Jay Bookman

Opinion columnist and blogger with The Atlanta Journal-Constitution, specializing in foreign relations, environmental and technology-related issues

Opinion: GOP doesn't yet grasp its health care predicament

David Perdue, the Republican senator from Georgia, said a very odd thing the other day. He told the AJC's Greg Bluestein that Republicans are going to have to compromise with Democrats if they hope to address challenges in the nation's health-care system.


With Democrats? On health care?

That's a pretty amazing turn of affairs, especially since Republicans haven't shown a capacity to compromise with their fellow Republicans, let alone with "those people" in the other party. But as Perdue accurately pointed out, referring to the aborted House effort to repeal Obamacare,  “How’d the other direction work out? It didn’t work out very well when we pretty much ignored them.”

Even President Trump is making similar noises, although he does so in typical Trumpian style, accompanied by bluster, bragging and bull-oney. In an interview this week with Fox Business News, Trump claimed that his plan to repeal and replace Obamacare is going great, really great, so great you wouldn't believe how great it's going.

"I think we're doing very well on health care," Trump told Maria Bartiromo, who nodded along as if she believed it. "It's been very much misreported that we failed with health care.  We haven't failed, we're negotiating and we continue to negotiate and we will save perhaps $900 billion.... We're going to have great health care."

However, in an interview a day later with the Wall Street Journal, Trump took another course entirely. After taking a number of small steps to scare insurers away from participating in the Affordable Care Act, he and his administration are now threatening to take action that would bring the whole apparatus crashing down at once.

That is, unless Democrats agree to surrender to stop him.

"What should be happening is [Senate Minority Leader Chuck] Schumer should be calling me up and begging me to help him save Obamacare," Trump said. "That’s what should happen.  He should be calling me and begging me to help him save Obamacare, along with Nancy Pelosi."

"The longer — the longer I’m behind this desk and you have Obamacare, the more I would own it.  Right now, we don’t own it at all."

Ah, but Republicans do own it. They own it all. GOP efforts to undermine the law and dissuade insurance companies from participating have already been well documented. Their incompetence at cobbling together a repeal-and-replace bill capable of clearing the first, very low hurdle, the House of Representatives, has been noted even by those Americans who generally don't read past the latest Kardashian scandal.

In short, Republicans begged voters for years to give them the power to "fix" health care, and they now have that power. They control the House, the Senate, the White House and the Department of Health and Human Services, which administers the law. But they have yet to fully grasp that with such power comes responsibility, and it is not responsible for the president to threaten to hit the destruct button on health insurance for millions of Americans unless his opponents surrender to him.

Ask Jared and Ivanka, Donald. They'll tell you.

So yes, in the end this will require significant compromise, but Republicans are nowhere near accepting the terms of what that compromise will be. No bill that strips health insurance from a significant number of Americans is going to become law, especially not with Democratic support. No bill that slashes $900 billion out of Medicaid assistance for the poor, the disabled and those in nursing homes so that wealthy investors can enjoy $900 billion in tax cuts is going to become law, especially not with Democratic support.

Perdue, Trump and their fellow Republicans may be willing to now utter the word "compromise," but they are a long, long way from accepting what it will really mean.  They face a lot more political pain, a lot more angry voters, a lot more legislative failure, before they understand their situation. They may even have to lose the House.

But it's going to happen.



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About the Author

Jay Bookman writes about government and politics, with an occasional foray into other aspects of life as time, space and opportunity allow.