The big news out this morning is the overnight decision to end so-called CSR payments to insurers. We’ll have articles out today with technical details. But these are payments which are part of the framework which keeps insurance rates affordable in the Obamacare markets. Doing this directly, intentionally makes rates spike. They may not say it out loud. But many Republicans, especially in the Senate, had no appetite for this action, mainly because they know the consequences will fall largely on them.
This morning President Trump tweeted out: “The Democrats ObamaCare is imploding. Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!”
This is almost word for word the kind of chilling message a hostage taker sends. I’ve got your kids. You need to call me.
Why is Trump doing this? That’s a question I want to address on a broader canvas below. But why is he taking this particular step? Part of it is dominance. The desire to act, dominate, destroy. There’s the need to produce something for his most ardent supporters. But the biggest drive is what is contained in this tweet. To force Democrats hands by using Obamacare beneficiaries as hostages.
“Dems should call me to fix!”
Setting aside any moral calculus, this is folly in political terms. A lot of Senate Republicans get this. This hurts millions of Americans. But Trump is doing the damage in plain daylight. He’s shooting himself without even realizing it. If the ‘deal’ Trump wanted was one that helped people, Democrats might face a dilemma over whether to follow their political advantage or making good policy. (Actually they faced this question and chose policy – that was the bipartisan stabilization legislation that was being negotiated before it was torpedoed by Graham-Cassidy.) But there’s no conflict. For Democrats politics and policy line up entirely.
So again, why is Trump doing this?
The underlying driver here is Trump’s transactional, bullying way of approaching business which he brought from his predatory business to the White House. I don’t think you can understand what’s happening here except through that prism. For Trump, Democrats own Obamacare. It’s theirs. If he breaks it, it’s still theirs. It’s all on them. The “Obamacare” brand is the entirety of it. The more he breaks it, the more they need him to fix it. It’s like if the Democrats owned a building or a company. They more he damaged it, the more they’d need him to stop. This is a logic Trump understands. It’s his native environment. This is an organized crime mentality, one he used again and again in his private business. But that’s not how big social programs like this work.
Legislation and governance is fundamentally about people. That’s not just lofty rhetoric. The consequences of government play out in elections. Trump doesn’t get that. A lot of Republican Senators do.
But let’s draw back for a moment. President Trump signed his executive order on cross-state insurance policies yesterday. He just cut off CSR funding. He’s about the decertify the Iran nuclear deal. Each action is consistent with the campaign he ran in 2016. But they’re coming in a rush. Why now? Each move has some contingent logic. But I suspect the big driver is that rising pressures on the President are leading him to act out. And the acting out is escalating. As I wrote a year and a half ago, beyond the policy specifics and verbiage, Trump’s politics is about dominance and destruction. It’s a drive deep in him and one that he shares – albeit with very different life experiences – with his core political supporters. That’s the bond.
Most of us have seen this raft of articles talking about rising pressure in the White House, that the President is coming apart, angry, isolated. I’m skeptical of these reports, to the extent they suggest he’s about to blow apart or lose it entirely. But he does seem increasingly erratic, impulsive. He’s under pressure because he feels like he’s losing. For Trump these policies and policy moves are not just about politics. They are characterological. The more pressure rises, the more he feels besieged, the more he’ll take unilateral actions to assert himself, to balance himself.