On May 4, President Donald Trump held a Rose Garden ceremony to praise the health care bill that had just passed the House. He praised the American Health Care Act as “something very, very incredibly well-crafted.” He predicted that “we’re going to get this passed through the Senate.”
On June 13 — 50 days later — Trump reportedly told Republican senators that the AHCA was a “mean” bill. He apparently hasn’t liked the media coverage much at all, and urged senators not to “get this passed through the Senate” but to come up with something “more generous.”
This likely comes as a surprise to Senate Republicans, who appear to be gravitating toward a health care bill that looks a lot like what the House passed. Like the House, they are exploring ending Medicaid expansion and reducing tax credits — not making the bill significantly more generous.
This quick about-face illustrates the difficulty that Republicans face in passing a health care bill under Trump. The president has not shown much interest in the actual substance of a health care bill; he has repeatedly given interviews saying the AHCA does things it doesn’t. He says deductibles will go down under the bill; the Congressional Budget Office says they’ll go up. Trump claims people with preexisting conditions will be protected under the AHCA. They won’t.
Trump cares less about policy and more about news coverage — how a bill is playing in the media. He liked the AHCA when it was considered a “win” for Republicans, finally moving a key campaign promise through the House. But now that it doesn’t feel like a win — the bill is hugely unpopular, with just 20 percent supporting the effort — Trump has apparently soured on the proposal. It doesn’t matter what is actually in the bill. What matters is what Trump reads about it.