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On health care, Trump seems deeply confused about policy and process

Republicans are divided into two camps on health care and could use some presidential leadership. Unfortunately for the GOP, they have Trump, who appears lost.
Image: President Elect Trump Continues His "Thank You Tour" In Grand Rapids, Michigan
President-elect Donald Trump speaks at the DeltaPlex Arena, December 9, 2016 in Grand Rapids, Michigan. 
When it comes to the health care debate, Republican unanimity has unraveled with surprising speed in recent weeks. GOP leaders in the House and Senate are committed to a "repeal and delay" strategy in which Republicans would repeal the Affordable Care Act quickly and work out the details in a few years, while a growing number of rank-and-file GOP lawmakers don't want to vote on repeal until the party has an alternative reform plan to replace "Obamacare."To help work out the differences, Republicans could probably use some presidential leadership. Unfortunately for the GOP, however, the party is stuck with Donald Trump -- who made clear in a New York Times interview this afternoon that he has absolutely no idea what he's talking about when it comes to the most rudimentary details of the debate.

President-elect Donald J. Trump pressed Republicans on Tuesday to move forward with the immediate repeal of the Affordable Care Act and to replace it very quickly thereafter, saying, "We have to get to business. Obamacare has been a catastrophic event."Mr. Trump's position undercuts Republican leaders who want a quick vote to repeal President Obama's signature domestic achievement but who also want to wait as long as two to three years to come up with an alternative. But he was also challenging the resolve of nervous Republicans in Congress who do not want any vote on a repeal until that replacement exists.

Hmm. There are two GOP factions on this: those who want to repeal the Affordable Care Act and then replace it with a more conservative alternative, and those who want to tackle both tasks simultaneously. Trump, in effect, said he kinda sorta disagrees with both approaches -- and kinda sorta agrees with both, too.The president-elect, completely clueless about his own party's plans, went on to tell the Times he wants to see a repeal vote "probably some time next week." Trump then wants the replacement bill to follow "very quickly or simultaneously, very shortly thereafter."That doesn't make any sense.Republicans are scheduled to vote this week -- the Senate on Thursday, the House on Friday -- on a reconciliation bill that would merely open the door to Congress eventually repealing the ACA by majority rule. In practical terms, this week's measure wouldn't actually affect the law, so much as it would give Congress permission to circumvent a filibuster when repealing some elements of the reform law.The Republican alternative to "Obamacare," meanwhile, is already seven years in the making -- they started working on this in June 2009 -- and nearly everyone involved believes it's still at least two years away from completion.By all appearances, Trump doesn't understand literally any of these details. Based on what he told the Times, the president-elect, who's never demonstrated any familiarity with even the more basic details of health care policy, is under the assumption that the whole thing will be worked out by Valentine's Day, if not sooner.That's bonkers.The amateur president-elect added in his Times interview that he wouldn't accept a delay of more than a few weeks before a replacement plan was voted on. "Long to me would be weeks," Trump said. "It won't be repeal and then two years later go in with another plan."In other words, Trump today announced he opposes the plan embraced by his own party's leaders in both the House and Senate. Whether he knows that he just rejected his own party's leaders' approach is unclear.It's also unclear if the president-elect understands that it's impossible for Republicans to formulate, write, debate, score, and pass a non-existent bill to overhaul the American health care system over the next few weeks.If Trump and his team had a reform plan of their own to present to Congress, that might help the process along, but during the campaign, the GOP candidate never really went beyond a vow to implement "something terrific."As of last night, Republicans were divided on the road ahead and the repeal crusade appeared to be faltering badly. As of this afternoon, the party's president-elect has made matters considerably worse.It's as if Donald Trump, who hates "Obamacare" but doesn't know why, has spent the last two months completely ignoring the ongoing debate, failing to so much as read a newspaper article about what his ostensible allies have in mind.