Trump’s unhinged crusade to destroy Obamacare
boomerangs back on GOP
Opinion by
Paul Waldman and
June 26, 2020 at 3:00 p.m. CDT
In the
annals of stupid political moves, what the Trump administration and Republicans
are doing right now — urging the Supreme Court to strike down
the Affordable Care Act, which would take health coverage away from 23 million people and scrap protections
for preexisting conditions, in the midst of a pandemic — must rank
extraordinarily high.
But
this is more than a story about one case or even just this presidential
campaign. It will set the stage for the next phase in our long national health
care debate, a phase that will begin if Joe Biden becomes president and
Democrats control Congress come January.
But
this time, Republicans will not only have profoundly wounded their credibility,
they will also have inadvertently helped Biden make the case for the reform
he’ll propose.
The new brief that the Trump
administration filed with the court on Thursday night left zero
doubt that Trump wants the entire ACA to be torn out, root and branch —
including its protections for preexisting conditions.
The
administration brief argues that because the individual mandate has been
rendered meaningless (in 2017, the GOP-controlled Congress reduced the penalty
for not carrying insurance to $0), the other pillars of the law must be
invalid.
Those
pillars include the requirement that insurers cover everyone regardless of
health status, and at comparable prices — which guarantees access to coverage
for those with preexisting conditions.
Those
pillars are invalid because the mandate was tied to them, the brief argues,
adding that “it necessarily follows that the rest of the ACA must also fall.”
This is
a legal argument that even ACA critics have dismissed as utter
lunacy. But it unequivocally confirms an important principle: Democrats want to
expand people’s access to health care, and Republicans want to take people’s
health coverage away.
First
let’s note that this brief deals a tremendous blow to the arguments that Trump
and Senate Republicans are making in their campaigns.
For
instance, note this new ad from
GOP Sen. Martha McSally of Arizona, who is trailing in her
reelection bid to astronaut Mark Kelly. In it, she states flatly: “Of course I
will always protect those with preexisting conditions. Always."
PolitiFact rated this claim
“false,” pointing to McSally votes that would have removed those protections.
But now
Trump’s own administration has declared this as an unequivocal goal.
Indeed, as James Hohmann details,
this brief can now be used against numerous GOP Senators up for reelection.
Trump
has undercut his own campaign arguments, too. He regularly vows to protect
preexisting conditions, yet he has not offered any plan to do so, and now his
brief lays his true intentions bare.
Indeed,
Trump has provided Democrats with potent ammunition against him. The Democratic
super PAC Priorities USA is out with new ads blasting
Trump for trying to gut these protections for millions. One of the ads explicitly mentions his
efforts before the Supreme Court.
Priorities
USA tells us its research has identified 1 million voters in battleground
states that are particularly susceptible to this sort of message about health
care, and that this group of voters is younger and more diverse than its
typical persuasion targets.
Now
imagine that Biden and Democrats do win this fall’s elections. This would be
the first presidential race that Democrats won since the ACA went into effect
that turned heavily on the debate over the law’s future.
That
would represent a 180-degree turn in our national health-care debate. In 2010,
Republicans marshaled outrage over the ACA to win back the House and hamstring
the Obama presidency, and while they lost the 2012 presidential election, they
won the Senate partly on the issue in 2014.
But
then, after 2016, when Republicans had total control of the White House and
Congress, not only did their efforts at repeal fail in 2017; they went on to
lose the House, largely over this issue, in the biggest midterm wipe out
suffered by Republicans since the Watergate era.
Thanks
to this lawsuit, if Biden wins, it will be even clearer that this was in part
because of Trump/GOP efforts to destroy the ACA. In fact, arguments in this
case will be heard this fall, when the campaign is on full boil. (A decision
won’t come until next year.)
And so,
while you should be skeptical about talk of “mandates,” this history will
certainly embolden Democrats to forge ahead with the reform plan Biden ran on.
Biden’s
plan creates an expansive public option open to anyone,
including people who now get insurance from employers. It automatically signs
up people who would have been eligible for Medicaid under the ACA’s Medicaid
expansion but live in states that refused to accept it. And it auto-enrolls
low-income people whenever they interact with the government.
Even if
that’s not Medicare-for-all, it’s still a dramatic expansion of government
insurance, one likely to enroll tens of millions of Americans.
So in
2021 you’ll have a convergence of factors pushing Biden’s reform: Democrats
will be emboldened. We will still be dealing with the horrific effects of a
pandemic that dramatically highlighted the need for far more comprehensive
health coverage. And we’ll have fresh memories of a truly depraved GOP legacy
of trying to strip coverage from millions — in the middle of that very
pandemic.
All
that is no guarantee of success, and Biden’s plan will meet fierce resistance.
But the chances for substantial reform look about as good as they ever have,
and Trump’s unhinged efforts may make them even better.