Political News

The simple explanation for Donald Trump's health care flip-floppery

Posted October 18, 2017 11:04 a.m. EDT

— On Tuesday afternoon at a news conference with the Greek Prime Minister, President Donald Trump was asked about the Affordable Care Act and his decision to end subsidies to insurance companies to incentivize them to cover lower-income Americans. Here's what he said:

"If you look at insurance companies and you take a good, strong look at the numbers, you'll see, since the formation of Obamacare, they're up 400%, 450%, 250%, 300%. They've made a fortune, the insurance companies.

So when I knocked out the hundreds of millions of dollars a month being paid back to the insurance companies by politicians, I must tell you, that wanted me to continue to pay this, I said I'm not going to do it. This is money that goes to the insurance companies to line their pockets, to raise up their stock prices. And they've had a record run. They've had an incredible run, and it's not appropriate."

Seems fine, right? And consistent with Trump's original messaging on why he agreed to end the subsidies.

Then came another question for Trump during that news conference -- a question that touched on a bipartisan deal between Sens. Lamar Alexander, a Tennessee Republican, and Patty Murray, a Washington Democrat, on health care that had been announced even as Trump was speaking.

Here's what he said about that:

"So they are indeed working, but it is a short-term solution so that we don't have this very dangerous little period -- including dangerous periods for insurance companies, by the way. For a period of one year, two years, we will have a very good solution."

"A very good solution" was understood to be Trump's endorsement of the Alexander-Murray plan. How could it be taken in any other way?

Except that Trump's endorsement of Alexander-Murray meant an endorsement of legislation that would reinstate the same subsidies Trump had eliminated last week and, earlier in the same news conference, derided as a pay out to the big insurance companies.

Which seemed, um, odd.

Trump, while still on the record as supportive of Alexander-Murray, condemned the subsidies provision in the bill during a speech Tuesday night at the Heritage Foundation; "Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies," Trump said.

Then, this morning, Trump tweeted this out: "I am supportive of Lamar as a person & also of the process, but I can never support bailing out ins co's who have made a fortune w/ O'Care."


How do you explain Trump's total flip flop -- and then flip again -- on the subsidies?

Simple: He had no real idea what was in Alexander's legislation. How else to explain Trump's initial endorsement of the Alexander-Murray deal? Or, as CNN's Phil Mattingly has reported, Trump's private urgings for Alexander to cut a deal?

Trump likes good headlines in newspapers and good chyrons on cable TV. And he knows that being for bipartisan deals cut by Congress is a way to get those headlines. Remember that reports at the time suggested Trump was ecstatic in the wake of the positive headlines produced by his much-ballyhooed deal on DACA with Democratic leaders Chuck Schumer and Nancy Pelosi. (SPOILER ALERT: The deal isn't happening!)

When he heard that Alexander and Murray were working on some sort of bipartisan deal on health care, Trump was drawn to it. Another chance for positive headlines! And a chance to push back on the "fake news" media narrative that he wasn't getting anything done!

Trump didn't -- because he doesn't -- familiarize himself with many of the details of the deal, most notably the fact that it would reverse his decision on subsidies. When he heard during Tuesday's news conference that a deal on Alexander-Murray had been reached, he jumped at the chance to a) show he knew it was happening behind the scenes and b) align himself with the bipartisan success.

Then, as CNN's Jeff Zeleny has reported, the White House began to hear lots and lots of conservative criticism for his seeming endorsement of the bipartisan deal. It also quickly became clear that conservatives -- particularly in the House -- wouldn't be for this bill, meaning that the only way it would pass is without the majority of the majority.

"We can't have another health care failure," a White House official told Zeleny, explaining how aides prevailed on him to reverse course.

And so, Trump reversed course -- a course correction that almost certainly dooms a piece of bipartisan legislation that he deemed "a very good solution" less than 24 hours ago.