La reforma de impuestos puede esperar dice Trump, primero hay que pasar la reforma de salud.
Trump Shifts Back to Health Care
President says his plan to change the tax code will have to wait
By Louise Radnofsky, Peter Nicholas and Richard Rubin April 13, 2017 8:58 p.m. ET
How Trump Could Tackle Health Care and Taxes
One of the big questions during The Wall Street Journal's interview with President Trump: What's up with your tax-reform plans? But Mr. Trump didn't want to talk about taxes, insisting health-care must be dealt with first. WSJ's Gerald F. Seib explains the likely scenarios to get both health care and tax reform back on track. Photo: Getty
WASHINGTON—After losing a fight to revamp the health-care system, President Donald Trump said last month he was prepared to put the setback behind him and move on to the next challenge, rewriting the tax code.
Three weeks later, he said he is determined to resurrect the health-care bill even if it means delaying the tax overhaul, telling The Wall Street Journal in an interview: “I want to get health care done…I think I will get it done.”
The tax overhaul, he said, would have to wait.
Mr. Trump’s revived push to fulfill a core campaign promise appears to be driven by three developments: First, a renewed confidence that he can still win enough votes to pass a bill; second, a belief that he needs the health-care savings to help pay for the tax bill and hit his economic growth promises; and third, a recognition that the tax-code overhaul isn’t near ready.
TRUMP'S FIRST 100 DAYS
As a result, instead of cutting his health-care losses, he is insisting on pursuing an elusive deal to overturn the 2010 Affordable Care Act, also known as Obamacare, and enact new health policy in its place.
The GOP president has long said he is loath to abandon a goal. In his book “The Art of the Deal,” he wrote that his approach is to “aim very high” and then “keep pushing and pushing and pushing to get what I’m after.”
He added: “Sometimes I settle for less than I sought, but in most cases I still end up with what I want.”
The abrupt shift caught some Capitol Hill Republicans off guard. They had been preparing to turn immediately to the tax legislation.
“We don’t get it. What a waste of time and political capital to return to the quagmire of health reform,” said Greg Valliere, chief global strategist at Horizon Investments, a North Carolina investment firm, in a client note Wednesday. Unlike taxes or infrastructure, he said the health bill is “clearly a no-win issue for the Republicans.”
The renewed focus on health care also raises the prospect of a second embarrassing defeat that would raise more questions about the new administration’s ability to shepherd complicated legislation through Congress.
But some allies said they were encouraged, not alarmed, by that pursuit now.
“Just because they didn’t achieve success at first on health-care legislation doesn’t mean it’s not going to get accomplished,” said Corey Lewandowski, Mr. Trump’s former campaign manager. “It’s going to get accomplished and they’re continuing to work on that. It’s a pledge he has made and will fulfill.”
In his interview with the Journal, Mr. Trump specifically mentioned a renewed confidence in the Freedom Caucus, a group of conservative Republicans he had just two weeks ago suggested targeting for defeat in next year’s midterm election.
“They want to do the right thing and they do like me and they do like their president,” he said.
Rep. Mark Meadows of North Carolina, a prominent House Republican and leader of the Freedom Caucus, said he had conversations with the president and his staff in which he set out a potential path to yes on a health-care deal for a number of conservative members and others.
He declined to discuss the specifics of that path, but praised the president’s past business history in making deals where no deals seemed to be in sight.
“He’s singularly focused on making sure he fulfills his campaign promises,” Mr. Meadows said.
While Mr. Trump has also suggested he is open to a deal with Democrats on health care, some White House officials believe the most direct route to passage of a bill involves persuading Republicans to go along. Democrats oppose the effort to repeal the law.
“Keeping it in the family is the easier path,” one White House aide said.
Another issue is at stake. Mr. Trump’s administration has projected a sharp increase in the nation’s projected growth rate, to around 3% over the coming decade from an average of 2% over the past decade due to policy changes.
The repeal and replacement of the health-care law is a significant factor in the improved growth outlook, said budget director Mick Mulvaney in an interview.
In addition, the tax plan Mr. Trump had expected to turn to may not be coming together as quickly as he had hoped. It will likely take months to write and advance a tax plan through Congress, making health care a more attractive engagement for a relatively speedy legislative victory.
"Tax reform’s going to be a very protracted process for a variety of reasons and I think the president desperately needs a very quick victory to get back on track,” said former Rep. Charles Boustany, a Louisiana Republican now at the lobbying firm Capitol Counsel.
The White House is still filling out its tax-policy team and reviewing its options, and meanwhile, it has offered little strategic direction to Congress. As a result, Republicans in the House and Senate haven’t yet reached consensus on key questions.
Among other things: The administration hasn’t decided whether to seek a tax cut, who might get a tax cut and whether to pursue the border adjustment feature at the center of House Republicans’ plans. When they do make those choices, it is going to be difficult, especially given the likely need to find almost all the votes for the tax bill inside the GOP, some officials said.
“Face it, when you change the tax code someone’s ox is going to get gored,” Mr. Mulvaney said.
What’s more, the two initiatives are interconnected, White House officials believe. Should a health-care overhaul pass, that would free up hundreds of billions of dollars that could be used to help pay for tax reductions brought about by the tax-code rewrite, they said.
“That’s the biggest driver in that decision,” a White House official said Thursday.
Under congressional rules, though, money from one bill isn’t deployed to another. What the health-care bill does is repeal taxes created in the Affordable Care Act, paid for by cutting spending on Medicaid.
Because the last week of April will be spent funding the government, Republicans have a window to work on health care without significantly delaying their tax agenda, which couldn’t advance publicly anyway during that time, said Kenneth Kies, a GOP tax lobbyist.
“There’s a window here to pull the health care thing back together and get it done without impeding tax reform,” he said.
Still, the prospects for that victory, however much Mr. Trump wants it, are mixed.
Current and former Republican House members believe that their colleagues could yet be inclined to get a bill voted through the lower chamber, if for no other reason than to tell constituents that they had done so. Whether Senate Republicans then can resolve their own, separate but equally divisive fights on health care is no certain matter.
“Taxes do not create the ideological, theological divides that health care does among Republicans,” Mr. Kies said.
—Nick Timiraos and Michael C. Bender contributed to this article.
Write to Louise Radnofsky at
louise.radnofsky@wsj.com, Peter Nicholas at
peter.nicholas@wsj.com and Richard Rubin at
richard.rubin@wsj.comAppeared in the Apr. 14, 2017, print edition as 'Trump Shifts Back to Health Care.'
Publicado: Jue Abr 13, 2017 3:39 pm