Who Wins and Who Loses From TrumpamaCare?

Eric Thayer/Reuters, Michael Brochstein, Tom Williams/Congressional Quarterly/Newscom via ZUMA


Earlier this morning I sketched out a possible compromise between Obamacare and Trumpcare that might have a chance of getting through Congress if everyone agrees to a plan that would rely on both Republican and Democratic votes. I consider the odds of such a thing small, but nevertheless it’s worth looking at why nearly everyone should find this idea attractive:

  • Donald Trump gets a big win. Paul Ryan couldn’t get his plan through Congress, but then Trump steps in and pulls off a huge deal. His presidency is back on track.
  • Republicans in Congress get an albatross off their backs. Right now, health care is a loser for them, and the Freedom Caucus is riding high. But if they pass a bipartisan plan, it sticks a finger in the eye of the FC ultras. And if they’re worried about their base, they don’t have to be. Trump will sell the hell out of the plan, and his fans will buy it.
  • Democrats have to make some concessions, but in return they get stability and permanence—and the possibility of future enhancements—for a social welfare program they’ve been trying to get enacted for decades.
  • The health care industry gets some certainty about the future, along with a system that promises to be a moneymaker for them.

Who are the losers in this deal? Hardly anyone. The ultras lose, but everyone wants them to lose. Rich people lose a bit because they continue paying a modest tax, but frankly, I haven’t noticed that rich people are all that upset about it. They care more about capital gains taxes and top marginal rates. Talk radio shouters lose a reliable audience pot stirrer, but they’ll support Trump in the end. And they have plenty of other ways of keeping their listeners at a fever pitch of outrage anyway.

Oh, and I almost forgot: the American people would be big winners too. Already, Obamacare covers 20 million people. A new and improved TrumpamaCare would probably get to 30 million within a few years.

Given all this, it’s almost insane that this deal isn’t likely to happen.