For Donald Trump’s domestic agenda, this week was the best of times and the worst of times. First, the best: Supreme Court nominee Neil Gorsuch aced his confirmation hearing before the Senate Judiciary committee. The well-prepared Gorsuch gave a near-perfect performance, sparring easily with half-baked tough lines of questioning from Democrats. There were no damaging stories dropped about Gorsuch before or during the hearing, nor did he make any unforced errors in his answers.
So after a stellar performance, the fact that Senate Democrats are threatening to filibuster Gorsuch’s confirmation says more about their abuse of the Senate rules than it does about Gorsuch. From the administration’s perspective, this week could not have gone better for their Supreme Court pick—and with or without the filibuster intact, he’ll almost certainly be confirmed.
Now, the worst: the American Health Care Act. This White House-backed bill that claims to repeal and replace Obamacare spent the week gaining more opponents from both wings of the Republican House conference this week than supporters. This, despite personal lobbying from President Trump of the conservative and moderate holdouts on the bill and some last-minute policy changes. Thursday’s scheduled vote has been pushed back, and will now happen on Friday, at the direct request of the president.
Even if the AHCA squeaks through the House, the painful and ugly process will have ended with a bill that no one particularly likes. If it fails to pass the House or even the Senate, it will represent a massive failure to deliver on a campaign promise. As one White House source puts it, there won’t be much appetite in Congress for taking another bite at the Obamacare repeal apple. And there may be less political capital to spend on other endeavors, like tax reform. That may explain why Trump himself, the New York Times reports, is already telling people around him he regrets leading his legislative agenda with health care.
A Tale of Two Issues
How did these two Trump goals—getting a conservative jurist on the Supreme Court and repealing Obamacare—end up with wildly different results? The Gorsuch nomination and confirmation has been orderly and worry-free from the very beginning. As Fred Barnes wrote back in February, this was thanks in large part to Trump’s willingness to let the Federalist Society’s Leonard Leo take the lead in both drafting a list of candidates for the position and guiding the eventual nominee through the confirmation process. Here’s more from Barnes:
The Gorsuch nomination was not just a well-executed scheme but a model for conservatives looking to influence policy and politics in the Trump administration. Conservative legal activists did their homework and came to the new president ready to go. Leo and top White House advisors needed only to present Trump with a choices and a plan, giving him the tools to make a good decision.
This was, needless to say, not how the health-care bill was undertaken.
A Disaster In Slow Motion
Repealing Obamacare, it must be said, is a more complex and complicated task than nominating a Supreme Court justice. It involves juggling the demands and political considerations of the Republican members of Congress, satisfying various interest groups, maneuvering arcane Senate rules—oh, and crafting good health-care policy.
Despite media and Democratic carping that Republicans had no plan, there were multiple plausible proposals for replacing Obamacare. Paul Ryan’s “Better Way” proposal from last year was something of a synthesis of several different conservative ideas on health care. Ryan’s proposal was primarily based on the plan developed now-Health-and-Human-Services secretary Tom Price. The White House policy shop, including Domestic Policy Council director Andrew Bremberg, were involved in drafting the bill, but it was written largely by the staff of the two relevant House committees, Energy & Commerce and Ways & Means, at the direction of House leadership.
So Republicans had the broad policy ideas ready, but an unsure procedure to move forward in Congress. Since much of Obamacare was passed under the Senate’s budget reconciliation rules, much of the law would have to be repealed through the same requirements. The House leadership-backed bill was written to try to conform to these Senate rules, leaving intact some major provisions of Obamacare, primarily insurance industry regulations, that conservatives viewed as the root of the health-care law’s problems. (The Trump administration maintains many of the insurance regulations of Obamacare can be minimized in the executive branch, since the law gives wide authority to the HHS secretary.)
The result was what one conservative health-care policy wonk called a “patchwork” bill, one that was substantively incoherent but might pass procedural muster and have enough support to crawl across the finish line. Perhaps that was always the fate destined for an attempt to repeal Obamacare or any complex legislative undertaking.
But the method that brought Trump success with the Gorsuch nomination—farming out the details and difficult work to others—has not done so on health care. Instead, Trump himself has had to swoop in in the final days to try to whip the House Republicans into shape, something House leadership appears unable to do.
Song of the Day
“Death Letter,” the White Stripes.
