Mar 25, 2017

The aftermath: There is no Trumpcare Plan B

Greg Ruben / Axios

President Trump likes to say that the easy thing to do would be to "let Obamacare fail" and blame the Democrats. Now, that might actually happen. It's the closest thing any Republican has articulated to a Plan B now that their repeal plan has gone down in flames.

The White House has been publicly insisting there was no Plan B in case the bill failed, and now that the bill has been pulled, it's pretty clear there's no backup plan now, either. "We're going to go back and figure out what the next steps are," House Speaker Paul Ryan told reporters at a press conference on Friday. A disappointed-looking House Energy and Commerce Committee chairman Greg Walden was blunt with reporters: "This bill's done."

Trump put a more positive spin on it: He says he's going to wait for Democrats to come to him, and then they'll work on a new health care bill together. "They're going to reach out whenever they're ready," Trump said. But his message was the same: Democrats will come to him because Obamacare is about to have "a very bad year" with "explosive premium increases."

Why they're stuck: Republicans didn't spend any time discussing a backup plan because they didn't want to believe they needed one. "We have not discussed a Plan B. I'm being authentic and genuine. There's no backroom discussions ... This has been all-in," Republican Study Committee chairman Mark Walker told reporters this morning. One senior GOP aide told Caitlin Owens that Republicans "will have to do a lot of soul searching."

  • What's next: Trump says he's moving on to tax reform: "I think we have to let Obamacare go its way for a while."
  • Ryan's warning to Democrats: Don't gloat, because Obamacare's problems are "going to get even worse."
  • Ryan suggested there won't be any Republican efforts to help the law through its struggles, like the huge premium hikes in the last enrollment season: "It is so fundamentally flawed that I don't know that that is possible."
  • That could change now that the bill's defeat is a reality. If nothing else, Health and Human Services secretary Tom Price has promised other measures to relax Obamacare's rules through administrative actions, and there's no reason those measures couldn't go forward.
  • And it doesn't mean all Republicans will want to just give up and leave Obamacare in place. "If we stopped there, it would be an unacceptable failure of insight or perserverance," Freedom Caucus member Trent Franks told reporters this morning. "Sometimes the greatest victories of all happen at 12:01 instead of 11:59." But he couldn't articulate what the next step would be.

Reality check: There's really no such thing as "leaving Obamacare in place" under a Republican administration that hates it. The law has needed a tremendous amount of implementation funding and support from the Obama administration, and it's not going to get it under Trump and Price. And some of the problems in the insurance market have been caused by the loss of "risk corridor" payments for health plans with expensive customers — which were cut because of Republican opposition.

The new talking point: "If we can't change the law on our own, and the law is what Obama and [Nancy] Pelosi and [Harry] Reid passed, pretty hard to say it's the GOP's fault," the senior Republican aide said.

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