Does Anyone Really Believe Trump Will Take On The Entire GOP To Give The American People Universal Health Care?

How many times have you heard your friends say something like, "Maybe he won't turn out that bad; after all he was a liberal Democrat his whole life. He's on record supporting Choice, supporting single payer, protecting Social Security and Medicare?" Forget it. Just forget it. He didn't let Pence talk him into appointing Georgia anti-Medicare fanatic Tom Price Secretary of Health and Human Services to do anything but destroy the health care social safety net. Trump doesn't believe in anything but winning-- at all costs... and not winning for a team, winning for Trump.

You probably remember the news reports after the election about Trump supporters who took him at his word when he explicity promised-- over and over again-- to be different from other Republicans and NOT take away their health care benefits and Social Security. Last month, for example, CNN ran an outstanding report (video above) on West Virginia and Kentucky Trump voters now frightened that Trump will sign Republican legislation that further devastates their lives. Trump repeatedly pledged two seemly incompatable approaches to health care during his campaign-- to repeal the Affordable Care Act and to make sure health coverage for poor people is even better. He never-- and has still not-- explained how he would do that. But his overwhelmingly and extraordinarily low-intelligence supporters aren't exactly critical thinkers and aren't used to getting into the weeds or figuring stuff out. They took Trump at his word. And now they're starting to worry.

On December 19 Dante Chinni was reporting for the Wall Street Journal that "more than 20 million Americans now depend on the ACA, also known as Obamacare, for health insurance. Data from Gallup indicate that a lot of those people live in counties that favored Mr. Trump. The Gallup data, analyzed with the county typology from the American Communities Project, show that eight county types have seen increases in health insurance coverage greater than the national average. Six of those types-- representing about 77 million people or 33 million votes, a quarter of the total cast-- sided with Mr. Trump, some by very large margins." Buyers' remorse was setting in-- and the Trumpists knew it.

And they knew it long before Colorado Republican Mike Coffman got a taste of it over the weekend when he snuck out the backdoor of a town hall meeting with angry constituents in Aurora, furious that Coffman had voted last week to repeal Obamacare (without a replacement). Since then, everyone has been buzzing about Bob Costa's Washington Post story about how Trump is promising universal health care again, probably, not in conjunction with the anti-health care fanatics-- Pence, Price, Ryan-- he's surrounded by. Trump told Costa his plan, which includes health insurance for all and overturning Republican Party dogma that prevents Medicare and Medicaid from negotiating fair prices for consumers with Big PhRMA. Referring to the huge bribes they pay Congress Trump said the drug makers have been "politically protected, but not anymore." (Keep in mind that the two top recipients of legalistic bribes from drugs manufacturers during the 2016 cycle have been Speaker Paul Ryan and Republican House Majority Leader Kevin McCarthy. They have worked diligently to protect the ability of the drug companies to gouge American consumers. Since 1990 Big PhRMA allies in Congress have gotten tens of millions of dollars from the drug makers particularly key committee chairs like Orrin Hatch (R-UT- $2,447,641), Richard Burr (R-NC- $1,466,696), Fred Upton (R-MI- $1,378,506). The two men who will set the agenda for drug pricing have been paid off very well by the drug companies over the leaders:

• Miss McConnell (R-KY)- $1,092,822
• Paul Ryan (R-WI)- $960,983

It's Trumpanzee so there are no specifics, just vague, contradictory promises. "Trump’s plan," wrote Coasta, "is likely to face questions from the right, after years of GOP opposition to further expansion of government involvement in the health-care system, and from those on the left, who see his ideas as disruptive to changes brought by the Affordable Care Act that have extended coverage to tens of millions of Americans."

The objectives of broadening access to insurance and lowering health-care costs have always been in conflict, and it remains unclear how the plan that the incoming administration is designing-- or ones that will emerge on Capitol Hill-- would address that tension.

In general, congressional GOP plans to replace Obamacare have tended to try to constrain costs by reducing government requirements, such as the medical services that must be provided under health plans sold through the law’s marketplaces and through states’ Medicaid programs. House Speaker Paul D. Ryan (R-Wis.) and other Republicans have been talking lately about providing “universal access” to health insurance, instead of universal insurance coverage.

