The only thing worse for President Trump than his failure last week to garner sufficient House votes to ‘”repeal and replace” Obamacare would have been to succeed. While the short-term political costs of this resounding defeat in his first major legislative effort are considerable, the long-term political costs of adopting legislation bearing close resemblance to the defeated House version, which combined a giant tax cut for the rich with 24 million people losing their health insurance, along with a hollowing out of essential care requirements for some of those who remain insured, would have been disastrous.
President Trump now has an opportunity for a reset on health care—one that can serve him well politically and serve the nation well substantively-if he is willing to fundamentally change course and fulfill his campaign promise that everyone would be insured and have access to great health care. This requires abandoning repeal and making the goal the reform and repair of Obamacare. It means building a completely different legislative coalition that includes Democrats, along with moderate Republicans and pragmatic conservatives.
As one of the sharper and more pragmatic Republican members of Congress, Tom Cole of Oklahoma told the New York Times, “the president is a deal maker and Ronald Reagan cut some of his most important deals with Democrats.”
This is good advice, especially on health care where a majority of Americans now approve of Obamacare, while less than 1-in-5 approve of so-called “Trumpcare or Ryancare.” Underlying these results, as I argued in a recent column, is the fact than 6-in-10 Americans say the government should be responsible for ensuring health care coverage for all Americans, as opposed to less than 4-in -10 who say this should not be the government’s responsibility, according to recent Pew Poll. This reflects a marked increase in the percentage of Americans who now believe that providing health insurance is an affirmative duty of the government.
Research demonstrates that the defeated House health care legislation would have hit older working class whites, Trump’s strongest demographic, particularly hard, leaving many without health insurance. If Trump is going to succeed politically, he needs to back-up his professed populism and concern for the ‘forgotten man’ with policies that help-not hurt—especially on an issue that directly impacts people’s lives.
Reforming and repairing Obamacare and restoring more competition can be accomplished by minimizing risks for health insurance companies and increasing—not lowering-- government subsidies. This can help put the brakes on big premium increases. These common sense fixes can be combined with experimenting with allowing health insurance to be bought across state lines and permitting small businesses to join large health care purchasing pools to give them more leverage in the market.
Since most experts believe, contrary to the doomsday arguments of Trump and the Republicans, that Obamacare is sustainable and polling shows that people who get their health insurance through it are mainly satisfied, by putting in place these more incremental reforms, Trump could ultimately emerge as a hero. His efforts would be directly responsible for more people being insured and more market competition to hold down premiums. And he could build a winning Congressional coalition for these kind of approach and truly demonstrate he is a different kind of Republican—one that looks out for average people.
That is the winning way forward, Mr President.
Rob Horowitz is a strategic and communications consultant who provides general consulting, public relations, direct mail services and polling for national and state issue organizations, various non-profits and elected officials and candidates. He is an Adjunct Professor of Political Science at the University of Rhode Island
Related Slideshow: Trump’s Proposed Budget Creates Winners and Losers in RI
The biggest winner in the Trump budget is military spending and correspondingly, many of Rhode Island’s largest private employers will see dramatic increased in spending.
General Dynamics/Electric Boat, Raytheon, and the Aquidneck Island defense-related companies will all see increase funding and Rhode Island will see job growth
Rhode Island’s public radio and television will be zeroed out of federal funding in FY18 under Trump's budget.
RIPBS’ General Manager David Piccerelli confirmed on Thursday that if the budget is adopted, the station would lose over $700,000, but said he is hopeful that funding can be restored.
In late February he appeared on GoLocal LIVE to talk about the importance of public broadcasting in Rhode Island.
According to the Corporation of Public Broadcasting, here is the funding to RI -- which would be cut.
Veterans' programs see a major boost in the Trump budget proposal — an increase of more than 6%.
The budget would make some major improvements to the funding structure for many veteran programs. “Trump’s budget plan also provides $4.6 billion in new funding 'for VA health care to improve patient access and timeliness of medical care services for over nine million enrolled veterans,' but offered few specifics on what that will entail,” said Military Times.
