Sunday, March 26, 2017


By Dominique Paul Noth

Nancy Pelosi despite minority role may control
the power balance in D.C.
The debacle of the GOP health care bill reveals a hard truth for Donald Trump.  There is a strongman in D.C. he will have to work with if he wants to get anything positive done.  Her name is Nancy Pelosi.

There are many threads to untangle in that statement. It’s made with full awareness that Trump and his minions don’t have a good grasp on reality (real analysis is in the DNA of minority House leader Pelosi).

The first thread to untangle – Paul Ryan may have the title of Speaker of the House and a 21 member voting edge, but he’s not an effective leader. His clumsy, inept and hasty health bill didn’t come as close as he and the president still claim.  It was not just the conservative Freedom Caucus that undid Ryan. He also lost moderate Republicans. (Since there never was a vote, the numbers can be fudged but I count more than 40 against.)

The next tangled thread: Why should the Democrats help? There are only two reasons to cooperate: Protecting the nation’s health and a possible change in public opinion.   Right now there are oodles of motives to let the Republicans stew in their own mess. 

But protecting health care is still necessary -- despite what Trump said as he pulled the plug on the GOP bill. He insisted in a news conference that he wanted Obamacare (or the ACA) to succeed but there was nothing he could do to stop it from exploding.

That was two lies in a row. 

Trump has already ordered his agencies, in one of his vague presidential resolutions, to throw up roadblocks – almost the first thing he did.

There are also pending government legal cases involving the ACA that his White House could withdraw from. He could also try to destabilize the health marketplace.

Does anyone believe he will let the ACA ride without tugging on the various tax levers Obama approved (levers that would require 60 Senate votes to totally undo)?  Picking at these levers is important to the vaunted tax legislation he wants to do next.

The biggest support Trump has for his tax relief for the very rich comes from the Freedom Caucus he attacked March 26.  The caucus couldn’t get a GOP health care bill cruel enough or ambiguous enough to satiate their desire to save money first. That opposition to Obama’s shrewd taxing methods will continue ferociously. Sabotage is always hovering even as Trump, rebuffed by the conservatives, confronts clear signals that he must moderate.

If left fairly on its own, the ACA is hardly in a death spiral or exploding.  In fact, there is growing appreciation of the balance Obama found and growing likelihood that it may even thrive.  Health insurance companies may come back into the exchanges as a way to improve their base clientele. Some pulled out for reasons that had nothing to do with ACA but with their own desire for excess profits, according to court documents.

Many of the new 2017 signers fit that attractive “young and healthy” profile though Trump pulled out of advertising the ACA signup. 

The mandate that everyone must have insurance assuredly soured some on the ACA, but many also recognized the value in how it expands the market pool and imposes a sense of responsibility for your neighbor.  The financial worries would evaporate if more states -- like Wisconsin – would grab the opportunity for expanded Medicaid coverage at minimal cost.

The public mood on the streets remains to not give in on anything Trumplike.

But untangle the next thread: Time is spinning and things could change. 

The Democrats could be painted to look as uncooperative as the Republicans were with Obama. There are fixes the Democrats do want in the ACA, which they have been afraid to introduce for fear of GOP sabotage.

The splintered GOP is already trying to flip the image of obstructionism to the Democrats, suggesting that if both sides cooperated there could be a better health care bill.

It’s hypocritical to frame it that way, but over time that now laughable vision of the Democrats as obstructionists could gain traction. Four years is a long time to retain anger and there’s Mike Pence in the wings puffing himself up as a more stable step-in – even though he’s not the sort of salvation Trump opponents want to see.

Now enter Pelosi.  There is a Sanders wing of the Democratic Party that bitterly remembers her early support of Hillary and has proclaimed her not progressive enough for them.  In their camp, fighting for anything less than Medicare for All or single payer is a retreat (even though saving the ACA for years into the future would be quite a victory).

Wielding Medicare for All as a club to save the ACA, however, may be more logical with a GOP House, Senate and White House that were in the hands of the other party and still couldn’t get universal health care through. 

Pelosi based on her liberal credentials, which are considerable, would certainly push the ACA more down the road Obama started – better health care as a human right.  Any movement down that road should be welcome in the Medicare for All camp. 

It is also boastfully idealistic and exaggerated for the progressive public to proclaim they stopped the GOP health bill on their own.  It was obviously more them regional and organic than the Democrats who brought down the bill with rallies, letters, citizen groups and inventive embarrassment of elected Republicans. But despite Trump’s blame game, no Democrat was even approached to support the bill.  Many Democrats in D.C. seem to have talked Republican colleagues into resisting. Such is the discipline of the Democrats in the House.

Pelosi has also been criticized for spending too many years in leadership, and retaining hold over the likes of Steny Hoyer (electorate class of ’81)  and Jim Clyburn (class of ’93). They could step right in and that’s been true for years. But retaining her leadership and their support demonstrates how well she knows the ropes.  As I once wrote, there are two things she can do well – she can count and she can keep the Democrats together.  That alone puts her two ahead of Ryan.

Trump’s a slow learner and egotistic, a terrible combination, but it could dawn on him that a coalition of Democrats and the moderate Republicans who can read the polls in their home districts are enough to give him a victory margin in the House and a better face to present in the Senate.

Not on everything – much of Trump’s slavishness to Wall Street and the very rich will remain anathema.  Much of his loose cannon foreign policy is despicable. So is his language. But on bills like the infrastructure and intelligent adjustments to health care, the road forward runs through Pelosi.

She would have to be careful, but she’s avoided pitfalls for decades.  There are many traps the GOP could lay. A central right wing GOP vision is to keep safety valves in the tax code and reduce taxes for the very rich or on health company CEOS.  For instance, the ACA does redistribute wealth -- and the Democrats should just admit it – with a minimal health tax of .09% on the very rich that means a millionaire pays $9,000 into the health care pool. There’s also a sensible penalty rule the GOP wants to kill limiting health care executive pay to $500,000 a year. But these are taxes that many Republicans support, as they do continued protection for women’s health issues.

Health experts and economists Pelosi listens to like the ACA yet would happily accept some improvements and even some changes they could live with, in such areas as expanded protection for those just outside the tax subsidy ranges, incentives for insurance companies, prods for states to take the Medicaid expansion and so forth.

Right now the greatest pressure on Pelosi is to stand pat.  But by the summer, after Trump hits his head against the tax relief wall among other impenetrables and after further Ryan failures to manage his troops, Pelosi should emerge as the unavoidable power center in D.C.

About the author: Noth has been  a professional journalist since the 1960s, first as national, international and local news copy editor at The Milwaukee Journal, then as one of the editors for its original Green Sheet, also  for almost two decades the paper’s film and drama critic. He became the newspaper’s senior feature editor, then was tapped by the publishers of the combining Milwaukee Journal Sentinel for special projects and as first online news producer before voluntarily departing in the mid-1990s to run online news seminars and write on public affairs and consumer news. From 2002 to 2013 he ran the Milwaukee Labor Press as editor. It served as the Midwest’s largest home-delivered labor newspaper, with archives at  In that role he won top awards yearly until the paper stopped publishing in 2013. His investigative pieces and extensive commentaries are now published by several news outlets as well as at his culture and politics outlets known as Dom's Domain.  He also reviews theater for 

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