Why have Congressional Republicans failed to pass a new health care law? The short answer is the one expressed by Pennsylvania Senator Pat Toomey at a town hall meeting on 5 July in the state capital Harrisburg. Responding to a question from a television reporter on why Republicans had been unable to agree on a way to repeal or replace Obamacare, Senator Toomey explained: “Look, I didn’t expect Donald Trump to win. I think most of my colleagues didn’t, so we didn’t expect to be in this situation.”

While there are any number of other reasons why Republicans in Congress have been unable to craft a replacement for the Affordable Care Act, Toomey’s comments are right on point. But he and his Republican colleagues were not alone in this regard: President Trump didn’t think he would win, either. In a 14 December speech, he told a Wisconsin audience that he rented a smaller election watch party venue because he thought he would lose and had also told his wife Melania: “We’re not going to win tonight.”

Such attitudes have impacted both the Republican-controlled Congress and White House in a variety of other ways. For example, the Clinton campaign had hundreds of current or former Democratic congressional staffers working as volunteer advisors who were angling for high-level positions in the State Department and other government agencies after the election. On the other hand, very few Republican staffers volunteered for Trump’s campaign because they didn’t think positioning themselves for those jobs was worth the effort.

As a result, hundreds of senior executive-level positions throughout the federal government remain unfilled six months into President Trump’s first term in office. Fewer than half of Trump’s 120 nominees for positions as ambassadors, assistant secretaries and agency heads have been approved by the Senate thus far. By contrast, former Presidents Obama, Bush, Clinton, Bush and Reagan had made more than 200 nominations, with over half of them approved at the same point in their presidencies. Furthermore, Trump still has to nominate another 1,100 people for jobs that need Senate confirmation.

Congressional Republican’s failure to anticipate the Trump victory has impacted their legislative agenda in other areas such as tax reform and infrastructure investment. House Speaker Paul Ryan and Senate majority leader Mitch McConnell huddled with Trump’s transition team soon after his surprising win and hurriedly decided to make repeal of Obamacare their top priority, with a two- to three-year window to devise a replacement. But that idea went nowhere when Republican moderates rebelled at the idea of waiting so long to develop a suitable replacement.

Making the repeal of Obamacare their number-one legislative concern also had a negative impact on Republican proposals to overhaul the nation’s tax code for the first time in 30 years, as well as on President Trump’s call for a $1trn investment in our nation’s infrastructure. The latter proposal would have been a much better initial domestic policy choice, as it would have garnered support from a large number of Democrats. It would have also set the stage for a tax reform bill that may have received a more modest but still significant level of support from across the aisle.

However, Paul Ryan and Trump’s Chief of Staff Reince Priebus argued that dealing with healthcare had to be the top priority, because Republicans had been denouncing the Affordable Care Act and promising to repeal it for over seven years, through four election cycles. Despite this reasoning, though, it was also one of the most politically stupid moves Republicans could have made.

Even if the Republican leaders in Congress had decided to start with infrastructure spending followed by tax reform, I still don’t think they would ever have been able to come up with the magic formula for a health care law that would win the support of the 50 Republican Senators as required to pass new legislation. The truth of the matter is that Congressional Republicans will never be able to come up with a viable solution to our nation’s health care dilemma on their own, because hardline conservatives in both the House and Senate care more about ideological purity than people.

The reality of the free market system, to which the more extreme Republican conservatives like Ted Cruz, Mike Lee and Jerry Moran are so rigidly committed, is that it will lead to sicker and older people either being denied insurance coverage or charged much higher prices for it. While Cruz and company tout the advantages of lower premiums, the truth is the only people who will see these lower premiums are young, healthy adults, many of whom won’t buy insurance if they don’t have to. 

That’s why Republicans like Susan Collins who care more about people than ideology are opposed to repealing Obamacare. But former House Speaker John Boehner offered perhaps the best explanation for why Republicans have failed on this matter, when he told a health care conference: “In the 25 years that I served in the United States Congress, Republicans never, ever, one time agreed on what a health care proposal should look like. Not once.”


Charles Laffiteau is a US Republican from Dallas, Texas pursuing a career in public service. He previously lectured on Contemporary US Business & Society at DCU from 2009-2011 and pursued a PhD in Public Policy and Political Economy.