Trump said he expects Republicans in Congress to move quickly and in unison in the coming weeks on other priorities as well, including enacting sweeping tax cuts and beginning the building of a wall along the Mexican border.

Trump warned Republicans that if the party splinters or slows his agenda, he is ready to use the power of the presidency-- and Twitter-- to usher his legislation to passage.

“The Congress can’t get cold feet because the people will not let that happen,” Trump said during the interview with The Post.

Trump said his plan for replacing most aspects of Obama’s health-care law is all but finished. Although he was coy about its details-- “lower numbers, much lower deductibles”-- he said he is ready to unveil it alongside Ryan and Senate Majority Leader Mitch McConnell (R-Ky.).

“It’s very much formulated down to the final strokes. We haven’t put it in quite yet but we’re going to be doing it soon,” Trump said. He noted that he is waiting for his nominee for secretary of health and human services, Rep. Tom Price (R-Ga.), to be confirmed. That decision rests with the Senate Finance Committee, which hasn’t scheduled a hearing.

Trump’s declaration that his replacement plan is ready comes after many Republicans-- moderates and conservatives-- expressed anxiety last week about the party’s lack of a formal proposal as they held votes on repealing the law. Once his plan is made public, Trump said, he is confident that it could get enough votes to pass in both chambers.

He declined to discuss how he would court wary Democrats. ...“I think we will get approval. I won’t tell you how, but we will get approval. You see what’s happened in the House in recent weeks,” Trump said, referencing his tweet during a House Republican move to gut their independent ethics office, which along with widespread constituent outrage was cited by some members as a reason the gambit failed.

As he has developed a replacement package, Trump said he has paid attention to critics who say that repealing Obamacare would put coverage at risk for more than 20 million Americans covered under the law’s insurance exchanges and Medicaid expansion.

“We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.”

Republican leaders have said that they will not strand people who gained insurance under the ACA without coverage. But it remains unclear from either Trump’s comments in the interview or recent remarks by GOP leaders on Capitol Hill how they intend to accomplish that.

...When asked in the interview whether he intends to cut benefits for Medicare as part of his plan, Trump said “no,” a position that was reiterated Sunday on ABC by Reince Priebus, Trump’s incoming chief of staff. He did not elaborate on that view or how it would affect his proposal. He expressed that view throughout the campaign.

Timing could be difficult as Trump puts an emphasis on speed. Obama’s law took more than 14 months of debate and hundreds of hearings. To urge lawmakers on, Trump plans to attend a congressional Republican retreat in Philadelphia this month.

Moving ahead, Trump said that lowering drug prices is central to reducing health-care costs nationally-- and that he will make it a priority as he uses his bully pulpit to shape policy. When asked how exactly he would force drug manufacturers to comply, Trump said that part of his approach would be public pressure “just like on the airplane,” a nod to his tweets about Lockheed Martin’s F-35 fighter jet, which Trump said was too costly.

Trump waved away the suggestion that such activity could lead to market volatility on Wall Street. “Stock drops and America goes up,” he said. “I don’t care. I want to do it right or not at all.” He added that drug companies “should produce” more products in the United States.

Those around Trump trying to paper over the differences between him and every other Republican by claiming his goal is "to get insurance for everybody thru marketplace solutions, thru bringing costs down," which is what Sean Spicer said yesterday-- and which, in practical terms, doesn't mean anything at all. Sunday, thousands of Americans rallied for the Affordable Care Act. Bernie led one in Warren Michigan that included the state's two senators, Debbie Stabenow and Gary Peters, local congressman Dan Kildee, and Senate Minority Leader Chuck Schumer. Elizabeth Warren-- along with Mayor Marty Walsh, Senator Ed Markey and congressmembers Katherine Clark and Richard Neal-- hosted an overflow capacity rally in Boston's historic Faneuil Hall and there were large rallies in San Francisco, New York (in front of a Trump hotel), Cleveland, Columbus, Cincinnati, Tampa, Sacramento, Honolulu, Philadelphia, Waukesha, Richmond, Burlington, Orlando, Chicago, Indianapolis, Des Moines (and 5 other Iowa cities), Newark, Albuquerque Los Angeles and Portland (both of 'em-- Maine and Oregon). And, of course, Pramila Jayapal hosted one at Westlake Park in Seattle.