The failure of Trump’s healthcare bill to reach the House

I’m an American citizen, and several times during my annual visits to my home state of Texas I’ve been shocked by the cost of both money and time that a simple visit to the doctor entails.  A broken leg without health insurance would cost up to $2,500 for non-surgical treatment.  Obama’s Affordable Care Act in 2010 gave millions of people healthcare insurance who would not otherwise have had it.  But Obamacare was not without its flaws.  In recent years I’ve noticed a vast increase in the waiting times in emergency rooms.  This was because Obamacare’s expansion of Medicaid meant that fewer and fewer doctors accepted it, as they didn’t want to deal with the bureaucracy of the program, so Medicaid patients would have to be sent to the emergency room instead in order to obtain a doctor.  I didn’t mind the wait when I had an ear infection, but the wait could have more serious consequences for a patient with a more urgent problem.

A relative of mine is a physician’s assistant in Texas, and adamantly against Obamacare.  “If most of the doctors I work for had known about Obamacare when they started out, they would have chosen a different career,” she says.  The problem is that with Obamacare, doctors have struggled to keep up with the higher demand of work.  And with an estimated 61,700-94,700 fewer American doctors in the next ten years, according to a report from the Association of American Medical Colleges, this could become more and more of a problem. It will be the fault of Obamacare, which was rated a “D” or an “F” by 46% of doctors who had dealt with it, according to a recent study.

Obamacare also worsens America’s debt problem, and costs states far more money than they had expected.  Since Obama became President, the National Debt has increased by over $8 trillion—roughly 70 percent.  The major entitlement programs, including, Medicare, Medicaid, and Social Security take up almost 50 percent of all federal spending, and as more Americans get older and retire, these programs are only expected to increase in size and cost.  It’s vital for less well-off Americans to have health insurance, but Obamacare is clearly not working.

The problem is that with Obamacare, doctors have struggled to keep up with the higher demand of work.

The 23rd March, the seventh anniversary of Obama’s Affordable Care Act, was supposed to be the date when the Trump administration repealed the act and replaced it with the American Health Care Act, their less substantial alternative.  Trump, who prized himself on the “art form” of his deal-making, spent time trying to convince the Republicans to vote for the bill by inviting them to White House bowling sessions and trips on Air Force One.  In the days leading up to the vote, the White House chief of staff, Reince Priebus, and White House Chief Strategist Steve Bannon, went to Capitol Hill to convince the doubters.  Trump was making calls from 6am to 11pm, and over 120 members of the House either visited or called the White House, according to Sean Spicer.

The Republicans had voted over 60 times to change or repeal the Affordable Care Act in recent years, but every time they had been vetoed by Obama.  This was their big chance to replace it with the bill that they’d had seven years to work on.  But there were a lot of problems with the bill that Trump in his campaign had promised would provide insurance for everyone.  According to an estimate by the, Congressional Budget Office Trump’s bill would lead to 24 million fewer Americans having health insurance over the next 10 years, and raised deductibles for millions more — and the savings would have gone to pay for tax cuts for millionaires.

The Republicans had voted over 60 times to change or repeal the Affordable Care Act in recent years, but every time they had been vetoed by Obama

With no support from the Democrats, and not enough from Republicans, particularly the far-right, House Speaker Paul Ryan had to tell Trump that the bill he had designed was not going to pass the vote, and the vote was cancelled. Trump’s response to what Lawrence O’Donnell, on MSNBC, termed a “complete disaster” was to announce his plan to “let Obamacare explode”, and then offer a revised bill.  But will this current failure affect how he is viewed by his supporters?

In a way, the failure of the bill to pass avoids the risk of Trump losing the millions of voters who would lose coverage under it and thus having a disastrous midterm election.  He implied that the blame lies with Ryan – who wrote the bill – with a tweet encouraging the public to watch a show on Fox News at 9pm, which was puzzling until on the show, “Judge Jeanine”, opened by declaring “Paul Ryan needs to step down as speaker of the House … he failed to deliver the votes.”  Trump also blamed the Democrats, telling Robert Costa “we could have done this, but we couldn’t get one Democrat vote, not one.”

To his base of supporters, Trump sold himself as a deal-maker, therefore his inability to make a deal in Congress that matches his success in business could seriously damage his reputation with this base.  The Republicans also plan to propose bills to reform the tax code and pass a major infrastructure package in the coming months, but if the far-right House Freedom Caucus again refuses to cooperate, Trump’s power and the Republican control of the House could be in danger.

To his base of supporters, Trump sold himself as a deal-maker

There’s no question that Obamacare needs changing: it’s not a sustainable program at the moment.  But Trump and the GOP’s shoddy alternative has left Trump looking embarrassed.  He told Costa “here’s the good news. Healthcare is now totally the property of the Democrats.”  But Americans – Republican or Democrat – won’t want to hear their President wash his hands of the responsibility for the nation’s healthcare because of one failed bill.  Criticism for the bill came from all sides of the political spectrum, with many Republicans condemning it, such as Michael Needham, head of the very conservative Heritage Action, who wrote: “It is an awful bill that will impact millions of Americans’ lives and is opposed by nearly every serious conservative healthcare analyst. This legislation is a policy, process, and political disaster.”

However, Trump’s core base of supporters will look for anyone to blame except Trump.  In February, the Pew Research Center found that, in the event of a disagreement, most Republican voters were more likely to trust Trump than Republican congressional leaders.  This could be Trump’s chance to remain relatively unscathed and lessen the power of Paul Ryan and the congressional Republicans.  After all, his supporters have not deserted him after the failure of the travel ban, and the still unseen wall on the southern border.  But if his attempts to reform tax are as unsuccessful as this healthcare bill, the future does not look good for the new President.