It’s the summer of 2016 and Donald Trump is delivering a major speech on his vision for reforming the American health-care system. He decries Obamacare as a total disaster — and vows to change everything that his party hates about the law.
The GOP nominee promises that, if elected, he and his allies in Congress will try to eliminate regulatory protections for people with preexisting conditions; cut nearly $800 billion from Medicaid; radically increase the cost of insurance for lower-middle-class elderly people in rural areas; radically increase the deductibles of plans sold over the individual market; restore the freedom of insurance companies to impose lifetime limits on coverage, thereby bankrupting families with children who suffer from severe medical disorders; add upwards of 20 million people to the ranks of the uninsured within the coming decade; and use the resulting savings to clear up budget space for delivering massive tax breaks for the wealthiest people in the United States.
The mogul’s gaze drifts away from the teleprompter, and he informs the crowd that Ted Cruz’s grandfather murdered Amelia Earhart. Or, so say many people. He ruminates on this theme for several minutes.
Then, he’s back to health care. Trump acknowledges that his plans may be difficult to pass through Congress, as they are extremely unpopular. But he vows that his administration will do everything in its power to undermine the existing law — sowing uncertainty to increase premiums, using public funds to discourage sign-ups — until the only choices before the American people are to accept his party’s draconian bill or a completely nonfunctional individual insurance market.
How many votes do you suppose he would have gotten? How many votes would Republican congressional candidates have received, had they run on the same platform?
We’ll never know, because Trump and his congressional allies didn’t want to find out. Instead, the president campaigned on a promise to deliver universal coverage that was both more generous, and less expensive, than what Obamacare had provided. Mitch McConnell lamented the millions that the Affordable Care Act had left uninsured, and the high deductibles that kept others from using the insurance they did have. And Paul Ryan just said the phrase “patient-centered” over and over again.
But make no mistake, had Trump delivered the speech outlined above, he would have told no lie (except, perhaps, for that Amelia Earhart bit). The president has not yet gone nuclear, and used his authority to withhold federal subsidies from insurers, thereby triggering chaos in the individual market. But he has also refused to promise that he won’t do this. When insurers came to Washington seeking such an assurance from the White House, the administration offered them the same deal it had implicitly offered the American people: If you don’t want us to sabotage the health-care system, then support our bill to throw 22 million people off of insurance. Insurers balked, and raised premiums to protect themselves against the threat.
On Thursday, the Daily Beast detailed another prong of the administration’s sabotage strategy:
The Trump administration has spent taxpayer money meant to encourage enrollment in the Affordable Care Act on a public relations campaign aimed at methodically strangling it.
The effort, which involves a multi-pronged social media push as well as video testimonials designed at damaging public opinion of President Obama’s health care law, is far more robust and sustained than has been publicly revealed or realized.
… Under Secretary Tom Price’s stewardship, HHS has filmed and produced a series of testimonial videos featuring individuals claiming to have been harmed by Obamacare. Funding for those videos would come from the Department’s “consumer information and outreach” budget, which was previously used for the purposes of advertising the ACA and encouraging enrollment…Two sources familiar with the videos say that HHS continues to draw money from the outreach fund, even though its objective has switched from promoting the ACA to highlighting the law’s critics and its shortcomings.
In 2015, the Government Accountability Office ruled that the Environmental Protection Agency had violated the law by encouraging public support for its clean-water regulations over social media — an effort that constituted “covert propaganda.”
While Health and Human Services is allowed to use funds to educate the public, it is prohibited from openly advocating for the passage of legislation. The department’s official Twitter account has done precisely that.
But these bureaucratic improprieties are less alarming than the broader effort they’re meant to serve: A major American political party is trying to take health care away from millions of Americans, in contradiction of its own promises, and in defiance of its own voters’ wishes, by actively sabotaging a duly passed law that has proven too popular to kill through legislative means.