It’s harder than Trump thinks to pull a thread or two out of the ACA.

November 12th, 2016 at 9:07 am

All the papers this AM tell me of softening in some of president-elect Trump’s positions, including health care, immigration, trade, and more. Some of his aides are straight-up saying that a lot of that stuff was just campaign talk.

He wouldn’t be the first to make such pivots. Moreover, his campaign wasn’t exactly policy driven and many of his voters won’t be surprised to hear that no, Mexico isn’t going to pay for the wall. During the campaign, almost every Trump supporter I met told me they didn’t believe everything he said. They just thought he’d shake things up.

It’s too early to know what to make of this alleged pivot; my instinct is not to make too much out of it. Trump may well turn out to be not that interested in wonky minutiae and will outsource it to people that are, like Ryan and Pence, which in turn implies the death of many progressive accomplishments. I’ve got a piece coming out on the wide swath of damage they could do if they wanted to, and their history suggests that they (e.g., Ryan) do, in fact, want to.

But speaking of wonkery, let’s take a shallow dive into Trump’s softening on health care, which in at least one key aspect, doesn’t make much sense. He reports that in his meeting with President Obama, the President convinced him that parts of the Affordable Care Act are worth preserving, including the requirement that insurers cover those with pre-existing conditions.

But for that part of the law to work, you need healthy people to subsidize sicker people, as the latter must be covered. That implies mandates, and if you mandate coverage, you must have individual subsidies and “community rating” (no individual underwriting; some variation within geo-areas allowed based on age and tobacco use). Without such provisions, the pre-existing condition requirement is meaningless, as insurers will offer unaffordable care to such persons.

In other words, there are lots of interacting, moving parts to the ACA, and it’s hard to pull out one thread.

One other item that caught my eye this morning. A Trump economic advisor claimed that the 45 percent tariff on China would only be used as an offsetting tax against currency manipulation. So if China reduces the value of yuan 45 percent relative to the dollar, they’ll raise the tariff. That would take legislation, and is actually much like a bill proposed by Sandy Levin, Sherrod Brown and others in years past. I should note that this bill always got big Congressional majorities but the leadership and the Obama administration opposed and blocked it.

It is said: You campaign in poetry, govern in prose. The poetry didn’t rhyme and some of the prose isn’t making a ton of sense. So, I’ll be carefully watching this alleged pivot.

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4 comments in reply to "It’s harder than Trump thinks to pull a thread or two out of the ACA."

  1. Ben Groves says:

    Considering Trump’s biggest segment was the pro-immigrant/trade theocrats, over do your your market, it will not end well. He won not for what the media thinks.

  2. Jill SH says:

    For some time I’ve suspected that this would be the Chinese Century. A country that large, with that size population [four time the US], will eventually outpace us.

    If Trump decides to start anything like a trade war with them, the Chinese could probably leave us in the dust pretty quickly economically speaking. And militarily too, if they decided. They are, after all, a directed economy, right?

    A conscious, careful, and politically savvy US government could manage this eventuality while keeping our economic and diplomatic preeminence if not hegemony. If Trump’s policies give China incentive to suddenly ramp up retaliatory behaviors, I think the US position as the world’s leading economic power would decline bigly.

    • Smith says:

      One looks in horror at most of Trumps foreign policy statements except for China.
      We want trip wire troops (40 to 50,000 each) and guarantees for Germany, Japan, and Korea, to
      a) Make sure Russia and China know we are committed to those countries’ defense.
      b) To make sure Germany, Japan, and Korea can’t be intimidated, since we have their back
      c) To keep Germany and Japan from developing a military infrastructure which due to their place as the third and fourth most economically powerful countries would severely complicate and threaten global stability while acting to diminish and restrict U.S. influence.
      Economically (because this is an economic blog), the price we pay (and it’s not that significant compared to our total defense bill) is comparatively small and worthwhile for the benefits secured.

      But as for China, the country is ripping us off, while corporate America and the 1% sells their soul for one generation’s profit. China steals industrial knowledge by insisting on joint ownership in investment. They manipulate currency to sustain the large trade imbalance, and are not above dumping excess production on U.S. markets. Their workers, with zero labor rights, human rights, and consumer level incomes, can hardly be expected to buy anything American when they must struggle for necessities. The business climate in China is one of state control, lack of labor rights, low wages (though now above competing nations with even cheaper labor), and the absence of Western judicial standards, or as we say, rule of law. Even if they played fair, cultural and levels of development could prevent any benefit for the average American worker. Look at the trade balance with Japan for example, and they are a developed nation.

      Disengagement is the only peaceful solution. Pressuring the Chinese to liberalize will only increase resistance. The Soviet Union didn’t collapse or release Eastern Europe due to increased trade with the West. Bankrolling the Chinese as we do now is the quickest way to our own destruction. They won’t need to invade the U.S., they’ll just buy it. Limiting ownership restrictions only to strategic industries like defense won’t stop the corporate takeover.

      Not a supporter of Trump, but when he says he won’t start a trade war because there already is one, and China is winning it, hands down, it rings true.

      But here are some facts and figures from EPI, definitely not a right wing conservative think tank….
      See also

  3. Deplorable says:

    I’m not even willing to talk about health care unless it involves a single-payer solution. If they pull the wrong thread, single payer is the only solution. Let them pull the thread…

    There are too many people in positions of control that overestimate their duties in my view. My advice: Advocate for what is right, but allow mistakes to prove you didn’t go far enough.

    It is a rough game. That’s just the way it is.