After watching Donald Trump’s first press conference as president-elect, I spent some time trying to refix my dropped jaw, and then wrote at New York about the damage the man had done to his party’s plans to repeal and replace the Affordable Care Act:

Yesterday, President-elect Donald Trump, in an interview with the New York Times, threw all sorts of sand into the gears of the congressional GOP effort to repeal and replace Obamacare. As Jonathan Chait explained, what he was saying made absolutely no sense:

“Trump stated that the Senate must repeal Obamacare ‘probably some time next week,’ and that ‘the replace will be very quickly or simultaneously, very shortly thereafter.’ That is completely impossible. It takes months to design a comprehensive reform plan for one-seventh of the economy, even if you have a party committed to a shared vision. And Republicans aren’t remotely committed to a shared vision: They’re promising wildly different things, from covering everybody (a promise they have no way to pay for) to a bare-bones dog-eat-dog free-market system where the poor and sick are mostly left on their own.”

So unsurprisingly, at today’s bizarre press conference, the first he has held since being elected president, Trump was asked to restate his basic views on how Congress should deal with Obamacare. And he responded with a somewhat different but equally screwed-up scenario:

“We’re going to be submitting, as soon as our secretary is approved, almost simultaneously — shortly thereafter — a plan. It will be repeal and replace. It will be, essentially simultaneously.

“It will be various segments, you understand but will most likely be on the same day or the same week — but probably the same day — could be the same hour. So we’re going to do repeal and replace — very complicated stuff. And we’re going to get a health bill passed — we’re going to get health care taken care of for this country.”

The new criterion Trump threw into the mix is that nothing at all will happen until Tom Price is confirmed as secretary of HHS. Price has to go through two confirmation hearings. The first is on January 18, at the Health, Education, Labor, and Pensions Committee. The second and “voting” committee on his confirmation is Finance, which hasn’t even scheduled a hearing. But the Senate is voting on amendments to the basic blueprint for Obamacare repeal right now; final passage in that chamber will probably occur tomorrow after votes today and tonight on literally more than a hundred amendments that could shape the repeal. If Trump thinks nothing should happen for weeks, he should have probably shared that sentiment with congressional Republicans, who have been talking for months, publicly and privately, about moving on Obamacare before Trump’s inauguration.

Beyond that new problem, Trump is also suggesting “we” will be “submitting” a “plan” for the whole set of problems. Who is “we?” HHS? The White House? The Republican Party? That’s unclear. Again, if he has policy preferences he has not yet shared with congressional Republicans, why aren’t they awaiting them obediently?

Finally, Trump went out of his way to confirm some of the craziness from the Times interview. “Repeal” and “replace” will happen “most likely on the same day or the same week — but probably the same day — could be the same hour.” Surely someone has told him by now that anything worth calling a “replacement” for Obamacare, with its many insurance regulations and other non-budget features, cannot be done via a budget measure, and thus will require 60 Senate votes. How is that going to happen? It won’t if it resembles any of the plans that Republicans are currently discussing.

Now maybe Trump is alluding to some talk from Paul Ryan about handling repeal and replace “concurrently” — which seems to mean including a few budget-germane elements of a replacement in a bill that repeals Obamacare. According to one report, that eternal conservative policy hobbyhorse, Health Savings Accounts (HSAs), could get some new money as a sort of down payment on a replacement plan that could be part of a package that needed no Democratic votes.

If HSAs are to represent the “replacement” that’s not delayed significantly, Trump may have created another problem in today’s press conference in a complaint about Obamacare:

“You have deductibles that are so high that after people go broke paying their premiums, which are going through the roof, the health care can’t even be used by them because the deductibles are so high.”

HSAs are a central part of a standard conservative health-care-policy scheme encouraging “personal responsibility” for routine medical expenses. That means paying for them not through insurance, but through out-of-pocket spending supplemented by HSAs. High deductibles and other cost-shifts from insurance companies to consumers are indeed a major complaint you hear about Obamacare. But the problem is going to get a lot worse under any GOP replacement plan we have seen so far.

