Jerry Kremer

A lesson in how not to pass a health care bill


Everybody knew that passing a federal health care reform bill would be tough. Just call former Presidents Clinton and Obama, and they’ll vouch for the fact that getting a consensus in Congress can be an impossible dream. Clinton failed, but Obama managed to get the Affordable Care Act passed after many months of hearings and amendments.

The only people in Washington who didn’t learn from the past were President Trump, Senate Majority Leader Mitch McConnell and House Speaker Paul Ryan.

I like to mention the words Affordable Care Act because the poll numbers from six months ago showed that the public was in favor of the ACA and opposed to Obamacare. Six months later, the public had figured out that Obamacare and the ACA were one and the same, and to no one’s surprise, they now favor both names for the same plan.

With no public hearings, and opposition from many of his own members, Ryan rammed through a bill to replace the ACA by the smallest of margins. He caved in to the conservative wing of the party, which wants to destroy not only Medicaid, but, if given a chance, Medicare and Social Security as well. Many current House members are philosophical descendants of former members who hated any form of government compassion.

Once the bill now known as Trumpcare passed the House, there were predictions that McConnell, a legendary dealmaker, would work his magic, and within weeks, the Senate would adopt the House bill. McConnell formed an all-male task force, which foolishly consulted only with conservative senators, ignoring moderates, many of whom are women.

Trump assigned the lobbying responsibilities to Vice President Mike Pence, assuming that Pence could deliver the votes. Pence doesn’t talk to Democrats, and only speaks to a small handful of senators who are as right-wing as he is. McConnell made some changes in the legislation, mainly to appease the conservatives, but didn’t confer with anyone else in the Senate.

Within hours after McConnell announced his plans for a quick vote, a number of things happened. A large group of Republican governors vigorously opposed the bill, and asked their senators to do the same. Given that senators have to run for re-election and governors often run for the Senate, the threats put a great deal of pressure on those senators, who were not eager to defy their state leaders.

As the hour for a vote approached, the insurance industry, doctors, senior citizens and almost any other group you could name vigorously attacked the bill, and warned that it would devastate Middle America, which includes many of the people who voted for Trump. Then along came the Congressional Budget Office, an independent arm of the government, which predicted that as many as 32 million people would lose their coverage.

Trump may be the author of “The Art of the Deal,” but when it comes to legislating, he doesn’t have the slightest clue what to do next in a situation like this one. He spent no political capital trying to get votes for the bill that failed, primarily because he’s unfamiliar with how the process works. In a typical real estate deal, a builder tries to get the most concessions from the other side. In Washington or Albany, deals are made with promises of sweeteners to get the other side to give in. Just sending Pence to a bunch of meetings with conservative legislators doesn’t work, and neglecting all the Republican women senators is a recipe for disaster.

To add insult to injury, rather than cajoling the senators to support the health care bill, Trump threatened to find opponents to challenge certain senators in next year’s election. Votes in Congress used to be partially about loyalty to the White House and the party. It’s hard to cultivate any loyalty among the current members when the president demands a vote and attacks them as disloyal.

Yes, health care is a very difficult issue to deal with. It requires real leaders to support bills that can pass, and requires the president to do what previous presidents did, which was reach out to members of Congress and make a sincere effort to win them over. Things are so bad in Washington that Republican leaders may even have to talk to the Democrats to get a bill passed.

Jerry Kremer was a state assemblyman for 23 years, and chaired the Assembly’s Ways and Means Committee for 12 years. He now heads Empire Government Strategies, a business development and legislative strategy firm. Comments about this column?