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Donald Trump is flailing around once again. On Saturday, he sent out a cryptic tweet urging his followers to watch Judge Jeanine Pirro’s Fox News show that evening; lo and behold, Pirro’s opening monologue was one long demand for Speaker Paul Ryan’s pink slip. Then, the following day, Trump fired off another 140-character discharge, this time accusing the House Freedom Caucus of rescuing Planned Parenthood and Obamacare.


As a #NeverTrump conservative, I’d love to blame the entire American Health Care Act fiasco on the president. But Trump’s morning-after indecisiveness aside, this isn’t his fault and he has every right to be furious. He did exactly what a president who doesn’t understand health care should have done: get out of the way, let Congress handle it, and stump relentlessly for it once it’s finalized. At last, the primacy of American government was put back on the shoulders of the legislative branch. It was they who failed and specifically Speaker Paul Ryan, who realized with a start that after seven long years of brick-wall opposition, he didn’t have a plan.

The line from Capitol Hill is that the AHCA’s failure is all the fault of those vandals in the Freedom Caucus who refused to accept that a superior bill was an impossibility. Listen carefully in Washington on a quiet night and you can hear the whining: “Better legislation couldn’t have made it throoooooough! You don’t understand how Hill procedure wooooooorks!” We should be contemptuous of these objections. The only procedural roadblock in front of Republicans was in the Senate, where leadership insisted that any legislation hacking away at Obamacare’s regulatory thicket would exceed the limitations of the reconciliation process, needed to overcome a Democratic filibuster. Except the parliamentarian told Senator Mike Lee that the regulations might be rolled back under reconciliation after all but that until recently nobody had bothered to ask her about it. How convenient. At any rate, process isn’t an excuse for policy; it’s the former that’s supposed to serve the latter, and if it doesn’t, by all means change it.

RELATED: Real health care reform means more than just adding a letter to “ACA”

No, this wasn’t a procedural failure, but a political one, somehow extracted from the jaws of a seven-year-long victory streak. Republicans had all that time to study the health care markets, take the temperatures of their members, and hammer out a bill that achieved real reform and was backed by consensus. The Freedom Caucus didn’t suddenly tap-dance in Vaudeville-style, wearing bowler hats and waving canes, singing about how great the word “no” is. Ryan and company knew it was there and knew it wouldn’t swallow anything less than a serious antivenin to the Obamacare poison.

Instead, they pumped out a lousy bill, demanded everyone sign on, tripped over utterly predictable conservative opposition, managed to get themselves blown up by a CBO report, and then blamed the dissenters when everything went horribly wrong. Of the Freedom Caucus, one sniveling Hill source whined to Politico, “There is no logical explanation for their behavior except they wanted to kill the bill.” Yes, imagine that—and of a piece of legislation that was supported by a whole 17 percent of the public, no less! Cut to Freedom Caucus chair Mark Meadows being toasted by his western North Carolina constituents for opposing the AHCA—a local poster displaying his visage reads “This is the face of leadership!”

RELATED: This is exactly what we elected the Tea Party to do

That statement, unfortunately, cannot be made about Paul Ryan’s baby blues. I’m no reflexive Ryan hater and I sometimes think the Steve Bannon-esque disdain for him goes too far, but this one is on him. He might have let health care simmer for eight months; he might have assembled an open-doors panel of wonks to advise him; he might have included the Freedom Caucus and the moderates; he might have done health reform piecemeal, with multiple bills ameliorating multiple parts of Obamacare, amounting in toto to a full repeal. Instead, he gave us an industry-sculpted rush job.

It’s well known that lobbyists write vast chunks of legislation, and that feels like the problem here—how else to explain the AHCA’s insensate 30 percent surcharge paid to the insurance companies? America Health Insurance Plans, which represents giants like Anthem and Cigna, happily endorsed key provisions of the law in advance of Friday’s non-vote. In that, they stood almost alone. Maybe the procedure really was the problem after all.

Don’t blame Trump: The health bill’s failure was Paul Ryan’s doing through and through AP Photo/J. Scott Applewhite
Matt Purple About the author:
Matt Purple is the Deputy Editor for Rare Politics. Follow him on Twitter @MattPurple
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