So Trump cannot open his mouth without complicating the already near-impossible job his party faces in satisfying conservative demands that Obamacare be repealed immediately, while dealing with the objective reality that it cannot be done without huge and politically damaging fallout.

As congressional Republicans vacillated and argued over how long to delay the effective date of an Obamacare repeal, they may not realize they have a bigger problem than how to transition into some ultimate “replacement” plan. Their own voters are going to be shocked when the see what GOP health care policy means for them. I wrote about this at New York:

[T]here is abundant evidence the white working-class voters whose sudden tilt toward the GOP in Rust Belt battleground states rewarded Donald Trump with the presidency and helped Republicans hang on to Congress really do dislike the Affordable Care Act disproportionately.

Here’s the problem, though: What these key Trump voters most dislike about life under the Affordable Care Act will get even worse under any plausible GOP replacement plan.

As the Kaiser Family Foundation’s Drew Altman reports in a New York Times op-ed, focus groups among Trump-voting Rust Belt white working-class voters who have obtained health insurance through Obamacare — i.e., those most familiar with the ACA — show a very consistent pattern:

“They spoke anxiously about rising premiums, deductibles, copays and drug costs. They were especially upset by surprise bills for services they believed were covered … When told Mr. Trump might embrace a plan that included these elements, and particularly very high deductibles, they expressed disbelief.”

Here’s what they’d rather have:

“If these Trump voters could write a health plan, it would, many said, focus on keeping their out-of-pocket costs low, control drug prices and improve access to cheaper drugs.”

The trouble is, of course, that keeping out-of-pocket costs high and letting market forces control drug prices are fundamental principles of conservative health-care policy, which have been reflected in every Republican health-care proposal for years. To conservative policy thinkers, overutilization of health services, encouraged by government subsidies and regulations (along with “defensive medicine” caused by consumer lawsuits), is the primary source of rising health-care prices and virtually every sin of the health-care system.

So when Republican policymakers talk about “personal responsibility” being critical to heath reform, that’s code for making sure Americans feel some pain every single time they access health services. The way you do that is by increasing exposure to out-of-pocket costs via premiums, deductibles, copays, and exposure to big bills if you don’t strictly obey your insurance company’s arcane rules. You can sugarcoat this a bit by offering a tax subsidy for personal savings so that you have more money for those out-of-pocket expenses; that’s the basic point of the Health Savings Account idea, a feature of every conservative health-care proposal since time immemorial, and a particular favorite of Vice President-elect Mike Pence. Indeed, the goal many Republicans have long embraced is a system where everybody gets a high-deductible insurance policy covering catastrophic health conditions, with no insurance at all for routine services, which consumers would handle themselves with some help from an HSA.

But if the KFF research is correct, it’s the routine services that Trump’s white working-class base thinks they should have access to without emptying their wallets or being hassled by an insurance company. That is partly why so many of these people exhibit resentment toward Medicaid beneficiaries who don’t have the same problems in obtaining routine services. Given the chance, of course, Republican pols would introduce “personal responsibility” requirements to Medicaid as well, as GOP governors like Mike Pence have shown in the deals they’ve cut with the Obama administration to expand eligibility in exchange for generous new federal dollars. In the ideal GOP world, everyone would be paying more for routine services — even the very wealthy, who would have to shell out large premiums for concierge services to keep them from rubbing elbows with the hoi polloi in waiting rooms.

So will white working-class Trump voters realize this conflict between their views and those of their party before an Obamacare replacement plan goes into effect? Nobody knows. But it’s not like they won’t be paying attention. As Ron Brownstein notes, the savage antipathy these folks feel for Obamacare is based on an intimate familiarity with the law, because so many of them receive health insurance via the ACA:

“[I]n practice millions of blue-collar whites have gained coverage under the law, particularly in states critical to the Republican electoral map. Using census data, the Urban Institute recently calculated that from 2010 through 2015, more non-college-educated whites gained coverage than college-educated whites and minorities combined in all five of the key Rustbelt states that flipped from Obama in 2012 to Trump in 2016: Iowa, Ohio, Michigan, Wisconsin, and Pennsylvania. Whites without a college degree also represented a majority of those gaining coverage under the law in core Trump states like Indiana, West Virginia, Kentucky, Arkansas, and Oklahoma.

