Trump­care 2.0 won’t go any­where, ei­ther

The Washington Post - - WASHINGTON FORUM - — Jen­nifer Ru­bin

The GOP 2.0 ver­sion of the Amer­i­can Health Care Act has about as much ap­peal as the orig­i­nal AHCA, or maybe less. It’s still a big tax cut for the rich, a hit to the pock­et­books of older and more ru­ral vot­ers, and less gen­er­ous than what re­cip­i­ents re­ceived un­der Oba­macare. Would a mod­er­ate in a dis­trict that Hil­lary Clin­ton car­ried over­whelm­ingly go for this? It’d be a high-risk propo­si­tion. Would a con­ser­va­tive who sees more reg­u­la­tion (the es­sen­tial ben­e­fits) go­ing back into the deal be thrilled? Prob­a­bly not. More­over, it’s clear the Se­nate would re­ject the bill, be­cause mod­er­ates pre­vi­ously said they’d refuse to go along with a Med­i­caid roll­back.

The list of peo­ple who would not like it is long: right-wing ac­tivists; Repub­li­cans in swing dis­tricts; ev­ery Demo­crat; Karen Han­del (the GOP can­di­date in the Ge­or­gia 6th Con­gres­sional Dis­trict runoff elec­tion), who’d have to take a po­si­tion on a cruddy bill; doc­tors; hospitals; and the AARP.

If you don’t feel like this makes a lot of sense, you’re not alone. Drew Alt­man of the Kaiser Fam­ily Foun­da­tion writes, “The pres­i­dent doesn’t have strong con­vic­tions him­self about fu­ture direc­tions for health care. But health pol­icy is not like real es­tate. The par­ti­san di­vide in health pol­icy is grounded in deeply felt dif­fer­ences on both sides over pol­icy and prin­ci­ple. It’s hard to see Trump’s ap­proach to deal­mak­ing work­ing very of­ten in health.” Pres­i­dent Trump may not care about the details, in other words, but plenty of peo­ple do. His threat to wreck Oba­macare is ut­terly in­ef­fec­tive be­cause Democrats may “cal­cu­late, for ex­am­ple, that the ad­min­is­tra­tion will own the fall­out for a col­lapse in the mar­ket­places, as polls are start­ing to sug­gest they will. Law­mak­ers are also hard to threaten be­cause most come from safe po­lit­i­cal dis­tricts. . . . and they have been get­ting safer and more po­lar­ized.”

Given that AHCA 1.0 was hugely un­pop­u­lar and rot­ten from a pol­icy stand­point, it is far from clear that Repub­li­cans want to give the lat­est it­er­a­tion a try.

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