Former President Donald Trump has officially abandoned his 2016 campaign promise to abolish the Affordable Care Act. He now says he would “make the A.C.A. much better than it is right now and much less expensive,” if he is elected to a second term.

The policy U-turn by the GOP’s presumptive presidential nominee comes in response to accusations from President Joe Biden that Trump aims to “terminate” the Obamacare health insurance program.

But Trump’s new emphasis on increasing government involvement in health care, as opposed to eliminating it, is actually more in line with Republican voters than the traditional “repeal and replace” message, according to a new survey by American Compass.

The survey measured 1,000 Americans’ “appetite for government.” What it found was the average Republican is hungry for more federal government solutions — or at least unwilling to remove anything from their current diet.

While Republicans were more likely to have unfavorable views of Washington, D.C., and to prefer rhetoric about lower taxes and smaller government, they showed strong support for expanding or maintaining entitlement programs — Social Security and Medicare — at the core of Congress’ spiraling deficit spending.

Well over half of Republicans (56%) would like to see the federal government do more to support the elderly through Medicare health insurance and Social Security benefits, the poll found. Nearly 40% want the federal government to continue with current levels of support for the elderly. Only 7% would like it to do less.

Is Romney’s former adviser building the post-Trump GOP?
Is Romney’s former adviser building the post-Trump GOP?

This ratio is repeated to a lesser degree among Republicans when asked about federal support for the poor and disabled as well as federal help for those who can’t afford insurance — like Medicaid and the Affordable Care Act. More than twice as many Republicans say they want these programs to grow as say they want them to shrink.

Chris Griswold, policy director at American Compass, said the poll, which was conducted in March, disproves at least three myths about Republican voters in a time of pervasive political realignment: that GOP voters broadly 1) believe government is bad at everything, 2) prefer smaller government and 3) want cuts to the welfare state.

“Those things seem to be assumptions that the political class in D.C. make about American voters, and American conservative voters in particular, that just don’t seem to be true,” Griswold told the Deseret News.

The inconsistency between the conservative consensus of “Paul Ryan” Republicans — to privatize Social Security and reduce Medicare, for example — and what many conservative voters say they want is a “warning sign to politicians,” Griswold said, especially to GOP candidates hoping to reach a more diverse working class coalition.

But other members of Griswold’s so-called “pundit class” are adamant that public opinion polls, with their uninformed respondents and paradoxical responses, are at best a rough roadmap for political figures, and should almost never be a compass for public policy.

Expert policy vs. populist concerns

“Public opinion polls shouldn’t dictate public policy,” said Scott Lincicome, the vice president of general economics at the libertarian Cato Institute.

Policy preference polls, Lincicome said, are often brimming with contradictory responses: People want higher tariffs and they want lower prices; they want more welfare and less bureaucracy; responsible national spending but no reforms to make Social Security sustainable.

The results of the American Compass poll did not bust any myths for Lincicome. It reinforced his belief that there has always been a “disconnect” between the principles of Republican voters and their attachment to “certain entitlements, mainly Social Security and Medicare.”

While elected officials have an obligation to reflect the values and goals of their constituents, Lincicome said, lawmakers should not expect citizens to be “policy wonks.” Instead, he continued, they should dig into the details with the help of think tank scholars like himself who understand that the current trajectory of federal government largesse is “unsustainable.”

In the first few months of 2024, the national debt surpassed $34.5 trillion, increasing by roughly $1 trillion every 100 days and resulting in interest payments that are expected to exceed defense spending by the end of the year.

Annual deficits — which occur when spending exceeds tax revenue — are driven mostly by automatic government payments. Half of the annual federal budget is devoted to money redistribution programs like Social Security (21% of the budget), Medicare (12%), Medicaid, the Children’s Health Insurance Program (CHIP) and the Affordable Care Act, according to the Center on Budget and Policy Priorities.

Warning signs point to a ‘debt bomb.’ Does the federal government need to be put ‘on a diet’?
Congress’ entitlement dilemma

The job of policymakers isn’t to describe what’s popular, it’s to prescribe what tradeoffs must be made to avoid bad outcomes — like more inflation, economic stagnation, or, if nothing is done, a global recession — according to Michael Watson, research director at the conservative Capital Research Center.

“I model public policy in terms of broccoli and ice cream,” Watson said. “And what I got from that poll was that people want to eat ice cream and not eat broccoli. And I think you can see in the current size of the national debt the consequences of that sort of policy.”

Watson, who has criticized American Compass for being at least partially funded by progressive nonprofits, said far from being a vehicle for libertarian austerity, the Republican Party has more often seen its members of Congress willing to dish out soft serve than serve the greens. At the end of the day, Watson said, policymakers have to communicate what fiscal conservatism actually entails.

“Entitlement reform is the ultimate broccoli policy,” Watson said, referring to proposals from former U.S. House Speaker Paul Ryan, R-Wis., that would have partially privatized Social Security.

“At some point,” Watson continued, “you go to the doctor, and the doctor says that your arteries are 75% obstructed and you’ve either got to do emergency surgery or you’ve got to lay off the ice cream.”

A Republican Party without fiscal restraint?

For many Republican voters, however, it’s think tank proposals that appear out of touch with their economic preferences, not the other way around.

The American Compass poll found that 81% of those who affiliate with the GOP believe Social Security is one of America’s great achievements and must be protected for future generations. Only 19% say the program is a “disaster” and that the federal government shouldn’t be providing retirement benefits that it can’t afford.

This show of support for the program came after poll respondents read a balanced description of Social Security that explained “it now sends out far more in payments each year than it collects in payroll taxes, making it a major cause of the growing deficit.”

Results like this demonstrate that Republican voters in the era of Trump have a “hunger ... for something different than has been offered in the past,” Griswold said.

Even the fact that 61% of Republicans say they prefer lower taxes and less government, compared to 15% of Democrats, is a sign that government minimalism is no longer considered to be “absolute non-negotiable table stakes for Republican politics,” Griswold said.

This shift in what it means to be Republican was catalyzed by the surprise success of Trump’s 2016 presidential campaign, which violated the prevailing “Republican orthodoxy” when Trump said he would not cut any entitlements, Griswold said — a trend that has continued as Trump now says he would not seek to get rid of Obamacare.

Griswold said the contrast between Republicans’ openness to federal government solutions and their dissatisfaction with what they are getting points to the need for a “new economic consensus” and “points toward a path that good leaders should take very seriously, which is not to be reflexively anti-government, but to, at the same time, ensure that what government does do is oriented around working families and communities.”

As long as Trump is “running the show,” it’s hard to know which path the Republican Party will take, Lincicome said. But he worries if the GOP does embrace the policy prescriptions of American Compass — higher taxes, higher tariffs, more anti-trust regulation and a larger welfare state — that the country would be saddled with “a left-wing Democratic Party and a right-wing Democratic Party.”

Without the GOP as a “counterbalancing force” to the Democratic Party, Watson said, “we will continue to eat the ice cream, our arteries will harden, we will not take our doctor’s advice and, well, we all know how that ends.”