“These states often saw enormous reductions in the number of uninsured working-class whites: about 40 percent in Indiana, Pennsylvania, and Wisconsin; roughly 50 percent in Ohio, Iowa, and Michigan; and 60 percent in West Virginia and Kentucky.”

So if they lose insurance altogether or are forced into new health-insurance plans that double-down on the very features they hate about Obamacare, these key Trump voters will not be very happy. And Trump tweets about how “terrific” the post-Obamacare world of health-care policy has become won’t help.

As you may have noticed, Donald Trump was given credit this week for a decision by Ford to keep some operations in Michigan that earlier seemed headed to Mexico. This is becoming a pattern, as I noted at New York:

From time immemorial corporate executives have played a certain back-scratching if fundamentally dishonest game with politicians, usually at the state or local levels. The corporate types make an investment or employment decision that appears to benefit a particular place, maybe because it makes sense generally, maybe in response to government inducements (maybe disclosed publicly, maybe not). And then they cooperate by giving credit to a friendly politician, who gets to announce a ribbon-cutting or ground-breaking or “jobs saved” claim which is supposed to symbolize the pol’s economic development chops. Usually the economic impact of the “deal” is small potatoes, and may even be offset by the cost of inducements. And in most cases the positive development would have probably happened anyway. But it is in not in the interest of any of the players in the game to admit that it’s all a shuck.

It is increasingly apparent that one of the distinctive features of the Trump administration will be raising that particular game to the national level. The first such Trump-brokered “deal” involved the Carrier Corporation, of course. But since that was a particular company Trump bashed during the presidential campaign for its outsourcing practices, and because Trump’s own running mate Mike Pence was in a position to create inducements as governor of Indiana, it looked like it could be a unique event.

Not any more. The automaker Ford has announced Trump is responsible for a decision to make certain cars in Michigan rather than Mexico. Ford claims they didn’t get any public subsidies or concessions to make this showy about-face, from Trump or anyone else; no, it was just a “vote of confidence” in the mogul’s plans to make America a lean, mean, job-creatin’ machine. Never mind that Trump attacked Ford for its Mexican plans during the campaign, or that he threatened to slap a 35 percent tariff on the company’s Mexican-produced vehicles — that’s apparently just a coincidence.

Now, aside from the rather ludicrous suggestion that Trump’s threats were not a factor in this decision, it is important to note that it involves 1,000 jobs (or so Ford claims, anyway). Yes, there are spin-off effects, and sure, if you are an unemployed or potentially unemployed autoworker living in Flat Rock, Michigan (the site of the plant now blessed by Ford and Trump) it’s a big deal.

Having said that, these 1,000 jobs or the alleged (though disputed) 1,100 jobs saved by the Carrier deal are not the stuff of a national economic strategy. It’s more like a Tinkertoy substitute for a national economic strategy at best, and a cynical exploitation of public misapprehensions about how the economy works at worst, with Lord only knows what kind of concealed price down the road. Is the President of the United States going to bribe or browbeat enough individual companies to double GDP growth? Or is this just a display for the benefit of Rust Belt Trump voters to keep them from concluding their hero has betrayed them when he kills Obamacare or plunges us all into a trade-related recession?

I don’t know the answers to these questions. But I do suspect that if Trump continues this narcissistic approach to job creation it will soon be apparent he’s like the rooster taking credit for the sunrise.

As Paul Starr reminds us, Republicans are about to enjoy only their third “trifecta”–control of the executive and legislative branches of the federal government–in 74 years. The most recent example should be of interest to those who want to avoid disaster, as I discussed this week at New York:

[T]he George W. Bush administration offers all sorts of recent evidence about how to profit from and squander a trifecta.

An incoming administration with this kind of power can go two different ways: using it to the hilt to achieve enduring ideological goals at the risk of losing popularity, or using it judiciously to expand the party’s base.

