Health care and particularly health insurance in America is a complicated affair. The twisted perversion that was Obamacare was foisted on the American public in a party-line vote with little discussion over the several months in which it was being concocted, and while it has led to more people gaining insurance and through it improved health care, is rightly reviled by conservatives. There has been some dissonance regarding the TrumpCare plan created by Paul Ryan, especially by those stalwarts of American values, the Freedom Caucus, but after weighing all the elements, I have come on board with TrumpCare.
The first reason for supporting TrumpCare is recognizing how important it is for Republicans. Ed Rogers notes that as this legislation passes through the committees and floor votes there will be chances for amendments. He notes that ultimately some Republicans will fail to get on board, and while he usually counsels against retribution towards recalcitrant party members, in this case the vote is so important that Trump and the Republican leadership should shame members who vote against it. It’s that important. Vice President Mike Pence underscores the importance of passing this bill saying, “The Obamacare nightmare is about to end.”
TrumpCare returns federal health policy to its appropriate roots, where policy should promote individual responsibility and further freedom. This point was well made by Republican Representative John Shimkus, who asked why men should pay extra so that their insurance policy would cover prenatal care. Just as individuals should be responsible for their own fortunes, women should take responsibility for their own health care. Shimkus is not the first perspicacious Republican to address the issue. As Obamacare was being composed in 2009, Senator Jon Kyl drove home the point that, “I don’t need maternity care.” Rep. Renee Ellmers followed up four years later when questioning Human Services Secretary Kathleen Sebelius, “To the best of your knowledge has a man ever delivered a baby?” While Democrats insist that men have some responsibility for pregnancy, Republicans rightly insist that a woman is accountable for her own health care.
Jennifer Rubin bolsters some of the components which make up TrumpCare in a series of questions she would ask of Paul Ryan. People who cost the system more will pay their fair share, “Older, sicker people [will] pay more out of pocket under TrumpCare.” Also, “healthier, younger people were subsidizing the sicker, generally older people.” Individual freedom is restored, “Your continuous-coverage penalty is less than the penalty for the individual mandate.” And the bill is a break from the politicking of the usual suspects, “The AMA, AARP, American Hospital Association, Heritage Action, FreedomWorks and many conservatives and moderates all oppose your bill.”
Alexandra Petri piles on with ever more reasons to support TrumpCare. If Democrats are against it, it must be an improvement, “Democrats …come out vigorously against the bill.” The system will be simpler, “Instead of the confusing system we have now where lots of people have coverage, [TrumpCare] will be much less confusing.” People should get back from insurance what they pay for it, “Ryan understands that insurance is not about pooling risks and having everyone pay in when young and healthy so that when people fall ill or age, they can take money out. Insurance is something different than that. It is this kind of deep understanding that has made people call Ryan ‘wonky’ and his plans ‘extremely wonky.’” Further, TrumpCare is about responsibility. “Rep. Jason Chaffetz explained this nicely. ‘Americans have choices. And they’ve got to make a choice, and so maybe rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on that, maybe they should invest in their own health care. They’ve got to make those decisions themselves.’” But mostly, TrumpCare is about rewarding virtue. “You can tell if a person is worthy of health care because this person is either very rich or has no ailments, or if the person is poor he [cannot] be accused of luxury.”
Ultimately, it boils down to courage and the conservative position, “You’re on your own,” as Paul Waldeman puts it. Bravely, they apply this position to their own constituents. By various estimates, over the next few years the number of people who currently have health insurance and will lose it number between 6 million and 24 million. And those who will lose most are those who were most likely to vote Republican and for Donald Trump in the recent election. Those who stand to lose the most in subsidies under TrumpCare versus Obamacare, $5,000 to more than $7,500, voted for Trump roughly 60-40, while those losing between $1,000 and $5,000 roughly split their vote between Trump and Clinton.
Trump voters in the working class are to be lauded for their adherence to principle. They understand the importance of returning to a “time of traditional values that celebrated god, masculinity, homogeneity instead of diversity, and traditional gender roles.” The Republican leadership is willing to sacrifice self-interest in pursuing its noble goals; its constituents likewise. They continue to vote for Republicans who promise to, while upholding their cultural values, diminish their economic interests by cutting health care, as in this case, along with Social Security, Medicare, and wages. Unlike the sleazy interest group politics of the Democrats, who would design a government that favored their constituents, Republican voters are willing to sacrifice to see a better nation, one in which the less-wealthy have the same opportunity to pursue personal freedom as the wealthy, even if with lesser means.