Here’s Why They Couldn’t Get Obamacare Replacement Right on Day One

Trump negotiation (Pablo Martinez Monsivais / Associated Press)
Pablo Martinez Monsivais / Associated Press

Indianapolis-based attorney and radio host Greg Garrison posed an interesting question on his program on WIBC radio on Tuesday morning: why couldn’t Congress and the White House propose a better Obamacare replacement on day one?

After all, with the Congressional Budget Office reporting Monday that the American Health Care Act will increase the number of uninsured Americans by 24 million, and President Donald Trump promising to negotiate fixes, would it not have been easier and better to craft the best policy possible well in advance, and avoid the growing political backlash around the country?

The answer is no, for three reasons.

First, to some in Congress, this is the best policy possible.

The experts who wrote it tried to anticipate opposition from the Democratic Party, and included several compromises in the bill. They also crafted a staged process that achieves easier fixes through budget reconciliation on a simple majority vote, and leaves more difficult changes to the end, when proponents of the reform would need a 60-vote majority in the Senate to overcome a Democratic filibuster.

But by beginning with a compromise “ideal,” the drafters guaranteed that the final legislation would require even more concessions from conservatives. It would have been better, simply from the point of view of negotiating tactics, to begin with a much more conservative bill — one that made repealing Obamacare explicit and complete before introducing new changes, for example — and work back to the compromise position. Instead, conservatives were immediately suspicious of the bill.

The second reason a perfect policy was impossible on day one is that perfection implies that stakeholders — doctors and patients in particular — are superfluous to policy design.

But the opposite is true: without including all stakeholders in a system this big, there is no way of earning the grudging support of groups whose members might suffer short-term costs.

And the third reason perfection was impossible on day one is that our political system simply rejects it. Collectively, we want to argue over the details. We want the opposition to be able to have its say; we want elected representatives to hear an earful from the voters; we want the stakeholders to hold endless and exhausting meetings where they haggle over minor points.

The last administration thought it could simply presuppose an ideal policy, force it through Congress, and read it afterwards. As a result, the country was divided, the policy was awful, and petulant left-wing pundits declared the country “ungovernable.”

We are not ungovernable. This is how we want to govern ourselves.

President Trump is a political outsider, but appears to understand the process better than the professionals. He likely anticipated the weaknesses of the new bill, and gave Congress enough rope to hang itself, politically.

Now, he is well-placed to lead the “big, fat, beautiful negotiation” that is to follow.

Joel B. Pollak is Senior Editor-at-Large at Breitbart News. He was named one of the “most influential” people in news media in 2016. His new book, How Trump Won: The Inside Story of a Revolution, is available from Regnery. Follow him on Twitter at @joelpollak.


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