We’re used to talking about how unified Republicans are — they approved President Trump’s Cabinet appointments almost unanimously, for example. But the House’s health care bill, which was unveiled on Monday, mostly seemed to divide them. Members of highly conservative groups in the House, such as the Freedom Caucus and the Republican Study Committee, have already bashed the draft legislation for maintaining too many of the policies and principles of Obamacare and for adopting a tax credit that they say is a “new entitlement.” However, conservative health policy wonks, whose views could be in sync with more mainline factions of the GOP, have critiqued the bill from another direction, saying it would considerably increase the number of uninsured people. Even the White House’s initial reaction was tepid, although Trump called the bill “wonderful” in a tweet on Tuesday morning. I’m not sure how I’d go about forecasting the probability of its passage, but it didn’t have an auspicious debut.
Health care is a notoriously difficult issue to tackle — most presidents have failed in their efforts to make wholesale reforms, or paid a substantial political price for attempting to do so (or both). But it’s worth considering why this is the case. Part of the answer is that in contrast to something like a Cabinet nomination, which is a simple yes-or-no question, health care is much more multifaceted, allowing for a myriad of possible legislative solutions.