One very important reason that the first Republican effort to repeal and replace Obamacare failed so spectacularly was that President Donald Trump appeared to have no idea what was actually in his party’s bill. Lacking any evident command of policy detail, he was unable to negotiate a compromise that would satisfy the various House GOP factions. That may have been an impossible task for any leader, but Trump—who dismissed fundamental issues dividing lawmakers as “little shit”—was entirely unequipped to even truly try.

This week, Republicans leaders are again struggling to pass health care legislation in the House. With the defection of former Energy and Commerce Committee Chair Fred Upton this morning, the effort may well be dead. And while there are of course fundamental, ideological reasons why Republicans are having continued difficulty reaching an agreement, I’m guessing one problem is that the president still has absolutely no clue what’s in the legislation.

This was evident at several points during his interview with Bloomberg News published Monday. When a reporter brought up the make-or-break issue of how Americans with pre-existing conditions would be protected under Trumpcare, he muttered the following:

TRUMP: Yeah, we’re having pre-existing conditions. That’s it. Plus, we’re having the pool, we’re doing a lot of things.

And the best thing that is happening with the health care is premiums will come down. We’ll have tremendous competition; you know, we’re getting rid of the border state lines, and we’re going to have tremendous competition.

This is surreal. Having muttered a nonanswer about pre-existing condition protections—the GOP bill would in fact gut them by letting states opt out of Obamacare’s rules—Trump suggests that the American Health Care Act will bring down health insurance prices by allowing carriers to sell across state lines. As Bloomerg’s Sahil Kapur noted, the legislation does no such thing. It’s not part of the bill. In fact, the entire deal hinges on the idea that states will be allowed to pick and choose which Obamacare regulations they want to keep within their borders. That compromise would be fatally undermined by letting people shop for coverage in any part of the country they wanted.

Having demonstrated that he still has no concept of how his own health care bill works, Trump continued emitting garbled noise about protecting Americans with pre-existing conditions. “Well, I want it to be good for sick people, Jen. Well, you know it’s not in its final form right now,” he said. Pressed a bit more, he added: “I’ll be looking into that.”

For what it’s worth, Trump may experiencing some of his own doubts about the effects of his legislation. Axios reports Tuesday that, “During a recent phone conversation about the evolving health-reform bill, President Trump asked a simplistic but apparently sincere question: ‘Is what we are going to do going to take care of people?’” The House member he was speaking with apparently said that, yes, the bill would take care of folks.



This is not typically a question a president would have to ask a member of Congress—about a bill, by the way, that’s been on his radar for months. Instead, his own staffers would have looked into the legislation, analyzed it, and briefed him about its likely effects. A particularly ambitious chief executive might even have read parts of the bill himself, or consulted with outside experts about the subject. Trump, instead, is asking a House GOP member a pointless and vague question. What supporter of this bill would ever say: “No, Mr. President, this bill we’re actively trying to pass does not take care of people, whatever you mean by that.”

Not only does Trump know nothing, he has no idea how to learn.