An unreliable ally to Republicans

President Trump is more than his own worst enemy. The damage he has inflicted during his first five months in office has undermined Republican congressional leaders, frustrated members of his Cabinet, exasperated top advisers and strained relations with some of the nation’s most important allies. This week’s case study is health care.

The most significant domestic initiative of the Trump presidency and the Republican Party is the fulfillment of a promise to “repeal and replace” the Affordable Care Act. That Republicans are struggling to find an alternative to Obamacare is plain to see. But as congressional leaders scratch to find the votes to pass a bill in the Senate, the president has demonstrated that he is an unreliable partner in the battle.

On Friday morning, as Senate Majority Leader Mitch McConnell (R-Ky.) was trying to balance potentially irreconcilable demands of hard-line conservatives and more moderate conservatives, the president decided to offer his own solution with a tweet: If the Senate can’t get there, why not just repeal now and replace sometime in the future?

Never mind that earlier in the year, he took the opposite position. At that time, McConnell and some others preferred to move with an immediate repeal vote that included a trigger for implementation sometime in the future, giving elected officials the ability to say they kept a promise and enough time to try to find a replacement. But the president overrode that idea, demanding that replacement had to accompany repeal.

Now, at the worst possible moment, Trump seemed to have shifted again, leaving Senate lawmakers frustrated and baffled.

The president appears to have no commitment to an explicit strategy for getting a health-care bill to his desk, only a desire for victory and limited patience for the legislative process. He also has no fixed views on the substance of health-care reform, having made contradictory statements about the topic throughout his campaign and since.

He has said he wants a health-care system with heart, one in which everyone is covered. But he embraces legislation that would leave 22 to 23 million additional Americans without coverage by 2026, according to the Congressional Budget Office. When the House passed its health-care bill in May, he showered it and GOP leaders with praise. Later he called the measure “mean.” He campaigned against cuts in entitlements — Medicare, Social Security and Medicaid. The congressional legislation would revamp Medicaid, significantly slowing the growth in spending.