WASHINGTON, DC - MARCH 1: Speaker of the House Paul Ryan (R-WI) pauses while speaking to the media after closed-door meeting with House Republicans, on Capitol Hill, March 1, 2016 in Washington, DC. In remarks following the meeting, Ryan said "This party does not prey on people's prejudices." (Drew Angerer/Getty Images)
Donald Trump held dozens of different positions on healthcare during the campaign, ranging from outright repeal with no replace to support for a single payer system. The Republican Party has been trying to repeal the Affordable Care Act since Obama signed it. Still, low income Republican voters might have voted for Trump for the exact opposite, evidenced by the fact that support for the ACA has spiked as the fight to repeal the ACA has stalled. All the while the Republican base is incredibly split as to exactly to do going forward.
There has been a lot of reporting covering low income Republican voters who voted for Donald Trump despite being dependent on the Affordable Care Act for their health insurance. Most notably Vox’s Sarah Kliff visited Kentucky voters who didn’t believe Donald Trump when he said he would repeal the Affordable Care Act, mostly because it was a program they depended on for health insurance.
It seemed sadly laughable post election, but they may very well have been right and that’s not for lack of trying on Trump’s part.
Almost immediately after election the House and the Senate took preliminary measures to repeal the ACA, with no clear plan to as to how to replace those services. An estimated 20 million plus would have lost insurance so Republicans can chase a policy the Paul Ryan wing have been dying to enact for a long time.
The congressional budget office recently reported that up to 18 million people could lose their health care within a year and even more in the years following repeal. The political consequences of such an act will be squarely on Donald Trump and the Republican majority which push it through. The pivot to attempt to push the negative side of repeal on Democrats for passing the reform in the first place is already underway, but that makes no sense, millions of people will lose their insurance and that is not on the Democrats for giving them access to insurance in the first place.
As has been said elsewhere, the Republicans are diving off a cliff and trying to build their plane on the way down. When it crashes that is their fault and their fault alone.
Which is why when it came time to push Paul Ryan’s plan through congress Republican lawmakers balked. The so called freedom caucus refused to support the bill and there is some debate as to whether or not the group’s complaint is genuinely that the bill was not conservative enough, or if they knew it would be a disaster for their constituents who largely depend on government programs for their healthcare. Either way, the group refused to support Trump and Ryan’s healthcare plan and the future of American healthcare depends on Republicans allowing the ACA to run its course without interference.
That seems unlikely, but if Republicans are looking at polls or focus groups of what the American people want they could fundamentally retool their health care arguments and run to the left. Whether Republican lawmakers want to admit it or not, the American people support government run healthcare. Not everyone supports single payer, but even that is far more popular than the bill Paul Ryan proposed, which limited polling data suggested was viewed favorably by 17% of Americans, only slightly more popular than congress itself at 9%.
Meanwhile support for the Affordable Care Act and a more liberal single payer system are becoming increasingly popular solutions to America’s healthcare problems. A February poll from Pew Research determined 54% of Americans viewed the Affordable Care Act favorably. A March poll from Kaiser Health News determined 49% of Americans viewed the Affordable Care Act favorably compared to 41% unfavorable. Which is a significant change from July of 2015 where Kaiser Health determined Obamacare reached an all time low of 39% favorability.
People do not like the GOP plan when compared to the current state of Obamacare, which very few contend is perfect. Recent polling data surrounding single payer is hard to find, but decades worth of public opinion data has consistently showed strong support for some sort of American government run healthcare system. As of January 2016 52% of Americans believe the government has a responsibility to fund healthcare for all citizens according to Gallup. Those same numbers show as many as 62% of Americans supported government healthcare in 2008 and for the last decade those number have rarely dipped below 50%. As of January 2017 Pew Research’s numbers showed 60% of Americans believed the federal government needed to provide healthcare for all Americans. No matter who is doing the polling, Americans seem to like government run healthcare.
One of the most interesting things all this polling data shows is a consistent call for government health care among low income Republicans. That same love is not held for the Affordable Care Act, especially when it’s polled as Obamacare, but one thing which Donald Trump’s populist appeal seemed to prove also seems to bear out in the polling data. Low income Republicans want government in their healthcare. According to Pew Research among Republicans earning over $75,000 only 18% support some form of government intervention into the healthcare industry. For Republicans earning less than $30,000 that number is 52%.
These are the same people who Donald Trump appealed to when he declared he was going to provide healthcare for everyone during the primary. When Donald Trump said he wouldn’t touch medicare or medicaid, sometimes even going as far as saying he would expand them, he was reaching these voters. When freedom caucus members from the poorest rural states defected from Trump and Ryan’s health care plan, these were their constituents. And even if they said they didn’t support it because it wasn’t conservative enough, deep down I think many of them know the truth. Paul Ryan and the president pushed a bill that would devastate their constituency and they didn’t vote for that.
Many of them probably voted for single payer. Something the Republican Party will never give them.
Donald Trump on the other hand hinted he might be different. Unfortunately that isn’t looking like anything but empty rhetoric which much to Paul Ryan’s dismay resonated heavily with the base.