W.’s administration, despite the incredibly controversial nature of its claim on the White House, did not begin with much humility or ideological moderation. Its first policy thrust was to fight for a huge upper-income-targeted tax cut. While that cut was enacted after some adjustments to win Democratic Senate votes, the prevailing atmosphere of ideological warfare cost Republicans control of the Senate almost immediately as Jim Jeffords switched parties. It looked at the time like the newly ascendent conservative Republicans had been taken down a peg. Then came 9/11, and an enormous accretion of popularity for Bush, which he largely used to pursue the ideologically tinged wars in Afghanistan and Iraq that eventually did so much to erode Republican power.

On the domestic front, however, Bush’s top political adviser, Karl Rove, directed a highly strategic effort to expand the GOP base via targeted policies aimed at seniors (the Medicare prescription-drug benefit), women with kids (the No Child Left Behind education initiative), and Latinos (comprehensive immigration reform). The whole mix was enough to get Bush narrowly reelected in the first presidential year after 9/11. But he went for ideological gold again with a proposal to partially privatize Social Security that backfired spectacularly. The rest of his second term was dominated by growing pubic dissatisfaction with the Iraq War, a sluggish economy drifting toward catastrophe, and big management/public relations mistakes like the handling of Hurricane Katrina. In the background, moreover, Rove’s outreach agenda produced a growing backlash from conservatives, who did not appreciate the political attractiveness of “amnesty,” a “new health care entitlement” or “federal interference with local control of schools.”

By the time Bush left office, about the only policy legacy conservatives took special pride in was the tax cuts. And the conservative backlash to his heresies eventually manifested itself in the rise of the Tea Party Movement and a general radicalization of a frustrated right-wing-dominated GOP.

What are the lessons for today’s GOP as it looks forward to using or abusing its trifecta? Probably that party unity is critical, ideological overreach is dangerous, and foreign-policy hubris can be deadly — nearly as deadly as ignoring signs of a housing bubble and an impending financial collapse. But the problem Republicans face now isn’t congressional RINOs like Jeffords or a too-clever-by-half “Mayberry Machiavelli” like Rove. It’s the figure supposedly at the wheel, the incoming president of the United States.

Trump and his closest associates have sometimes exhibited a deep interest in achieving big — or to use his language, “huge” — ideological goals. But it is not clear the ideology in question is conventional conservatism. They’ve also eagerly shown they want to use their power to build political support for the GOP. But that may be at the cost of deposing the Republican “Establishment” and turning the GOP into a cult of personality revolving around the Boss. As for the foreign adventures and economic malfeasance that brought down George W. Bush and wasted his trifecta, it is absolutely anybody’s guess what might happen in the next four years.

What should make the whole situation alarming to Republicans is that for all their chest-beating about their party being stronger than it has been since the Coolidge administration, they know they are one really bad midterm away from the situation they were in during the last two years of the second Bush administration. They should remember that not long before he became a figure of ridicule, W. was being hailed as the Liberator of Iraq, the savior of the conservative movement, and a world-historical figure standing astride a supine world like a colossus. Are they really sure Donald J. Trump will succeed where Bush failed, and for that matter, will not stab them in the back and leave them behind? If so, they truly are the Party of Faith.

Tis the season for Democrats to get over November 8 and begin to plan ahead for how they intend to turn things around. I wrote up a nine-step recovery plan at New York this week:

Now that the 2016 election has formally ended, and there’s no denying Donald Trump the presidency, Democrats can finally and fully focus on their strategy for opposing him. I say “opposing him,” because everything Trump has done since November 8 shows beyond a reasonable doubt that there’s not going to be some shockingly moderate Trump administration as open to Democratic as to Republican policies and priorities. Becoming a “loyal opposition” is not an option, and if Democratic leaders actually went in that direction (beyond a few formulaic expressions of willingness to cooperate with Trump if he turns out to be someone other than himself), the Democratic rank and file would probably find themselves new leaders.

