Repeal, Replace, Resist

Republicans should have no trouble repealing the Affordable Care Act, better known as Obama­care. They can invoke the procedure known as reconciliation, which means only 51 votes in the Senate will be needed to kill the unpopular health insurance plan. Since there will be 52 Republicans in the new Senate in 2017 and a Republican in the White House, repeal is a safe bet.

As for Obama­care itself, Repub­licans won't waste their time negotiating over saving any of it. Senate Democrats want to keep the entire program alive by tinkering with its parts and bailing it out with billions in new funding. Forget that. Republicans are committed to a total replacement that emphasizes free-market incentives and patient choice. Both of those features are anathema to Democrats.

But Senate passage of a replacement is far from assured. It will take a second vote in which reconciliation will not apply. With Democrats all but certain to stage a filibuster, Republicans will need 60 votes to enact an alternate health plan. Assuming all 52 Republicans vote for it, they will still need 8 Democrats.

And that's where President Trump comes in. Passing an Obama­care replacement is likely to require the use of the bully pulpit by Trump. And not because he's a bully. The bully pulpit was President Teddy Roosevelt's name for exploiting the White House as a platform to advocate a proposal or an agenda or simply making a large point.

Trump is well equipped to use his new platform. His 17-month campaign consisted mostly of speeches at rallies—as many as six a day in the final weeks of the presidential race. While he did poorly in three debates with Hillary Clinton, the speeches in which he exhorted large crowds to vote for him were effective. They were Trump the candidate at his best.