Donald Trump's 'fake it until you make it' strategy on healthcare won't work

Trump calls for healthcare vote again
Trump calls for healthcare vote again


    Trump calls for healthcare vote again


Trump calls for healthcare vote again 02:56

(CNN)To hear Donald Trump tell it, passing a plan sometime next week that would reform and replace the Affordable Care Act is going to be very, very easy.

"The plan gets better and better and better and it's gotten really really good and a lot of people are liking it a lot," Trump said at a joint news conference with the Italian prime minister on Thursday.
Except, not really.
Here's what we actually know about attempts to resuscitate the health care law that failed to even make it to a floor vote in the GOP-controlled House last month:
    1. The leaders of the House Freedom Caucus and the Tuesday Group, an organization of Republican moderates, have been meeting regularly about a compromise plan that, according to congressional sources, could yield between 18 and 20 more "yes" votes from the party's most conservative wing than for the previous iteration of the bill. It's unclear whether those 20 votes would be enough to get health care through the chamber.
    2. The changes being discussed involve the curtailing or, at the least, re-jiggering of one of the most popular elements of Obamacare: Prohibiting insurance companies from discriminating against people with pre-existing conditions.
    3. Outside of a very small group of negotiators, the new and improved bill is a mystery to members of Congress who are expected to be briefed on it over the weekend.
    4. Congress must pass a government funding bill next week or watch the government shut down -- a result that would be a catastrophe for Republicans in power.
    None -- and I mean NONE -- of those things would lead me or any veteran Congress-watcher to conclude that Trump's optimism about the "really, really good" plan that that "people are liking" a lot is based in anything close to political reality.
    I get what Trump is up to here. He's trying to fake it until he makes it. If I say the bill is getting way better and that lots of people like it, I'll create a self-fulfilling prophecy and build some actual momentum for the legislation when Congress comes back next week.
    It's not the worst strategy and it's born, of course, from Trump's experience as a developer and reality TV star. Create your own reality and then exert pressure to bend other people to believe it. And, if it doesn't work, declare victory and move on.
    The problem for Trump is that Congress doesn't work like a business you are the boss of or a reality TV show that, um, you are the boss of. The House is essentially comprised of 435 small businessmen and women, all of whom view themselves as the boss of their own fiefdoms.
    Faking it until you make it doesn't work on this crowd. Especially when, like Trump, your approval ratings are mired in the low 40s -- and are even lower in many of the country's swing districts where Republicans need to win to hold onto their House majority in 2018.
    Trump simply lacks the political leverage at the moment to turn his happy talk into actual results. No member of Congress worried about their chances of winning next November is going to take a rushed vote on a health care bill they have barely even seen but that fiddles with the pre-existing condition clause -- or any of the other popular elements of Obamacare.
    Trump may declare victory no matter what happens in Congress next week. But that won't change the fact that simply saying the health care bill is "better and better and better" doesn't make it true.