There is not much question that most congressional Democrats will be taking as a template Mitch McConnell’s declaration of scorched-earth opposition to all Barack Obama’s policies and initiatives in early 2009. Partly it’s a matter of payback, but the more important motive is that it worked: Democrats lost their control over Congress at the very first opportunity, in the 2010 midterms; even before that, major elements of Obama’s agenda — including climate-change legislation — were derailed. But there are some major differences between the situation of Democrats today and that of Republicans in 2009 and 2010 that should be reflected in the party’s strategy.

Democrats controlled 60 Senate seats as the Obama era began; today’s Republicans only control 52. That theoretically gives today’s Democrats more leverage — or, at the very least, it forces Republicans to squeeze as much of their agenda as possible into budget-reconciliation legislation that cannot be filibustered. At the very beginning of 2010, however, Republicans got a huge break when GOP candidate Scott Brown won a special election for the seat vacated when Ted Kennedy died, ending the Democrats’ ability to overcome a filibuster without Republican votes. Henceforth, Senate Republicans displayed impressive unity, and 41 votes were enough to pretty much end the really productive period of Democratic rule.

Can 48 Democrats accomplish as much obstruction as 42 Republicans did in Obama’s first two years? That’s not as clear as you might think, thanks to an unbelievably difficult 2018 Senate landscape that will constantly tempt the ten Democrats up for reelection in states Trump carried to defect. Six Republican senators from states carried by Obama in 2008 were up in 2010, but all of them were from states that were narrowly blue in 2008 and ripe for reversion to the GOP in midterms where turnout patterns favored Republicans.

Unify their ranks. Senate Democratic Leader Chuck Schumer is trying to keep potentially wayward colleagues inside a “big tent” with a broad leadership team that includes the especially vulnerable Joe Manchin of West Virginia. But it will take constant vigilance and even imagination to offer a message and agenda that gives senators like Manchin, Joe Donnelly of Indiana, Heidi Heitkamp of North Dakota, Claire McCaskill of Missouri, and Jon Tester of Montana — all from states Trump carried by landslide margins — some opportunities to sound bipartisan without actually joining Senate Republicans on important votes. Outside Washington, the best template for party unity may be Howard Dean’s “50-state strategy” at the Democratic National Committee (working in harness with Democratic Party committees in Congress) that helped keep Democrats focused on Republican weaknesses from the party’s 2004 defeat until its 2006 midterm landslide win.

Opportunities for unity will be enhanced if Democrats can get through a DNC chair contest early next year without too many recriminations, and avoid going back down the rabbit hole of finger-pointing about the shortcomings of the Clinton campaign or what might have happened with Bernie Sanders as the nominee.

Find a way to pick off three Republican senators. This will be absolutely crucial for confirmation and budget votes. Unlike Republicans eight years ago, Democrats cannot filibuster executive-branch or non–Supreme Court judicial nominations. This is a result of the party’s 2013 decision to invoke the “nuclear option” — that is, changing the Senate rules to provide for simple majorities in those situations. A key test of power in January and February will be whether 50 Senate Republicans (or fewer, if they can flip Democrats) can hang together to confirm Trump’s entire cabinet and enact a budget bill that repeals Obamacare and defunds Planned Parenthood (and perhaps other goodies for conservatives). There are already Senate Republican misgivings about Rex Tillerson at State, and all sorts of concerns about the structure and timing of an Obamacare repeal. So alert Democrats could find an opportunity to register early wins over Trump, but the need to appeal to Republicans could temper their rhetoric as well.

Beginning even before Trump’s inauguration, Democrats have to keep a keen eye out for opportunities (which may or may not arise) to split the GOP coalition — not just by picking off three senators now and then, but by exploiting any big differences of opinion between Trump and congressional Republicans (over budget, trade, or immigration policy, for example), or within the congressional Republican caucuses (perhaps a House Freedom Caucus revolt over raising the debt limit in March or a budget that does not sufficiently cut federal spending later in the year).

