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Trump’s Health Care Plan Comes Straight From the Republican Establishment

Republican Presidential Candidates Debate In Greenville, South CarolinaRepublican Presidential Candidates Debate In Greenville, South Carolina
Republican presidential candidate Donald Trump participates in a CBS News GOP Debate.Photograph by Spencer Platt—Getty Images

Mitt Romney is so terrified of Donald Trump winning the Republican nomination that he gave a 15-minute speech on Thursday detailing why he thinks the real estate magnate would be a disastrous candidate for his party and his country.

Romney isn’t the only Republican establishment figure who has taken such a position. Romney’s predecessor as the Republican standard bearer, John McCain, put out a similar statement on Thursday as well, and many Republican officials and conservative intellectuals have said the same thing.

It’s understandable why someone might find Donald Trump un-presidential. But for all the talk about how Donald Trump is bucking Republican orthodoxy, his actual policy proposals are not only very similar to what the Republicans have been proposing for years, they very much support the interests of those we typically associate with the Republican establishment.

This was made clear on Wednesday evening when Trump finally announced a more detailed health care plan. Trumpcare is simply a rehashing of of the the new Republican party consensus on Obamacare: repeal the law and replace it with subsidies for individuals to buy care through the tax code. Contradicting what he said last week at the Republican debate in Texas, Trumpcare would “let people slip through the cracks.” It would turn Medicaid into a state-run program that the federal government supports financially but does not control, and it does not include any mention of requiring insurance companies to cover people with preexisting conditions, a hallmark of Obamacare.

Many Americans think this is the best path for healthcare policy. Ted Cruz’s plan, for instance, makes no provision for people who can’t afford healthcare, nor does it force insurance companies to cover already sick people. But Ted Cruz also doesn’t go around saying that he won’t let people die in the streets.

Donald Trump’s tax plan is yet another example of the Republican frontrunner talking a big game but, when it comes to standing up to the establishment, he falls back into the party line. When Trump announced his tax reform plan, he said, “We’re reducing taxes, but believe me, there will be people in the very upper echelon that won’t be thrilled with this,” suggesting that through eliminating deductions that the wealthy often use, the rich would pay more.

But it’s impossible to square this characterization with the actual text of Trump’s tax plan. The Tax Policy Center estimates that the Trump plan would cut taxes by $9.5 trillion over ten years, reducing federal revenues more than 20%, and it would boost the income of the wealthiest 0.1% by $1.3 million per year. This plan is very similar to the last Republican president’s, George W. Bush. He too supported large, deficit-increasing tax cuts that were tilted towards the rich, though Trump’s is much larger in scale.

Trade is the one area where Donald Trump truly does buck the Republican establishment. Instead of supporting new free trade deals, as most Congressional Republicans do, Donald Trump has opposed deals like NAFTA and the current Trans-Pacific Partnership now being debated in Congress. But his solutions for shrinking the U.S. trade deficit with China, namely labeling China a currency manipulator and placing tariffs on Chinese goods, are not as heretical as you might think. For years, Republican officials have demanded that the Obama administration hold China accountable for currency manipulation, and even President George W. Bush wasn’t afraid to rely on higher tariffs to support U.S. steelmakers.

One of the aspects of Donald Trump’s political genius has been his ability to use his truly heterodox rhetoric, and turn that into the impression that the policies he’s actually proposing are novel. His policy proposals are just detailed enough that his opponents can’t credibly claim that he has no plan, but they are vague enough that regular Republican voters can read into them what they want.

It’s a delicate tight-rope to walk, but it’s worked like a charm for him so far.