ANALYSIS: Trumpcare carries uncertain price tags, for individuals and the GOP

The bill faces long odds, still, to become law.

ByRICK KLEIN
May 4, 2017, 5:07 PM

— -- After fits and starts and apparent dead ends, House Republicans feared inaction more than they feared action. They took a stand in a way that will have profound implications for politics in the Trump era – and for the health care of millions of Americans.

On one level, the belated approval of a health care bill by the House should be unsurprising. This is delivering on a promise that’s united the GOP, including with the new president who has shattered so many Republican traditions.

Except this is both much less and much more than that. It’s much less in that this isn’t a true repeal of Obamacare and does nothing to change the complicated politics of health care in a divided Senate. It faces long odds, still, to become law.

It represents much more in terms of the statement this sends. Republicans are holding to principles, even under a president whose conservative commitments are readily questioned and who has threatened to turn on his fellow Republicans on this very issue.

That was the message in the celebratory tone in the White House Rose Garden, where President Trump took the unusual step of hosting House members long before the bill can hope to reach his desk. He basked in the moment and presenting himself as having a united team behind him.

"How am I doing, am I doing OK?” the president asked, rhetorically. "I’m president. Can you believe it?"

His presidency has new energy now. But the principle of remaking, if not quite repealing, Obamacare comes with a series of price tags.

There’s no cost estimate, with voting coming ahead of a final Congressional Budget Office analysis. There’s no estimate of impact on the country, with the White House press secretary admitting it’s "literally impossible" to determine how individuals with preexisting conditions will be affected.

If Trumpcare winds up replacing Obamacare, it will be judged based on the real-world implications for individuals. But like health care reform efforts before it, most memorably in 1994 and 2010, this is bound to become a voting issue.

Long before it goes to voters, constituents will have their say, both among House members on recess next week, and with senators whose action comes next in the process.

"Most Americans don’t know who their member of Congress is, but they will now," warned House Democratic leader Nancy Pelosi. "You will glow in the dark on this one."

This was a strange sequence of events for the president. Despite meandering leadership, broken deadlines, confusion around the bill’s particulars and even threats to "come after" reluctant members of his own party, Trump has the first major legislative victory of his time in office.

But back to the costs –- the effort has already consumed the early months of Trump’s presidency. Now, Trump gets to learn what his predecessor did, multiple times over, about the political perils around health care.

It won’t be enough for the Republican Party to stand united in the sunlight at the White House. They’ll need to finish a bill that delivers for millions of Americans who view the events in Washington as something they’re not ready to celebrate just yet.

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