It wasn’t the politics of health care that did in Trumpcare. It was the substance.

Nancy Pelosi and Chuck Schumer earlier this year. Photo (cc) 2017 by Lorie Scholl.

I find myself frustrated at the tone of much of the commentary following the humiliating withdrawal of the Trump-Ryan health-care bill Friday. I could find a bunch of stuff to link to, but we’ve all seen it. It’s all about winning. So much winning. And if the bill had been approved, most commentators would be hailing President Trump for his big victory.

Yes, Trump got the politics wrong. But of far greater significance is that he and House Speaker Paul Ryan got the substance wrong. There was nothing in their legislation other than a chest-thumping assertion that Obamacare is dead — and that we’re going to screw the poor, help the rich, and dismantle much of what was accomplished by the Affordable Care Act.

The two groups that defeated the legislation did so on principled grounds: Democrats and moderate Republicans who wanted Obamacare to remain entirely or mostly intact; and the House Freedom Caucus, whose extremist members don’t want any government involvement in health care whatsoever. On the other side, those who supported Trumpcare couldn’t point to a single provision that would have improved anyone’s lives other than the wealthy people who’d get a tax cut.

After the defeat, Trump blamed House minority leader Nancy Pelosi and Senate minority leader Chuck Schumer. He’s right — it’s on them. And we should thank them for saving the most important piece of social legislation since Medicare was approved in the 1960s. And these folks, too:

And the #groundwork of tens of thousands of #district based activists pounding on their own Congressperson via direct actions & phone calls https://t.co/7WyrtdZjZ2

— judymeredith (@judymeredith) March 25, 2017

Any major new program needs technical fixes along the way. Unfortunately, after Obamacare was approved, congressional Republicans refused to consider any such legislation. That, along with attempts by many Republican governors to undermine it in their states, is responsible for the ACA’s not working as well as it should.

On Friday, the ACA was saved. It now must withstand at least two years of Republican attempts to starve it of funds. But as Jonathan Chait of New York magazine points out, it’s not likely to be repealed after the debacle of this week. Trump and congressional Republicans won’t be in power forever. At some point, we’ll have an opportunity to get this right.

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