I don’t think there is just one conclusion to be reached from the failure of the House Republicans to pass the health care bill advocated by Paul Ryan, and supported by President Trump.

Marc Thiessen blames the Freedom Caucus, The Freedom Caucus blows its chance to govern

For weeks, as President Trump courted the group, members of the caucus used their leverage to make the bill better. They asked for language capping the maximum income to receive the tax credit — and got it. They asked to allow states to choose between a traditional block grant and a per capita block grant — and got it. They asked to allow states to impose work requirements on able-bodied Medicaid recipients — and got it. They asked for language preventing non-Medicaid-expansion states from becoming expansion states — and got it. They asked for flexibility for states to change “essential health benefits” — and got it.

But each time they got a concession, and were asked to support the bill, they instead came up with new sets of demands that made the legislation increasingly unpassable. Eventually it became clear to Trump that the Freedom Caucus would never take yes for an answer. So he cut them off ….

Freedom Caucus members had a chance to repeal the individual mandate and the employer mandate, transform Medicaid, end $1 trillion in Obamacare taxes, expand health savings accounts and defund Planned Parenthood. Instead, they chose to keep Obamacare intact.

There is an equally good argument that blaming the Freedom Caucus is blaming the messenger – it was a bad bill that continued Obamacare’s institutionalization of federal government micromanagement of health care.

That micromanagement, with the presumption that it is the federal government’s duty to provide expansive health insurance to everyone, is one of the prime problems of Obamacare. Central planning didn’t work in the Soviet Union, and it won’t work and hasn’t worked in the U.S. healthcare system for similar reasons.

The answer to Obamacare is not more Obamacare.

I’m not going to get hung up on Round 1 in the Obamacare repeal and replace war. While Trump says he’s moving on, I think that’s some bluster. Ryan says he’s still working on a revision. But when Ryan brings another plan to Trump, it better be with enough Republican votes to pass it.

There is a bigger issue here. It’s the risk for conservatives in undermining Trump when conservatives can get most of what they want. That will be a continuing issue beyond health care, on a long list of issues from immigration to deregulation to tax reform to judicial nominations.

I get back to a point I made on March 8, as the Republican House health care bill was first being debated. The main problem was not that the bill was not conservative enough, though that may have been true.

The main problem was that the conservative candidate in the Republican primary, Ted Cruz, didn’t win, and the winner wasn’t an ideological conservative, You go to war against Obamacare with the President you have:

I would have liked to see a truly conservative alternative. But in order to do that we should have elected a truly conservative president.

That’s not a knock on Trump — he is what he is, and as pointed out during the primaries he never has been an ideological conservative. There are many things he believes and already has done that are conservative, but it’s not his nature. He’s always believed in big government, but big government that seeks to make America great again, not big government that seeks to make America weak again.

Ideological conservatives had their chance in the primaries. They lost. We lost. I supported Ted Cruz, but he couldn’t pull it off.

We don’t have a conservative president, but we do have a president open to doing conservative things.

Keeping that president doing conservative things as much as possible should be the goal. Insisting that Trump do only conservative things is not going to work, because conservatives didn’t elect Trump.

Trump’s going to do some non-conservative things, but he’s the only opportunity we currently have or are likely to have in the near future to promote conservatism.

We shouldn’t waste it by insisting on all or nothing.


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