Why TrumpCare failed: You can’t unite a party that is fundamentally divided

Freedom Caucus members have a cold vision of health care reform, but a coherent one. They believe that the government being involved in health care, either through regulation or subsidies, is the factor driving up prices, and undoing all of that architecture is what’s necessary to allow market forces to drive down prices. Being coherent in this way on health care policy means accepting the trade-offs that your vision entails, and Freedom Caucus members accept that this approach would leave a lot of vulnerable people in the lurch, left to the care of charities and communities. They have an odd belief that a vast majority of the American public shares this vision despite representing only a small percentage of the House of Representatives.

“Moderate” Republicans and rank-and-file members don’t get off any easier. They can’t support the nefarious Obamacare, and what the free marketers want would be political suicide. But … what do they want? They didn’t answer this question, so they got what conservatives dubbed “Obamacare Lite.” Party rhetoric had made the individual mandate so toxic that, when their bill needed a similar mechanism to ward against adverse selection, they landed on a lesser idea called “continuous coverage” that would only worsen adverse selection. They had railed against the bill’s tax increases so much that, in order to pay for their repeal, they slashed and burned Medicaid spending, which a large number of their constituents rely upon. That’s not a way to muster popular support for your bill! The ACA’s income-based tax credits for people to purchase plans on the individual market, meanwhile, were so visibly evil and socialist that they resorted to … smaller age-based tax credits! And when those age-based tax credits shockingly didn’t align with people’s needs, they decided to means-test them—i.e., to include an income factor, like the ACA’s.