“As a candidate, I promised that we would protect coverage for patients with preexisting conditions and create new health-care insurance options that would lower premiums,” writes President Trump in a USA Today op-ed – or, I should say, “writes,” since the text is not nearly digressive or incoherent enough to have sprung from the man’s own pen. “I have kept that promise, and we are now seeing health insurance premiums coming down.”
The first line, you might notice, contains a hyperlink. If you click it, it takes you to a Washington Post fact-checking story which explains that Trump’s administration is supporting a lawsuit to eliminate protections for patients with preexisting conditions. “With no explanation or warning, the president now supports an effort to nullify the provisions that make it possible for millions of people to purchase affordable insurance,” the article says, concluding, “Thus this new position, directly contradicting his repeated stance as a candidate and as president, qualifies as a flip-flop.”
Either the link was inserted by a subversive editor at USA Today (do those exist?) or by an especially lazy Trump speechwriter (those definitely do exist) who Googled Trump and “preexisting conditions” and called it a day without reading past the headline. Either way, it’s perfectly clear Trump has not remotely kept his promises on health care. He very specifically promised to retain the protections for patients with preexisting conditions written into the Affordable Care Act (Trump: “except pre-existing conditions, I would absolutely get rid of Obamacare.”).
Trump ran for president as a right-wing populist, and voters accordingly perceived him as being more moderate than previous Republican nominees. Once in office, he has made a deal with his party, where he would abandon his populist stances and govern as an orthodox K Street Republican, in return for which his party would cover up his misconduct and criminality.
The latest sign of this political reinvention is his op-ed, which is mostly a rehash of hoary right-wing warnings about health-care reform. Democratic plans to expand Medicare, he claims, will lead to “rationing,” on the assumption there is only a fixed amount of medical capacity that can exist, and that giving more coverage to people who lack it will necessarily come at the expense of those who already have it.
“The Democratic plan would inevitably lead to the massive rationing of health care,” he writes. “Doctors and hospitals would be put out of business. Seniors would lose access to their favorite doctors. There would be long wait lines for appointments and procedures.” Soon Trump gets around to predicting America will become Venezuela. This is more or less the same rhetoric Ronald Reagan employed to predict in the 1960s that the establishment of Medicare would extinguish the last gasp of freedom in America.
The most striking thing about the op-ed, other than the ludicrous claim to have fulfilled his promise on preexisting conditions, is that it does not mention his biggest and most important health-care campaign promise: to cover everybody. Trump promised this over and over. “I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now,” he said in 2015. “We have to take care of them,” he said in 2016. “Now, that’s not single payer. That’s not anything. That’s just human decency.” He pointedly contrasted his decency with the party’s traditional stance on health care, which he described as letting people “die in the streets.”
He hasn’t covered everybody. He hasn’t proposed, let alone enacted, a “terrific” health-care plan. If protections for people with preexisting conditions remain in place, it will be only because his administration loses its legal fight to eliminate them. Whether Trump is more than dimly aware of any of these facts is an open question. The most perfectly emblematic fact about Trump’s health-care record is that he has written an op-ed pointing out that he has broken his own promises.