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Trump signals total GOP surrender on health policy

President Donald Trump's latest take on U.S. health insurance policy is that striking a deal on a new bill to overhaul Obamacare will be "an easy one" and is "going to happen very quickly."

Say what? Was there anything that looked easy about the failure of the GOP's Obamacare replacement bill? Did the 17 percent approval rating for that bill make it look like an easy product to sell to the voters? Did everyone in the White House just forget about the last two weeks?

No. What's likely behind President Trump's latest bit of bluster is the simple fact that he and the Republican leadership have abandoned the notion of repealing Obamacare and will now pursue the relatively easier process of "fixing" the Affordable Care Act by adding a few changes and calling it a day.

In other words, the White House and establishment Republicans are surrendering. And surrendering is easy.

In fact, they've been in something of a surrender mode from the beginning. For one thing, we now know that Speaker Ryan and the rest of the Republican leadership were operating from a position of weakness all along by refusing to fully use a legislative tool at their disposal called "reconciliation." Reconciliation is a process that allows bills to be passed by a simple majority vote and are not subject to any delay by a Senate filibuster.

"And why are these Republicans surrendering? It's the same reason anyone surrenders: fear."

Ryan and company insisted that they couldn't use reconciliation to insert the key provisions conservatives have wanted in our national health policy for decades. Those were provisions like allowing insurance companies to sell across state lines, and letting anyone buy cheap "major medical" plans.

But Senator Ted Cruz and others actually cited the Senate rules earlier this month and noted there is nothing in them that says the Republicans couldn't in fact use reconciliation to insert those conservative-friendly items.

If the Ryan and Trump teams really wanted to repeal Obamacare and replace it, why didn't they follow Senator Cruz's clear interpretation of the rules and put those provisions in there that would have earned the Freedom Caucus votes? Answer: they were surrendering then and they're surrendering now.

But now they're even further into surrender territory. Senate Majority Whip John Cornyn proved that by preemptively declaring defeat Tuesday when he said the Republicans will no longer pursue the repeal of Obamacare through the reconciliation process. That's nice, considering they didn't do it when it really counted.

That statement by Cornyn was eerily reminiscent of then-House Speaker John Boehner and Senate Majority Mitch McConnell publicly promising in 2014 that even though the Republicans had just won both houses of Congress, they would not even try to shut down the government in order to gain any kind of advantage in negotiations with the White House over Obamacare. That wasn't just a cop-out, it was a blatant breach of the Congressional duty to use its power of the purse to check the Executive Branch.

So it's twice now that the GOP Congressional leadership has not only refused to use all of the Constitutional weapons it has at its disposal, but refused to even threaten to use them. If that's not defeatist, what is?

And why are these Republicans surrendering? It's the same reason anyone surrenders: fear. The GOP may believe that free market policies will eventually bring down health costs and get more people access to care. But in the interim, there's a good chance a few million Americans who got "coverage" via Obamacare will suddenly lose their health insurance plans.

Those "Obamacare orphans" are a potentially lethal soundbite and viral social media weapons for the Democrats to use in the midterm elections and beyond. And while President Trump proved to be almost immune to news media and other scrutiny during the 2016 election, Congressional Republicans don't want to take that kind of a chance.

And don't be fooled by Speaker Ryan's comments Wednesday night warning President Trump not to work with the Democrats on any new health bill. Ryan is likely only making that statement because he knows if the White House does make open compromises with the Democrats, even the phony public image of the GOP standing strong for conservative values will be wiped away.

So what will this surrender look like? Republicans will likely seek to add a few more free market-friendly measures to the existing law and call it a day. Some of those measures may be along the lines of freeing smaller businesses from employee health coverage minimums or boosting the tax-free limits of health savings accounts. Health Secretary Tom Price said Thursday that the White House will want to trim some of the "essential benefits" requirements that every health insurance plan currently needs to carry.

Well, even if all those changes were successfully added and passed, we're still talking about the small stuff. And making those changes won't be easy in this environment; don't expect even one Democrat vote for them in either the House or Senate. Still, they'll be a lot easier to push through than convincing a now perpetually gun shy Republican Congressional leadership to make more significant reforms.

Some Freedom Caucus members will probably go along this time, considering they will like these small changes as opposed to doing absolutely nothing. That's especially true if they aren't paired with odious provisions like the massive subsidies found in Ryan's now dead bill.

But the bottom line is the hard part of health insurance legislation was never even tried by the Republican leadership. And everything is easy when you don't try.

Commentary by Jake Novak, CNBC.com senior columnist. Follow him on Twitter @jakejakeny.

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