GOP struggles on health care

There’s a disconnect between the Republican Party leadership, President Trump, conservatives in the House, practical deal-makers in the Senate and those hard-core working-class voters who supported Trump’s election chiefly based on their hatred for President Obama.

In fact, there are so many disconnections that Republicans’ plans to dismantle the Affordable Care Act are starting to be reminiscent of a shade-tree mechanic who boasts as he takes apart a motor — and then has no idea how to put it back together.

What a mess the Republicans have made. Their leader on the issues, House Speaker Paul Ryan, may be trying to deliver a slick rollout of a new health care plan, but Ryan’s own small government philosophy is getting in his way. He somehow believes that most Americans like his “small government” ideas, but he doesn’t understand that small government sounds good until it shrinks something that’s important to people — such as their health care benefits. Then, they don’t like it so much. (Ryan also would like to change Medicare and Social Security, but even some of his conservative allies are afraid of that.)

Ryan has spent too much time in conference rooms on Capitol Hill and not enough in town hall meetings, which revealed a monumental public discontent with the dismantling of “Obamacare” to those members who bothered to listen.

So Ryan’s reform has slowed, even with President Trump backing it. This, even though the president campaigned on a promise that he’d repeal Obamacare and replace it with something less expensive, less complicated and less restrictive that would cover everybody. But Ryan’s plan is just something less, period. And now the nonpartisan Congressional Budget Office says that while the federal deficit may diminish under Ryan’s plan, 24 million fewer people will have health insurance 10 years from now.

That roils Democrats and mainstream Republicans and even conservative Republicans who recognize they’ll have a hard time selling it back home.

Then there are the tea party Republicans, who’d like to abolish entitlement programs and certainly don’t want tax credits for lower-income people of the kind in the Republican plan. Nothing Ryan does short of repeal without replacement will satisfy them.

And, though Trump is backing Ryan — the president would like a big “accomplishment” to go down during his first 100 days in office — Republicans know well that Trump is no conservative ideologue. His political philosophy bends in the notions of the moment. He may agree with Speaker Ryan today, but if public sentiment turns the other way, no one knows where Trump will be tomorrow.