Trump Repackages Random Ideas Into ‘Great Healthcare Plan’

For many years, dating all the way back to 2015, Donald Trump has promised he’d someday offer a health-care plan to replace Obamacare. For months Republicans have fretted over allegations that they are clueless or heartless about rising health-care costs, exacerbated by their refusal to extend expiring Obamacare-premium subsidies received by around 22 million Americans. They’ve tossed out a bunch of random conservative health-care panaceas, as has Trump, mostly revolving around health savings accounts and other individualistic measures for undermining Obamacare-style regulated insurance markets.

Today, without any warning, Trump released a video claiming a bunch of these well-worn ideas represent the “Great Healthcare Plan” he’s been talking about for so long.

It’s significantly less vague than most of his past maunderings on health care but hardly anything you could call a blueprint, as the New York Times observed:

The plan was short on specific details and left much of the direction for how to finalize it up to Congress. It amounted to a few paragraphs on a webpage, released with a video of Mr. Trump promoting what he called “the great health care plan.”

Trump’s video unveiling this “proposal” was an odd pastiche of boasts about what he’s already done in the health-care arena (particularly his jawboning of pharmaceutical companies to lower prices for some drugs), denunciations of the “Unaffordable Care Act” (a term he clearly considers a bon mot), and wild claims about how incredibly good and cheap health care will soon become. He talked of lowering prices by far more than 100 percent, which is a mathematical impossibility. He failed even to mention the biggest problem Obamacare was created to address: the refusal of insurers to provide coverage for people with preexisting conditions or inherently expensive treatments. And once again, Trump’s impulses led him in contradictory directions; despite his denunciations of Obamacare, one of his big ideas is to build on an Obamacare discount feature called “cost-sharing reductions.”

It’s unclear what Congress is expected to do with this plate of spaghetti thrown against the wall. Not a single Democrat will support this “plan,” which whatever it is, clearly aims to blow up Obamacare, just as Trump and the GOP unsuccessfully tried to do in 2017. That means the only path forward is via the party-line budget-reconciliation procedure, like the one that produced last year’s One Bill Beautiful Bill Act. Going in that direction in an election year with a topic as complex and controversial as health care may please conservative hard-liners who have been longing to destroy Obamacare for many years. But it hardly seems doable in a Congress where Republicans have such tiny margins of control.

More likely than not, the president is just engaging in some high-visibility pre-midterm “messaging” to show concern over a set of problems that have stumped him and his party for eons. Maybe it will eventually turn into a proposal that more or less hangs together, even if its enactment by Congress is the longest stretch imaginable. Unfortunately, Trump’s claim that he has a “plan” will almost certainly kill off the already languishing efforts to come up with a bipartisan fix for the Obamacare-premium spike that is just now beginning to be felt in pocketbooks everywhere. He should have kept his rambling thoughts to himself.