Does Trump Actually Know What's in His Own Healthcare Bill?

The president insists he knows his stuff, but his public statements leave room for doubt.

Jun 28 2017, 3:12pm

Some Trump masks. Photo by TOSHIFUMI KITAMURA/AFP/Getty Images

Oh, what a time we live in! What wonders unfurl in front of our eyes daily! The president of the United States, who just a couple years ago was upbraiding Gilbert Gottfried for telling sex jokes at a presentation to a frozen-food company, can take out a phone anytime he wishes and tell the world what he is mad about.

The source of Donald Trump's frustration Wednesday morning was apparently a New York Times story from the previous evening about a meeting Trump had with Senate Republicans to hash out what was going on with their healthcare bill. As you probably know, the proposed law cuts taxes for the wealthy in exchange for slashing benefits to the poor. A planned vote on it had been delayed amid widespread criticism; the Times reported that Senate Republicans were frustrated at Trump and that the president hadn't really been involved in negotiations over the bill.

But what everyone was paying attention to were a couple paragraphs near the end of the story:

A senator who supports the bill left the meeting at the White House with a sense that the president did not have a grasp of some basic elements of the Senate plan—and seemed especially confused when a moderate Republican complained that opponents of the bill would cast it as a massive tax break for the wealthy, according to an aide who received a detailed readout of the exchange.

Mr. Trump said he planned to tackle tax reform later, ignoring the repeal's tax implications, the staff member added.

This seems to be more evidence of a theory many Trump opponents have about the small-handed commander-in-chief: He tends to govern on instinct and bluster while ignoring details like what is actually in the signature bill his party is advocating. (Or, more simply, Trump may not have any idea what's going on.) Though he campaigned on bringing jobs and infrastructure to the country, in practice he's basically pursued an ordinary Republican's anti-regulation, anti-tax agenda—or rather, he's let other people pursue that agenda while tweeting and periodically appearing at rallies in the heartland.

Trump doesn't like being called ignorant, however, and he let his displeasure be known:

It's impossible to say for sure how well Trump knows his own healthcare policy. We do not even know what is in the minds of our lovers when they are lying next to us in the dark. How can we know whether Trump understands anything? Other people will forever be as mysterious as the furthest depths of the ocean.

But Trump's statements about healthcare during and after the campaign do not suggest this is a man who has spent much time contemplating the intricacies of Medicaid block grants and essential health benefit waivers. To wit:

  • As a candidate, Trump vowed not to cut Medicare or Medicaid; as president-elect, he said that there would be "insurance for everybody" and wanted to make drug companies negotiate with the government over prices.
  • That rhetoric was notably distinct from usual Republican talking points on healthcare; the GOP generally doesn't want more government involvement in the market, even if that means fewer people have insurance. When Trump released his official healthcare plan in March 2016 during the primaries, it was largely in line with Republican priorities.
  • But Trump didn't seem too engaged with that plan. He spent time bashing the Affordable Care Act, but rarely talked made a positive case for what should come after it. In February, as Republicans debated replacements, he famously said that "nobody knew that healthcare could be so complicated."
  • Yet even since then, Trump doesn't seem to have to boned up on the subject. In March, after celebrating the passage of a House bill that would result in millions more people not having insurance, Trump praised Australia's universal healthcare system, which is more or less the opposite of the system Republicans want, while meeting with that country's prime minister. Later, the White House claimed Trump "was simply being complimentary of the prime minister," whatever that means.
  • About that House bill: Though Trump praised it at the time, this month he called it "mean," and in an interview with FOX & Friends he said, "I want to see a bill with heart."
  • Though it's unclear what "heart" means, the bill currently being debated by Senate Republicans would cut Medicaid, which Trump was previously opposed to, and drive up premiums for many older people, a.k.a. part of his base.
  • Trump periodically accuses the Democrats of obstructing healthcare reform, but Republicans have made no efforts to even involve the other party in discussions about the bill. (Senate Majority Leader Mitch McConnell implicitly conceded this earlier this week when he warned actual bipartisanship might be necessary if the Senate bill dies.)
  • Trump continues to talk about healthcare in the most general possible terms, just as someone would if he didn't know (or care) about the details. "This will be great if we get it done," Trump said this week. "And if we don't get it done, it's just going to be something that we're not going to like. And that's OK, and I understand that very well."

Anyway, Trump will be president until at least 2021, probably.

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