If you listen to the 45th president of the United States long enough, he’ll say things that just take your breath away, even taking into account his regularly dishonest approach to facts and even the most recent history. You may recall that he spent a good part of his first year in office working with congressional Republicans to repeal and replace Obamacare, failing once in the House and twice in the Senate. He endlessly and redundantly referred to Obamacare as a “disaster,” dating back to the 2016 presidential campaign. Yet here he is telling NBC’s Chuck Todd in an interview over the weekend that he deliberately kept the health-care program alive:
I could have managed Obamacare so it would have failed or I could have managed it the way we did so it’s as good as it can be. Not great, but it’s as good — it’s too expensive and the premiums are too high. I had a decision to make. I could have politically killed Obamacare. I decided not to do it.
Aside from its efforts to kill the Affordable Care Act legislatively, the Trump administration has undertaken 60 distinct initiatives to undermine Obamacare, according to a careful analysis by the Center for Budget and Policy Priorities. The most recent was on June 13:
The Trump Administration finalizes a rule on health reimbursement arrangements (HRAs) that will likely lead employers to shift millions of workers from traditional employer-sponsored group health plans to individual coverage with a limited employer contribution. Under the rule, employers can forgo offering coverage and instead contribute money to a tax-free account for employees, who would then use it to help buy their own coverage. The complexity of enrolling in an individual plan (compared to employer coverage) could lead to more employees losing coverage and will make employees more susceptible to broker schemes that enroll them in skimpy plans instead of comprehensive coverage.
Employers with sicker workers are likelier to take up this option, which could raise premiums for everyone in the marketplace. It comes at a cost to taxpayers of $51 billion over ten years — resources that could have been used to make existing forms of coverage more affordable.
This is a good example of an administration initiative that is not ostensibly about Obamacare, but would have the effect of destabilizing the private insurance markets on which Obamacare depends, and/or pushing consumers into Obamacare coverage by denying them the insurance they had earlier. From the very beginning, Team Trump has worked to promote the “market-friendly” GOP policies that force Americans to bear an ever-higher percentage of their health-care costs on the atavistic theory that this is the best and only way to hold down overall costs.
Even those who share this point of view are generally willing to admit it is totally inconsistent with the thinking behind the Affordable Care Act, which of course was opposed by every single Republican member of both Houses of Congress.
Paige Winfield Cunningham notes the simple reason Trump is offering this audacious retroactive spin:
It was clear from yesterday’s NBC interview that Trump is trying to rewrite history around what happened with the ACA — and advance a winning health-care message — as he looks ahead to 2020.
Trump keeps talking vaguely about his brilliant ideas for a “great” health-care system, but based on his first-term record, his ideas involve the same old Republican schemes to put health-care insurers and providers back in the drivers’ seat and put Obamacare and Medicaid on the road to extinction. No wonder he’s lying about that record.