Develop an effective strategy for dealing with Trump’s SCOTUS nominee. A great deal of early drama will come from Trump’s pick to fill the vacancy at the Supreme Court. In theory, Democrats will be able to filibuster that nomination and beat it with 41 votes, but the odds are extremely high that would trigger the GOP’s own “nuclear option” eliminating SCOTUS filibusters, too. So again it will be a matter of keeping Senate Democrats together and “flipping” three Republicans, which will only be possible if Trump nominates a real judicial extremist.

Decide when and how to fight for Obama’s executive orders. Still another theoretical opportunity to thwart Trump will be on votes to overturn recent Obama regulations via the Congressional Review Act (which will probably be amended to allow bundling of regulations to be killed into a single bill). Democrats must decide if such measures, which may attract Senate Democrats, are worth trying to stop with a filibuster. And they must also keep in mind that if they become too frustrated, Republicans could take the ultimate step of “nuking” filibusters of regular legislation.

Get prepared for what will probably be the most important bill of all — the GOP’s 2018 budget. After all these exciting preliminaries, the 115th Congress will settle down to “normal” business, though later in the year the odds are very high that Republicans will try to move a second, much larger budget-reconciliation bill that will likely include high-end tax cuts, defense spending increases, and potentially very large cuts in safety-net programs — in effect some version of the Ryan budgets congressional Republicans have been kicking around for years.

Hope that they’ll have a chance to fight for Medicare. Democrats are already expressing hopes that Trump and the GOP will overreach in their legislative onslaught and do something politically perilous like big changes to Medicare (entirely possible) or Social Security (much less likely). If that happens, congressional Democrats and their allies will replay the successful 2005 effort to beat back George W. Bush’s partial privatization proposal for Social Security, and no matter what happens the subject will be a big part of Democrats’ midterm message in 2018.

Barring that easy call for Democrats, they may be able to find other initiatives Trump and congressional Republicans are pursuing that can be exploited for public-opinion advantage or even a rare congressional victory. For example, if either in the Obamacare repeal bill or later Republicans pursue the plans both Ryan and Trump have embraced to turn Medicaid into a block grant (flat or reduced federal funding in exchange for state flexibility in running the program), the blowback from Republican governors and legislators worried about funding could cause problems, especially in the Senate.

Try to flip the House in 2018. Ultimately, of course, any Democratic strategy for dealing with the new realities created by the 2016 elections must aim at an electoral payoff, and again, their prospects do not quite resemble those of Republicans heading into what turned out to be a 2010 landslide. The aforementioned Senate landscape probably makes any Senate Democratic takeover in 2018 all but impossible. And so in contrast to 2016, Democrats, their donors, and advocacy groups will likely focus on the House, where the 26-vote gain necessary to flip the chamber could become feasible if the Trump administration stumbles badly or Republicans overreach. Democrats will also, of course, spend a lot of time going into 2018 on state-level elections, in preparation for the round of redistricting that will follow the 2020 census. And in both efforts they will need to solve the puzzle of how to get constituencies that typically do not turn out proportionately in nonpresidential elections to vote in a midterm.

Get ready for 2020. If Democrats fail where Republicans succeeded in decisively winning that first midterm after the White House has changed hands, they could still succeed where Republicans failed against Obama by denying Trump a second term. How to do that is a subject for many separate columns, but obviously doing damage to the ruling party wherever possible is part of the prep work.

Find tea-party-levels of intensity in the base. Above and beyond all the “inside baseball” strategies I’ve been talking about, Democrats must begin building the kind of “outside” organized pressure that the Republicans benefitted from when the tea party arrived on the scene in 2009. If the specter of Donald Trump in the White House does not generate immense energy for a popular opposition that need only be organized to unleash regular fury on a Republican-dominated Washington, it will be even more surprising than the mogul’s election.

It’s all quite a challenge for a Donkey Party that did not expect to be in this situation, and that is still tempted to engage in recriminations over Hillary Clinton’s nomination and campaign, or to struggle to define its own soul.

But if Republicans could succeed in thwarting a president as popular as Barack Obama was at this point eight years ago, Democrats ought to be able to do as well against the president who won the White House despite a historically low approval rating and immense concerns about his very legitimacy.

This is just a first draft for Democratic recovery; others are welcome.