As the inauguration of Donald J. Trump as US president approaches, it’s still uncertain how exactly he is going to govern, since his actions before and after the election show his total disregard of accepted political norms.
He has surrounded himself with a billionaire cabinet whose members have political views that conflict with each other and himself; but this may in fact be how he intends to rule, elevating himself above clashing voices like a Mafia Godfather. The Washington Post comments: “A number of people have been given the highest level of White House jobs without a clear indication of who is in charge. By some accounts, Trump likes this sort of management chaos around him. But it is not conducive to policy creation.”
Trump specializes in creating political confusion while promoting his next “big reveal,” such as a “beautiful” health care plan with “insurance for all.” But regardless of these promises, the ultimate outcome of the chaos and corruption within his cabinet can only be the Republican agenda of dismantling state regulations and agencies on behalf of corporations and the plutocracy.
Healthcare is a concrete example of policy confusion that eventually defaults to the position of the Republican right. On the campaign trail, Trump vowed to repeal Obama’s Affordable Care Act but at the same time save Medicare and Medicaid. He repeated his promise last weekend, telling the Washington Post he would unveil a nearly finished plan that would guarantee “insurance for everybody.” This conflicted with Republican rhetoric that they would focus on lower costs to ensure “access” to insurance, rather than universal coverage.
But Wednesday, the day of the confirmation hearing for Tom Price, his nominee to lead Health and Human Services, Trump backtracked on the promise in two separate interviews. The Washington Post’s Greg Sargent comments: “While he reiterated that people without money will get coverage, he clarified that he’s considering a mechanism to do this: Medicaid block grants. … Progressives tend to oppose Medicaid block grants because they are all but certain to get cut, and because states would restrict eligibility requirements. … Thus, this idea – which seems likely to be at the center of the Trump/GOP replacement plan – would dilute the guarantee of coverage that Obamacare is striving to make universal. … Republicans just don’t believe health reform should guarantee coverage in the manner that the ACA does. … But the point is that Trump and his advisers are trying to obscure this. Trump does not want to be the guy who kicked millions off insurance. But it appears congressional Republicans philosophically cannot support anything that does not do this.”
In the confirmation hearings, Price himself twisted and turned to avoid answering a question from Elizabeth Warren if Medicare or Medicaid would be cut. Asked point-blank if dollars would not be cut, he replied: “We should put forward the resources to take care of the patient.” Earlier, he repeated the Republican line that individuals should have the opportunity to “gain access” to coverage, as opposed to “insurance for everybody.”
Trump’s role in this scenario is to create public uncertainty about what his administration is actually going to do about healthcare, a smokescreen for what Republican legislators like Price are preparing. This is a big deal because the deindustrialization of America has eliminated most unionized jobs with health benefits. The Republican rush to repeal the Affordable Care Act and remove coverage from up to 32 million Americans will affect many Trump voters who believed his promises of a better healthcare plan. But since the Republican strategy is to repeal the funding for Obamacare before a new plan takes effect – described by Elizabeth Warren on Sunday as “repeal and run” – it will be politically impossible to restore the taxes that will pay for any of the things he or his spokespeople have promised.
Many people who voted for Trump believed he would stop short of removing the coverage they were already receiving under the ACA. Greg Sargent reports a CNN feature about “people who live in Eastern Kentucky coal country and backed Trump because he promised to bring back coal jobs. Now, however, they worry that a provision in the ACA that makes it easier for longtime coal miners with black lung disease to get disability benefits could get eliminated along with the law. That provision shifted the burden of proving that the disability was directly caused by work in the mines away from the victim” and placed it on the owners.
Sargent argues that “while Trump did repeatedly vow repeal, these voters were absolutely right to conclude that he would not leave them without the sort of federal protections they enjoy under Obamacare. That’s because Trump did, in fact, clearly signal to them that this would not happen. … Yes, Trump said endlessly that he’d do away with the ACA instantly. Yes, his own replacement plan would leave millions without coverage. But here’s the rub: Trump also went to great lengths to portray himself as ideologically different from most other Republicans on fundamental questions about the proper role of governmental intervention to help poor and sick people without sufficient access to medical care. … Trump also repeatedly vowed not to touch Medicare, explicitly holding this up as proof he is not ideologically aligned with Paul Ryan on the safety net.”
Now the reality of Trump’s plans is not only causing extreme emotional distress but also imperiling the health of people currently covered by the law. Although under-reported, Bernie Sanders’ “Our Revolution” organized a day of action against ACA repeal on Sunday. At least 40 rallies took place in different cities, the highest profile one in Macomb County just outside of Detroit, Michigan, drew up to 10,000 in below-freezing weather to hear Sanders call for the defense of the ACA and the creation of a Medicare-for-all, single-payer system. Some in the crowd were Trump supporters now scared of losing their coverage. Elizabeth Warren spoke to 6,000 people at the historic Faneuil Hall in Boston – the rally was intended to be inside the hall, but had to be moved outside because of the size of the crowd.
In Price’s confirmation hearing, Democratic Senator Patty Murray told him: “My constituents are coming up to me with tears in their eyes, wondering what the future holds for their health care given the chaos Republican efforts could cause.” And in local meetings, Republican legislators are confronting angry constituents demanding answers on Obamacare repeal. The Houston Chronicle reported that far-right Ways and Means chair Rep. Kevin Brady, a vocal critic of the law, encountered 50 people at a meeting where he expected them to share “experiences with rising costs and loss of coverage and choice.” Instead they grilled him about his support for repeal without a replacement. “Don’t lie!” shouted Emily Hoppel, a 39-year-old with her 2-year-old son perched on her hip, when Brady moved from one goal of dismantling ACA to another of defunding Planned Parenthood, which he said used taxpayer money for abortion. “The Hyde Amendment,” she sputtered, incredulously, as Brady continued to talk over her. In Grand Rapids, Michigan, Rep. Justin Amash was repeatedly interrupted by constituents concerned about the repeal of the Act during a packed town hall meeting. After Amash referred to the healthcare law as “Obamacare,” a number of audience members interrupted to insist that he call it the “Affordable Care Act” instead.
The left needs to cut through the smoke-and-mirrors rhetoric that Trump, the Confounder in Chief, uses to dominate the media and work to build support for Sanders’ and Warren’s defense of the ACA, together with other movements of mass resistance to corporate hegemony. This means developing an organized opposition to the Democratic leadership which failed to mobilize the party’s voters in the 2016 election.