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On health care, Trump replaces old, bogus promise with a new one

Trump, his team, and his party have absolutely no idea how to govern in the area of health care policy. His promises should be seen through this lens.
Image: Donald Trump
President Donald Trump speaks during a coronavirus disease (COVID-19) pandemic briefing in the Brady Press Briefing Room of the White House, on Aug. 3, 2020.Jonathan Ernst / Reuters

On July 17, Donald Trump sat down with Fox News' Chris Wallace in the White House Rose Garden, and the host asked about the president's ongoing efforts to destroy the Affordable Care Act, which would strip benefits from tens of millions of families. The president replied that he still intends to "replace" the ACA.

The host reminded Trump, "But you've been in office three and a half years, you don't have a plan." It was at this point that the president responded with an unexpected vow: Trump said he'd "sign" a "full and complete" health care plan "within two weeks."

As we discussed the other day, two weeks went by, and the "full and complete" health care plan was nowhere to be found. On Friday, pressed for some kind of explanation, the president told reporters, "We're going to be doing a very inclusive health care plan. I'll be signing it sometime very soon. It might be Sunday, but it's going to be very soon." (He added earlier in the day that the upcoming White House health care plan will be "very big.")

On Sunday, the Republican went golfing. He did not unveil or sign a health care plan. Yesterday, Trump moved the goalposts once again.

"I do want to say that we're going to be introducing a tremendous healthcare plan sometime prior -- hopefully, prior to the end of the month. It's just about completed now."

Sure, it is, big guy. Sure it is.

The president added that the new health care plan "will be very impressive to a lot of people." He appeared quite serious.

I generally avoid making predictions, especially about a volatile White House in which anything is possible, but I'm going to go out on a limb and say Trump will neither unveil nor sign an impressive, inclusive, and comprehensive health care plan later this month.

Part of the problem, of course, is that in our system of government, a president cannot unilaterally overhaul the nation's health care system without Congress. Trump may be under the impression that the Supreme Court recently gave him the authority to start signing new laws without lawmakers' approval or input, but in the United States, systemic changes like these have to go through Capitol Hill.

Another part of the problem is the familiarity of the circumstances. Trump has spent more than four years assuring Americans that he and his team, any day now, will unveil an amazing health care plan that will offer more coverage at a lower cost. It's a promise that always goes unmet.

There's no great mystery as to why: the president, his team, and his party have absolutely no idea how to govern in the area of health care policy. (See chapter three of my book.) GOP officials have been promising a superior alternative to the Affordable Care Act since the summer of 2009 -- well over a decade ago -- and they've failed spectacularly because they don't know how to craft such a blueprint. It would require some form of federal investments and regulation of the marketplace, both of which the party rejects for ideological reasons.

Hating "Obamacare" is not a health care plan. Once Republican policymakers come to grips with this simple detail, they can either give up trying to take health security from tens of millions of Americans or they can roll up their sleeves and try to govern on the issue.

Either way, those waiting to see what Trump intends to unveil later this morning are waiting for a mirage that will always remain on the horizon.