We are about to see a collision between simplicity and complexity — and it will be a public-policy pile-up for the ages. Every incoming president has the problem of squaring optimistic campaign promises with fiscal and economic realities, of course, but Donald Trump faces an epic reckoning.
Start with the Affordable Care Act, which Trump promised to replace with something “much better” and “much less expensive.” Here’s where basic health care reality intercedes: You can have one of the two, but you can’t have both.
Beyond the vaguest of outlines, Trump himself can’t be said to have a health care scheme. But his Republican congressional allies do: Stealth Care. They plan to vote to repeal the ACA now, with an effective date several years down the road, and then use the interim to cobble together something they can call a replacement plan. Remember the GOP’s “repeal and replace” mantra? This is repeal and pretend.
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