The health care vote shows Trump thinks the US presidency is just another reality television show

The perfect photo-op.
The perfect photo-op.
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Republicans in the US House of Representatives voted in a health-care bill on Thursday (May 4) that has already made them wildly unpopular with some American voters, and is almost certain not to pass the Senate or become a law in any semblance of its current form.

If you’re watching this bit of American governance unfold, a reasonable question right now is…”Why?”

Why would lawmakers back a bill that may strip health care from millions of the poorest citizens (many of whom are Republican voters), could make it cripplingly expensive for tens of millions more, likely leaves them vulnerable in the next election—and that ultimately could be toothless, as fellow Republicans in the Senate are already condemning it?

There is one resounding answer coming from Washington: Because president Donald Trump desperately wanted something he could call a “win.” And while it may not make sense as a political strategy, it does make sense in a context he knows well: reality TV.

Stung by “first 100 days” reports that he hadn’t achieved much—and in particular, by his failure in March to repeal and replace the health-care law passed by his predecessor, Barack Obama—Trump in recent weeks dispatched top aides and worked the phones himself to convince House Republicans to vote for the new version of his bill. “No one is getting what they want here, but we have to get a deal, we have to get a win,” Trump told Republicans recently.

That pressure meant the bill was voted on without having been evaluated by the nonpartisan Congressional Budget Office (CBO). The CBO had predicted that the previous version—which just 17% of Americans approved of in a March poll—would have led to 24 million more people without insurance over the next decade. (The bill’s supporters disputed the CBO’s forecast, in part because it over-estimated how many people would originally sign up for Obamacare; but in such a politicized debate, it’s the most neutral referee there is.) The new bill goes even further to roll back Obamacare, allowing states to waive requirements that insurers cover a list of essential health care needs, and could weaken health coverage for much more of the country. Yet lawmakers voted on it without a CBO assessment of its impact on people or on the federal budget.

After the vote was cast, Republicans wheeled cases of Bud Light into the House chamber and smoked cigars to celebrate, while heaping praise on Trump. “This was Donald J. Trump, the negotiator, getting it done,” Chris Collins, a long-time Trump supporter and New York Republican representative, said afterward. He hadn’t even read the full text of the bill before voting for it, he admitted, and had to ask a local reporter to explain to him a clause in it that could strip healthcare from 19,000 of his own constituents.

Trump, meanwhile, basked in the moment in the Rose Garden at the White House. For at least a few minutes, he had created the perfect, telegenic image of a man who was getting things done.

In reality TV, unlike in a serial, the plot-line doesn’t have to advance from one episode to the next; the only rule is to keep things interesting in each one. That’s a pretty good summary of Trump’s first 100 days in office. “This is a television presidency,” says Adam Garfinkle, editor of the American Interest magazine and a former speechwriter for both of George W. Bush’s secretaries of state. “It is full of artificial drama and conflict and the episodes don’t connect. Tuesday and Wednesday have nothing to do with each other.”

That mindset extends to the people surrounding Trump, who have been picked with a casting director’s eye. Vice president Mike Pence was picked in part because he “looks very good,” Trump himself said, while John Bolton was reportedly nixed because of his mustache. Press secretary Sean Spicer is repeatedly mocked by the press for his evasiveness and tortured syntax, but for Trump the important thing is that Spicer “gets great ratings. Everybody tunes in.” Hate-watching, after all, is a huge component of reality television’s audience.

Advisors are pitted against one another by design, and their internal clashes—a reality-show staple—have been front-page news. Trump even staged a “situation room” photo at his private club that looked remarkably like the one his predecessor released after overseeing the killing of Osama bin Laden.

The question is whether Trump’s reality-show approach to the presidency will convince his loyal fans to keep supporting him if his policies begin to hurt them. Democrats are betting that it won’t.