On Friday, the Republicans pulled the American Health Care Act from the House floor. Paul Ryan said that the Affordable Care Act would remain law “for the foreseeable future.” Headlines have described this as either Ryan’s defeat or Trump’s. Or both. That suggests that more skilled Republican leaders wouldn’t have lost.
But it’s just as valid to see it this way: America had a choice between the ACA and a Republican alternative. They chose the former. David Frum argues that this is because American moral values have changed:
In that third week in March in 2010 [when the ACA was passed], America committed itself for the first time to the principle of universal (or near universal) health-care coverage. That principle has had seven years to work its way into American life and into the public sense of right and wrong. It’s not yet unanimously accepted. But it’s accepted by enough voters—and especially by enough Republican voters—to render impossible the seven-year Republican vision of removing that coverage from those who have gained it under the Affordable Care Act. Paul Ryan still upholds the right of Americans to “choose” to go uninsured if they cannot afford to pay the cost of their insurance on their own. His country no longer agrees.
This change is visible in Pew Research polling data,
Currently, 60% of Americans say the government should be responsible for ensuring health care coverage for all Americans, compared with 38% who say this should not be the government’s responsibility. The share saying it is the government’s responsibility has increased from 51% last year and now stands at its highest point in nearly a decade.
Journalists write stories, and stories need protagonists, and celebrities are all-purpose protagonists, and there is nothing more delicious than watching a celebrity get publicly shamed. Therefore, the commentary on the defeat of the AHCA will focus on the humiliation of America’s Celebrity, Donald J. Trump, the supposed superstar dealmaker.
That trivializes what happened. The Congress was voting on a bill, not Donald Trump. The American people were offered a Republican and conservative approach to health insurance, and only 17% of them approved of it. The defects and merits of the ACA had been debated in four successive elections and litigated in two Supreme Court cases. The Republicans held the Presidency and both houses of Congress. Yet the ACA won.