At one point, pressed on his specific position, Trump vowed to “repeal and replace” the Affordable Care Act with “something terrific” – without making any effort to explain what that “something” might be or how it’d be “terrific.”
Today, Trump talked to the Wall Street Journal, where the president-elect said something about health care that’s quite a bit different from his previous rhetoric.
President-elect Donald Trump said that, after conferring with President Barack Obama, he would consider leaving in place certain parts of the Affordable Care Act, an indication of possible compromise after a campaign in which he pledged repeatedly to repeal the 2010 health law.
In his first interview since his election earlier this week, Mr. Trump said one priority was moving “quickly” on the president’s signature health initiative… Yet, Mr. Trump also showed a willingness to preserve at least two provisions of the health law after the president asked him to reconsider repealing it during their meeting at the White House on Thursday.
The president-elect told the Journal, “I like those very much.”
Trump went on to say that, as part of his lengthy meeting with the president, Obama pointed to specific provisions of the ACA that are worth preserving. “I told him I will look at his suggestions, and out of respect, I will do that,” Trump said, adding that the law “will be amended, or repealed and replaced.”
You’ll notice that “amended” is a new addition to Trump’s health care vernacular.
It’s a safe bet that his WSJ interview will not be popular with Republicans, especially his “I like those very much” rhetoric with regards to popular provisions of the reform law.
This is also an interesting reminder that Obama can be pretty persuasive, and when he met with Trump at the White House, the president must have made a compelling pitch.
But here’s the part of the story worth watching in the months ahead: the Affordable Care Act is built on a series of measures that rely on counter-balances. For every popular element that people like and want to keep (protections for pre-existing conditions, tax breaks for small businesses, lowering prescription-drug costs, coverage for young adults, etc.), there are unpopular elements that are unfortunately necessary (individual mandate, cost-saving provisions, some tax hikes, etc.).
Obviously, if it were possible to create a system with only the stuff people like, with none of the stuff people don’t like, Democrats would’ve gladly passed that bill years ago. But complex policymaking doesn’t work that way in reality – and the popular provisions are, in practical sense, made possible through unpopular parts.
It’s easy to imagine Obama and Trump having a conversation in which the president focused on the positives, and Trump thought they all sounded pretty good. It’s equally easy to imagine it slowly dawning on Trump that if he screws over millions of Americans with pre-existing conditions – and strips young adults of their coverage, and makes seniors pay more for medication, and reimposes annual and lifetime caps, etc. – that’s a sizable group of registered voters.
Welcome to the health care debate, Mr. President-elect. It’s a lot more complicated than you probably realized.