How Conservatives Can Convert the Healthcare Failure into a Win for Trump and the American People

The crisis created by the demise of the American Health Care Act (AHCA) philosophically, politically and procedurally presents an opportunity for conservatives.


Will they seize it?

In the wake of the collapse of the legislation, the Trump administration has pinned some of the blame on conservative members of the House Freedom Caucus (HFC), and said that it will work with moderate Republicans and Democrats to advance its agenda going forward.

The president recently took to Twitter, implicitly threatening primary challenges against HFC members in 2018:

Thus, he invoked his strongest means of leverage.

Bear in mind, however, that in spite of the weight of such words, the administration prioritizes pragmatism over ideology, and views debates as negotiations, which are necessarily fluid and transactional.

Parties can be up one day and down the next depending on the state of play.

The president is also concerned with being perceived as a winner.

The AHCA, drafted and backed by many who were staunch opponents of the president during the 2016 election, was a political loser, and the loss undermined the president and his agenda.

It united in opposition not only conservatives, but over a dozen moderates including the House Appropriations chair. The bill received a mere 17 percent approval among the American people.

If conservatives are to convert this loss into a temporary setback on the road to victory, they must meet the president where he stands, and appeal to his core motivations.


Conservatives will not win the fight on healthcare or any other issue by arguing that we are putting forth the most conservative piece of legislation.

What we must argue is that we are putting forth the legislation that will result in the best outcome for the American people – superior healthcare at a lower cost – the political benefit of which will redound to the president.

Foisting on the American people a bill that would have retained the core components of Obamacare while removing the funding elements that kept it (barely) solvent, thus precipitating its death spiral, would not have been in the interest of the president, the Republican Party, or the public.

That Republicans put forth such a universally unpopular piece of legislation as its first major legislative act under President Trump represented just another example of the establishment he ran against undermining him.

Conversely, the House Freedom Caucus members who stood with the president throughout the election saved him from a bill that would have betrayed his staunchest supporters, the forgotten men and women who elected him to take on the establishment on their behalf.

Given the foregoing, it is incumbent upon conservatives to take this opportunity to come to the president and convince him as to why their plan for repeal and replacement is in his best interest, and to argue that they can put forth a better bill on the politics and merits, win the public political argument, and then win the policy.


That bill would be based on market principles illustrated by those like Senators Cruz and Paul, and Representative Meadows, geared towards truly freeing the healthcare system. The case must be made that a free market in healthcare, as in every other sector of the economy, will enable innovation, competition, choice and thus a superior service at a lower cost. The bill would emphasize not just empowering the American people, but striking at the swamp of crony capitalists, regulators, lobbyists, attorneys and accountants who have benefited from the raft of taxes, regulations, subsidies, carve-outs, mandates, and penalties in the current Obamacare monstrosity.

In finalizing such a plan, they should have readily available answers for how to deal with the issues most concerning to more moderate Republicans, including the idea that millions could initially be thrown off health insurance rolls. Various alternatives should be laid out and poll-tested.

Some of the end results may not be fully free market, in particular when it comes to those who still cannot afford basic healthcare after factoring in the benefits to the healthcare market and the economy, and private efforts undertaken in civil society. But the goal should be to create the freest market bill politically possible, with the elements requiring government intervention crafted as cheaply and efficiently as possible. This is consistent with the president’s focus on pragmatism.


Conservatives might call first for the immediate repeal of Obamacare – keeping the president’s promise – and then to go on a roadshow outside of D.C. to pitch a truly conservative healthcare bill to the public.

In other words, they should take the conversation outside of the Beltway, messaging to the public in a clear way why their plan is superior and how it will be implemented.

They should then ask for the administration’s help in pressuring Congress to allow for a truly open and honest debate on healthcare on the conservative bill, as well as any competing ones, moving the conversation out of smoke-filled rooms and into the living rooms of Americans.

This will make for both good politics and good policy.

Out of that process, public polling will indicate whose plan is more popular, and thus what direction Congress should go.

At that point, the president can commit to the conservative bill, or not.

But the will of the people will be clear, the essential debate will have been had, and no party will be able to complain that their view was not heard.

The American public deserves nothing less.


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