Donald Trump wonks out on healthcare with Republican Senators. Photo: Alex Wong/Getty Images

Barack Obama helped pass the Affordable Care Act by defending its merits in meaty press conferences and hours-long public exchanges with Republican interlocutors in which he debated the bill’s fine points. It would obviously be unthinkable for Donald Trump to attempt anything of the sort. One reason is that Trump’s plan is deeply unpopular — yet another poll finds it commands the support of just 17 percent of the public — and Republicans have calculated that secrecy and speed offer the best chance of passage. The other reason, of course, is that Trump is an ignoramus who could never defend its merits against criticism, or probably even outline its most basic features.

The New York Times reports one telling detail from yesterday’s meeting with Senate Republicans. One Republican asked about criticisms that the bill would cut benefits to pay for a large tax break for the rich, a charge that is indisputably correct. (Forty-four-point-six percent of the benefits of the tax cuts would accrue to the highest-earning one percent of the public.) Trump apparently had no idea what the senator was even talking about:

A senator who supports the bill left the meeting at the White House with a sense that the president did not have a grasp of some basic elements of the Senate plan — and seemed especially confused when a moderate Republican complained that opponents of the bill would cast it as a massive tax break for the wealthy, according to an aide who received a detailed readout of the exchange.

Mr. Trump said he planned to tackle tax reform later, ignoring the repeal’s tax implications, the staff member added.



The tax cuts in the health-care bill are not an insignificant detail. They are probably its most important feature. The decision to use the bill to cut taxes is what forces Republicans to cut an equally large amount in benefits, which in turn is the reason the bill makes health care unaffordable for millions of people. If Republicans kept the taxes funding Obamacare in place, they would have enough money to craft a plan that would at least fund the priorities conservatives believe are needed to make their version of health-care reform work, like high-risk pools and health-savings accounts for people with low incomes.

But because they are driven primarily by a desire to cut taxes for the rich, Republicans had to design a plan that makes insurance unaffordable, and would stick working-class people with premiums they couldn’t possibly afford. It’s an incredibly fateful choice. And Trump seems to be literally unaware of it.

Trump, an avid New York Times reader, lashed out at the report by insisting he does too know a lot about his health-care bill:

Some of the Fake News Media likes to say that I am not totally engaged in healthcare. Wrong, I know the subject well & want victory for U.S. — Donald J. Trump (@realDonaldTrump) June 28, 2017

Well, then, should we sign the totally engaged president up for a daylong Blair House summit to discuss the bill’s details on camera, like the one Obama held?