If there is a faster way for President Trump to signal he has no idea what he’s doing with his latest healthcare push than naming Sen. Rick Scott (R-FL) his congressional point man on the issue, I’d like to see it.
Trump made the announcement last Thursday, telling reporters that Scott, along with John Barrasso of Wyoming and Bill Cassidy of Louisiana would take the lead on hammering out a new Republican healthcare policy. “They are going to come up with something really spectacular,” he told reporters, immediately raising the question of whether Trump could define the word “spectacular” if you spotted him a dictionary.
Scott’s relevant experience in healthcare policy comes in two areas. One was his job in the 1990s as CEO of Columbia/HCA, a company that owned hundreds of hospitals and medical facilities. During Scott’s time at the helm, the company committed what the Department of Justice eventually called “the largest health care fraud case in U.S. history.” The DOJ investigation found that Columbia had defrauded the government out of hundreds of millions of dollars in fraudulent Medicare and Medicaid billing and home-health-care visits for patients who did not qualify for them, among other transgressions.
Scott had resigned as CEO in 1997 when the investigation first became public. The company eventually pleaded guilty to 14 corporate felonies and paid the government a total of $1.7 billion in fines and penalties.
Scott’s second point of experience is as governor of Florida, a position he ran for on the basis of an opposition to the Affordable Care Act that bordered on messianical. Since then he has gone back and forth on the ACA. In his second term as governor, he finally accepted federal funds for the law’s Medicaid expansion in his state. He has admitted to liking the ACA’s requirement that insurance companies cover people with pre-existing conditions without charging them more and promised to fight to protect that provision.
At the same time, just since his election to the Senate last November, he has written multiple editorials about the need to repeal the ACA. He has introduced an amendment in the Senate that would protect the pre-existing conditions requirement even if the law gets repealed without apparently understanding that other parts of the ACA, such as the individual mandate, help keep the premiums he complains have shot up too high from rising even more.
What Scott and his fellow Republicans are discovering is that there is no real room to the right of the ACA for a healthcare reform plan that could keep many of the provisions people like about the law without the regulations that conservatives hate. This point is underscored by a story in The Hill on Monday morning reporting that Sen. Mitt Romney of Utah is part of a group of senators who have had “early discussions” about coming up with a new healthcare plan. Romney, while governor of Massachusetts, famously signed into law a healthcare reform plan that contained some of the elements upon which the ACA was later based, most notably the individual mandate. He was forced to renounce that plan when he ran for president in 2012, lest the frothing GOP base tears him limb from limb for his apostasy.
If genial Mitt Romney had to renounce a moderate plan that had his name on it seven years ago, what good is he going to be in 2019 when the party has moved even further to the right?
The problem for Republicans is what it has been for a decade. They cannot admit that their preferred healthcare plan for America is “nothing.” They cannot admit that their position of “no government involvement in healthcare” is nonsensical, since government is already involved in it in so many ways. They cannot admit that some of the popular provisions of the ACA are possible only because of the unpopular provisions propping them up. And they certainly cannot admit that the ACA was not, as they kept scaring people into believing, a socialist takeover of the entire healthcare system.
This is why some Republicans have spent the past few days signaling that they would rather not touch Obamacare repeal again with a pole long enough to reach the sun. They have long run out of room to find an ACA replacement with more conservative principles still achieves the same goals. But the word “Obamacare” still sends them and their voters, and particularly the president, into a state of apoplexy.
Meanwhile, Democrats won big in November’s elections partly by running on a message of reforming healthcare even more from the left, and they are going to do so again in 2020.
So what are Republicans to do? Trump, in his usual lazy way, is rebranding the GOP as “the party of healthcare” and asking someone else to do the hard work of figuring out what that means. In other words, they are going to keep running in ever more frantic circles rather than admit they have lost the argument.