Obama’s Memoir Illustrates Why Trump Failed at Destroying the ACA

The negotiations would quickly turn fraught. Though the Obama administration plan was modeled after the one Mitt Romney, his future 2012 challenger, had successfully implemented in Massachusetts, Republicans lined up behind Mitch McConnell’s obstruction strategy—buoyed by the energy of the nascent Tea Party movement, an ostensibly populist campaign whose small government messaging barely concealed the racism, xenophobia, and conspiracy-addled paranoia that Trump would eventually exploit. Meanwhile, on the left, there was a sense that the Obama administration was capitulating to Republicans and lobbyists, calling instead for universal healthcare—something he believed in, but did not believe was politically possible, at least not yet. “Had we been starting from scratch, I would have agreed with them,” he wrote. “But neither Massachusetts nor the United States was starting from scratch.”

In the excerpt, Obama recalls the torturous process of trying to run that gauntlet: the behind the scenes policy work of people like Kathleen Sebelius, then the Health and Human Services secretary, and Nancy-Ann DeParle, head of the new White House Office of Health Reform; the political maneuvering of lawmakers Max Baucus, the former Democratic senator from Montana, then-Senate Majority Leader Harry Reid, and others; and his own efforts to build public support for his reforms, an already challenging prospect made even more difficult by Tea Party talk of death panels and communism. Throughout, Obama gives a glimpse into his thinking during this stretch—including his growing realization that his promise to transcend partisan politics would be met by stubborn opposition from McConnell, the GOP, and their propagandistic media allies like Fox News. But Obama’s recollection of the period also gives the impression that the ACA’s sturdiness was at least partly a function of the trials it faced in its path to passage.

In his memoir, Obama is clearly aware that flaws in the legislation or in the process could render it “politically more vulnerable down the road.” The law would ultimately include more concessions to industry interests than he and others in his party would have liked, and the affair would be more partisan than he’d initially hoped. But it passed, and while imperfect, has yet to be outdone by the Republicans who have since based much of their political identity on repealing and replacing it—even when they had the White House and both chambers of Congress in the first half of Trump’s first term.

Indeed, Trump continues to plot Obamacare’s demise, with nothing so much as a hint at the “beautiful” plan he’d put in its place or how he’d protect those with pre-existing conditions. Trump may be able to rely on the anti-ACA talking points that have been his party’s line since the Tea Party days, but nothing he or his colleagues have put forth has had the substance of Obama’s legislation, nor has this self-professed master dealmaker shown an ability to bring anyone into accord on a plan. It was easy to criticize Obama’s healthcare plan; it’s far harder, it turns out, to come up with…