Obamacare Lite: A Lesson in Political Expediency, Policy Ineptitude, and Trumpism

President Trump meets with his apparent mentor in health care policy, former President Barack Obama, shortly after Trump's election.

For the past eight years, Republicans have unleashed a seemingly endless torrent of attacks on the Affordable Care Act. For eight years, conservatives denounced Obamacare to anyone that would listen. “Premiums and deductibles are skyrocketing” we said. “Forcing insurers to cover pre-existing conditions defeats the point of insurance” we said. Then we decided to copy and paste much of it into our own bill, a hilariously named monstrosity called the “World’s Greatest Healthcare Plan of 2017.”

This plan represents much of what is wrong with Trumpism. The President is not a fiscal conservative who values freedom above all else, but a populist with little regard for principle. The bill is an amalgamation of conservative and liberal standards for what good health care policy should look like and the result is hideous. In order to appease the left and make sure “no one is going to die on the streets” (a noble thought that says nothing about policy), Trump has ensured that pre-existing conditions will continue to be covered. Of course, this is just as preposterous an idea under Trump as it was under Obama. You cannot wait until after your house burns down to purchase fire insurance and then expect coverage. Now, the elimination of the individual mandate for buying health insurance is cause for celebration, that part of the Affordable Care Act was an unconstitutional infringement on personal freedom. Yet the fact that its removal is coupled with the staying of the aforementioned pre-existing conditions coverage clause presents a quandary. Older, sicker people with pre-existing conditions will buy coverage only to see their costs skyrocket as younger, healthier people drop their health insurance since they are no longer legally required to lest the government fine them. Say what you will about Obamacare, at least it was ideologically consistent.

The problems with Trumpcare do not end there though. The tax credits offered under the bill are insufficient to make a real difference and they end up serving as a new entitlement program that benefits wealthy Americans more than those in the middle class. Furthermore, the bill fails to repeal the outrageous, cost-raising 40% “Cadillac” tax on high quality insurance plans, effectively punishing insurers for offering–and customers for purchasing–a desirable product. Electorally, the mere proposal of this bill will prove to be disastrous for Republicans. They lose whether it passes or not. If it is signed into law, it may accelerate rising costs instead of stopping them and many will lose their health insurance. If it is not made law, and this is the more likely scenario, Republicans have reneged on one of their core campaign promises and have conceded that Obamacare works better than anything they could come up with.

Political expediency, policy ineptitude, and selfishness on the part of the Trump Administration are largely responsible for the mess conservatives have on their hands now. Trump is unwilling to embrace a conservative, free market based solution to healthcare because he is afraid of the political ramifications. Yet in crafting this bill, he has created something far worse for himself, his party, and his country.