Donald Trump Will Soon Have to Make Ted Cruz’s Choice on Healthcare

Ted Cruz single handedly shut down the government on the eve of the implementation of the Affordable Care Act, refusing to be the vote that would sign the funding bill allowing it to take effect. The government shut down, and he was broadly criticized. In retrospect, he has gained respect from many opponents to ACA, who saw the mess that was coming.

But “in retrospect” never looks good before an election. It always does after. Now President Trump is trying again to strike out ACA in the courts. He is arguing that since Congress stripped ACA of its Individual Mandate, it has lost its funding mechanism, and thus is unconstitutional. However, Congress (both RNC & DNC) has continued to fund ACA through other means.

To the surprise of many onlookers, Trump has won so far. The Fifth Circuit has declared ACA unconstitutional. Now it soon heads to the Supreme Court, assuming the whole Fifth Circuit doesn’t change its mind in an en banc review.

It’s not that Trump is wrong to do this, he’s throwing red meat to supports that want to see action – especially before an election where the promise of Make America Great Again has worked out in numbers – but perhaps not so much in policy. Aside from mild tax reform (which has mildly backfired), and a few miles of border wall, President Trump – much like his predecessor – has found hope, change, and ambition are ground down easily in Washington, DC.

The problem with Trump’s game of chess on this is that the Supreme Court has a very easy out. The Supreme Court can pass the ball back to Congress; declare ACA legal as an entitlement, but say that Congress has to find the money (alternative funding) to keep it in effect. In other words, the Court can punt; letting Congress (and the President, who has to sign off on all spending) decide to either keep throwing money at ACA, or simply kill it off by defunding it.

This isn’t really hard for Speaker Pelosi – she’ll fund it no matter what from general treasury funds (taxpayers). But it creates a nightmare scenario for President Trump.

See, based on the decision that the Supreme Court is likely to make, President Trump will be given a clear choice: Fund Obamacare, upholding its legality, or veto the Democrat’s congressional spending bill, creating a government shutdown.

Much as we saw on the border wall, Democrats are willing to keep the government shut even on a small fraction of a single percent of the budget. Here we are talking one-fifth of the national economy. They’ll stand their ground, and keep government shut… blaming President Trump for trying to kill the now-popular ACA via shutdown.

President Trump’s only hope for an out on this, is that the Supreme Court won’t decide the legality of a mandate-free ACA until after 2020, ensuring he can win re-election, gain the Court’s blessing to kill ACA by defunding it, and re-take Congress. That is threading a needle she shouldn’t bet on. When President Obama won re-election, Congress stayed in Republican hands. That partly perpetuated the Healthcare Hell we are now in, but it also is likely to happen again in the opposite direction.

For one, the Supreme Court very much could grant cert and hear this case next year. If they do, the President will have to decide if he wants a total, long-term government shutdown… during an election year. Or if he will stand his ground, and vow to do so right after the election, if Congress stays in the hands of Democrats. This could backfire – people with lots of money don’t want a six month government shutdown, and handing the presidential election to Democrats, would avoid that.

If that sounds like the decision Ted Cruz had to make on the eve of ACA taking effect, it is. Cruz narrowly won re-election against a populist congressman, but even that was a surprise to many onlookers. Trump should be nervous about history turning the other direction, on the same decision point.

For two, assuming Trump wins, even if the GOP takes the house in 2020, a re-elected President Trump will then have to actually kill ACA. This, at a time when ACA has more than 50% popularity, and even a consensus amongst Republicans is that Diet Obamacare is better than Socialized Medicine. With no alternative, the only option then would be to revive Paul Ryan’s AHCA, which the President himself described as Obamacare – before of course begging the late Senator John McCain to support it (spoiler alert, he did not).

America should be angry, but the fault is in our own stars on this one. Democrats should be angry at their own party for promising to end the healthcare divide at ACA, and avoid Socialized Medicine (before admitting that was a sham – and that ACA was indeed a backdoor to single-payer). But the ball is in the GOP’s court. The GOP either needs to (quickly) invent an ACA-free healthcare reform mandate, fall back in love with AHCA, or capitulate and embrace ACA based on the mandate becoming entrenched. There is no fourth option this time.

Personally, my advice would be to get out the can of compressed air, and start reading through the last draft of AHCA. There’s a former speaker from Wisconsin that may be able to help with that.

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