That question is still open to debate.

The fiasco surrounding the American Health Care Act demonstrated that it is easier to say “No” than to make decisions and lead effectively.

Everything was in place for success. The Republicans asked for control of the House, Senate and Presidency so they could repeal and replace Obamacare.

The American people gave that reality to them, and the opening salvo is a miserable failure.

What went wrong?

The answer to that question begins with Speaker Paul Ryan. Ryan thought he could force the health care bill through by making it a “binary” choice, either yes or no. He gambled on the fact that the Freedom Caucus would cave in when given those options. That did not work as the Freedom Caucus wanted input into the bill and did not want a bill that would fail as Obamacare did.

Further, Ryan missed a fundamental element of group decision making. The various viewpoints represented in the Republican caucus needed to be heard by having the health care issues debated openly within their caucus at the outset. By denying this process, Ryan failed to come up with a bill that the Republican caucus could live with and support.

Decision makers need to feel they have “skin in the game.” Obviously, the Freedom Caucus did not. Ryan, in effect, left the bill to chance.

He was also unfair to the President since he expressed confidence the bill would pass successfully. The President did all he could to lobby his Republican House members but Ryan gave him little to work with in that effort.

There was a further misstep in that only 17% of the American people supported the bill. How could an allegedly astute politician expect to pass a bill with only his caucus and no Democrat support when the American people simply did not support this bill. Further, that lack of support, in large measure, was due to the incompetent way in which this bill was explained to the American people.

What happens to the Medicaid recipients after 2020? Since the program would end at that point, do we have millions of Americans with no coverage at all? The tax credits would be meaningless to these people since their income levels would not invoke those credits to their benefit.

What about people aged 50-64? Their premiums would actually go up at least for the first 3 years of this plan. After that, the hope would be that competition would kick in and help bring those rates down. Should the Freedom Caucus have given blind trust to that fact and also see people in their middle years suffer for the next 3 years.

The President was outstanding in his effort to gain the support of the Freedom Caucus throughout this process. But he is now making a huge mistake. It is a miscalculation to now condemn the Freedom Caucus and indicate that he will turn to the Democrats. That position has a number of risks to the President’s political capital.

First, in order to get Democrat support, the President will have to agree to policies in a health care bill that would be unacceptable. How do we know that? Because Senator Schumer has already stated that he is willing to negotiate changes to Obamacare but not its repeal. Since the President used the phrase “Replace and Repeal Obamacare” more times during the campaign than almost any other statement he made, how can he even think that there is a way to work with Democrats and fulfill his promise to the American people during the campaign?

Also, many of the Freedom Caucus members are in safe districts. That makes it unlikely that they will respond to threats from the President that he will campaign against them in 2018. And, what would be the consequence if he did so? Those members would feel less allegiance to the President on other issues that he wants to pursue. For example, if he polarizes the Freedom Caucus, he is not likely to get their support on a Border Tax or Tariffs on products coming into the United States.

The President should not allow short term frustration with the lack of support for the health care bill. Instead, he needs to reach out to that group and work with them on other issues as well as health care.

The strategy of polarizing the opposition may have worked for him in the business setting, but it will not work in the political arena. He needs the Freedom Caucus as an ally. The desperate move of going to the Democrats and their radical agenda simply will not fly with the Republican Controlled Congress or the American people who supported the President.


Finally, either Paul Ryan has learned from his miscalculations on the health care issue or he should step down as Speaker of the House.