The Trump budget would eliminate all funding for the National Endowment for the Humanities. The agency's Chairman William D. Adams released the following statement on Thursday afternoon:
“We are greatly saddened to learn of this proposal for elimination, as NEH has made significant contributions to the public good over its 50-year history. But as an agency of the executive branch, we answer to the President and the Office of Management and Budget (OMBTherefore, we must abide by this budget request as this initial stage of the federal budget process gets under way. It will be up to Congress over the next several months to determine funding levels for fiscal year 2018. We will work closely with OMB in the coming months as the budget process continues. The agency is continuing its normal operations at this time."
Between 2008 and 2012, institutions and individuals in Rhode Island received $6.4 million, according to NEH. Programs funded included Brown’s John Carter Library, which was awarded $270,000 to support a fellowship program for NEH designated scholars.
One of the federal agencies hardest hit by Trump's budget is the EPA.
The EPA lab in Narragansett as well as clean-up programs like Superfund will be impacted.
The Washington Post reports, “Trump's budget begins to dismantle the EPA, shrinking its funding by 31 percent and eliminating a fifth of its workforce. More than 50 programs would be eliminated altogether, including Energy Star; grants that help states and cities fight air pollution; an office focused on environmental justice and cleanup efforts in the Chesapeake Bay and Great Lakes; and infrastructure assistance to Alaskan native villages and along the Mexican border. Funding for drinking water infrastructure would remain intact, but the agency's scientific research would suffer massive cuts.”
“Hollowing out the EPA will leave communities at the mercy of big polluters and signal surrender in the fight against catastrophic climate change. How exactly does allowing industrial plants to pollute our air and drinking water put America first? How does hamstringing our diplomatic corps put America first?” said U.S. Senator Sheldon Whitehouse in a statement on Thursday.
Federal agencies will win under the Trump budget, including funding for a beefed up border. Funding will go to “build a border wall, for 500 new Border Patrol agents, and 1,000 new Immigration and Customs Enforcement agents.”
However, certain RI state agencies, local police and emergency agencies will see cuts. According to the Washington Post, the budget "cuts $667 million from grant programs to state and local agencies, including pre-disaster mitigation grants and counterterrorism funding.” Total impacts on Rhode Island are unknown.
If Rhode Island is anything, it may be the "Arts State". And arts are getting slashed under Trump's budget.
National Endowment for the Arts Chairman Jane Chu said, "Today we learned that the President’s FY 2018 budget blueprint proposes the elimination of the National Endowment for the Arts. We are disappointed because we see our funding actively making a difference with individuals of all ages in thousands of communities, large, small, urban and rural, and in every Congressional District in the nation."
For everthing from Trinity Rep to public art projects -- the budget cuts will dramatically change the funding available for arts groups.
The Trump budget would hit some key programs that impact Rhode Island that are funded via the Commerce Department — these include coastal research programs, and efforts like the Rhode Island Sea Grant which is one of 33 programs across the country “working to enhance environmental stewardship and long-term economic development and responsible use of coastal and marine resources.”
Also getting slashed in the proposed budget is the Economic Development Administration, which has been targeted for decades. U.S. Senator John Chafee called for the elimination of the program and called it “pork” back in the 1980s.
Senator Whitehouse criticized the cuts to funding for NOAA, “Slashing the NOAA budget will take away resources from our coastal economy in Rhode Island.”
The Department of Education is slated to be cut by 14 percent under Trump's budget, including a $3.7 billion cut for teacher training, after-school, summer, and low-income aid programs.
However, school choice advocates will see this budget as a win.
"Trump is also pitching a $1.4 billion boost for school choice, which budget documents call a down payment on Trump's campaign promise to pour $20 billion into expanding student options.
The charter school grant program, currently funded at $333 million, would get a sizeable increase of $168 million..Trump is also proposing a new $250 million private school choice initiative that could provide vouchers for use at private schools, including religious schools," writes Edweek.
