcare system than he wanted to jail Hillary Clinton. All he really wanted to do was cater to the base and rack up a win. It didn't happen.

Of course, Trump being Trump, he is now playing off this disastrous defeat as no big deal. Trump's inability to admit mistakes means he can never learn from them, so expect him to continue to ignore experts and allow hacks like Ryan to create legislation he doesn't understand or care about.

Why It Happened

For eight years Republicans have been dreaming of what they would achieve when they finally were back in power. So how did their first major push to reshape government end so disastrously?

One big issue was that Obamacare was based on the Republican plan known as Romneycare, forcing Republicans to run against what was basically the Republican healthcare solution. It wasn't the bill they hated but Barack Obama himself. This left them with no place to go; they would have been better off had Obama created a single-payer system that could have been countered with Romneycare.

With the only sensible Republican plan co-opted by Democrats, Ryan created pure nonsense and hoped hatred of Obamacare was so strong that no one would care what disaster they replaced it with.

Part of Ryan's own explanation is that Republicans don't know how to govern. He explained that for ten years all Republicans had to do was be against things, and they've only had three months to learn how to be a governing party.

This sums up everything that's wrong with the modern Republican approach to government; they believe you only govern when you are in charge. In reality, governing is something you can do from either side of the aisle. You can introduce legislation, you can engage in bipartisan dealmaking, you can win people over to your side and let them win you over to theirs. The GOP's decision to forgo governing  in favor of continuously attacking  Obama has allowed their government skills to atrophy. Many of them don't even seem to understand how government works.

If Trump really wants to govern, his best shot would be to move a little to the left, ignoring the Freedom Caucus in favor of winning over moderate Democrats in pursuit of actually fulfilling campaign promises like improving healthcare and increasing employment opportunities. If the Freedom Caucus wants to further their agenda, then they would need to stop insisting on all or nothing when they simply don't have the power to get that all. If Ryan wants to be effective, he needs to stop pretending to take policy matters seriously and actually take them seriously.

I don't see much indication that any of that is going to happen. The Three Stooges of the GOP will continue to poke eyes and slap faces and create nothing but mayhem. And just like the real Three Stooges, it's only funny sometimes.

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