Trump failed horribly, but America killed GOP health care plan

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President Donald Trump pauses as he speaks from the Oval Office of the White House in Washington, DC, on March 24, 2017. / AFP PHOTO / MANDEL NGANMANDEL NGAN/AFP/Getty Images

Follow @csteditorialsWhy did the Republican health care plan crash and burn on national TV?

Not because President Donald Trump is a rank political amateur, though he is. The great “deal maker” could not close the deal.

And not because House Speaker Paul Ryan failed to control his Republican caucus, though he did fail. Once again, the tail wagged the dog. Ryan was done in by the same right-wing zealots who shut down the federal government in 2013. The Speaker is hopeless as a leader if he still believes they will ever, in his words, “give a little to get something done.”

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The Republican health care plan went down to ignominious defeat because people didn’t like it. Only 17 percent of Americans, according to polls, thought well of the draconian American Health Care Act, which would have eliminated a minimum level of coverage and really stuck it to older men and women.

But — and here’s the key to moving forward — Americans in growing numbers actually do feel positive about the existing health care law that the Republican plan was intended to replace. For all its drawbacks, a majority of Americans — 53 percent — support continuation of the Affordable Care Act, also known as Obamacare. They do not want to see it repealed and replaced. They want to see it fixed.

Trump and Ryan refuse to accept that, which is a political calculation, not a practical one. Trump on Friday said Obamacare is “exploding,” but the only thing exploding is his presidency. Ryan said Obamacare is probably too “fundamentally flawed” to be “propped up.”

That’s a scary thing for Ryan to say, given that even he now agrees Obamacare is the “law of the land.” Is he prepared to stand by and watch it fail? People will still get sick.

Ryan also is dead wrong. The GOP will never come up with a better plan, not so long as 40 or so hard-hearted Republicans in the House think our social responsibility to each other begins and ends with braking for pedestrians at red lights. But the Affordable Care Act can be improved, reducing costs without diminishing coverage.

Only politics — an unwillingness among more moderate Republicans to part ways with the zealots and work across the aisle with moderate Democrats — stands in the way.

We feel a little cruel going hard on Ryan today. At a press conference in Washington on Friday, he looked like a whipped puppy that just wanted to run home to Janesville, Wis., and hide under the couch. But he has a moral obligation now to make Obamacare work. It is a responsibility he cannot shirk.

Here are five ways, among many others, to proceed:

  • The biggest problem with Obamacare is that insurance premiums are rising faster than expected. This is because fewer than expected young and healthy people, whose presence reduces the average risk in a pool of people covered, are signing up for insurance. One solution would be to increase the penalty for not signing up, bringing it closer in line with the cost of insurance.
  • Because premiums are expensive, a second proposed fix would be for the government to offer premium subsidies for individuals and families who are a little higher up the income scale, though not so high as called for in the Republican bill. The Affordable Care Act offers tax credits to families with incomes up to $90,000.
  • Provide more relief to insurance companies directly, which would attract more participants and create greater competition. A greater payment or subsidy could be given to a company when it gets an extraordinarily high number of sick people, increasing their risk.
  • Control the growth of prescription drug prices by making it easier for generic products to come to market and reviewing price increases to see if they are justified.
  • Consider tightening the window during which people can sign up for Obamacare, which is now from Nov. 1 through Jan. 31. Insurers say the wide window makes it too easy for people to wait until they get sick to sign up.

Repeal and replace is dead. So is a more incremental approach to abolishing Obamacare.

If this mess in Washington taught us anything, it is that Americans, by and large, want access to affordable health care that covers basic services, such as maternity care and mental health care, and they are not keen on bumping aside the poor, the old and the sick.

The Republican health care plan did not fail because Trump and Ryan made a hash of it, though they did. It failed because our nation is better than that.

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