Here’s a piece of political fiction: In the middle of America’s worst health crisis in a century, a president proposes to take health insurance away from millions, really stick it to the poor, force those with pre-existing conditions to go it on their own — and in the process give a huge tax cut to the wealthiest citizens.
Except it’s not fiction: Donald Trump may do exactly that.
In late June, the president’s solicitor is slated to file a brief on the administration’s support of a U.S. Appeals Court throwing out the entire Patient Protection and Affordable Care Act.
While the COVID-19 crisis is taking up most of the political oxygen during a critical presidential election, this would be a time bomb for the president and Congressional Republicans.
The Affordable Care Act, a.k.a. ObamaCare, has become increasingly popular, starting when Trump and Republicans on Capitol Hill sought to kill it. It now commands support from a solid majority of voters and was an important factor in the Democrats’ 2018 congressional victories.
To even hint at ending the Affordable Care Act during a cataclysmic crisis is political madness. Listen to New Hampshire’s Republican Gov. Chris Sununu, who has been an opponent of the Affordable Care Act, charging that repealing the law now “would be devastating to New Hampshire.”
The Supreme Court wouldn’t hear the case until the next session, and it couldn’t be decided until after the November election. If, in June, the Solicitor General reiterates Trump’s long-held public position, it will be an indescribable gift for Trump’s opponents.
The proposed repeal would take away comprehensive health insurance for the 20 million Americans who got coverage under ObamaCare. That number would be larger as millions more have lost their jobs — and presumably their coverage — during the pandemic.
Among other provisions that would be eliminated, if Trump gets his way, is the expansion in 37 states of better Medicaid coverage for lower income residents, the protection against discrimination in coverage for tens of millions of Americans with pre-existing conditions, a limit on out of pocket expenses for catastrophic illness and the ability of parents to keeps kids on their coverage until age 25.
Repeal of the act would give an estimated $45 billion tax cut to the wealthiest Americans who are paying a small levy on unearned income to fund the expanded coverage.
Republicans contend they will replace ObamaCare with a better system. But when they controlled both houses of Congress and the White House, they failed — every one of their proposed measures covered fewer people, gutted basic protections and failed to lower costs.
Donald Trump has promised for almost five years a better alternative to broaden coverage and cut costs. He will sing this song again in the general election. Yet he has not offered a single specific proposal.
To repeat: As president, in 1193 days Trump has not put forth a health care proposal.
The Supreme Court already upheld the law in 2012, with Chief Justice Roberts the decisive vote. The requirement to buy health insurance was permissible, he wrote, under the tax code as the penalty was a tax. Then — in the big 2017 tax cut — Republicans did away with the tax but not the mandate. Opponents then went to a friendly federal judge in Texas who ruled that without the tax, the whole law was unconstitutional. Most experts disagreed, but it was upheld on appeal and now is before the Supreme Court.
Last month Trump said he still supports overturning the act; that would be reflected in the administration’s brief due June 25. Without any reporting, I can already see the Democratic ads up on June 26.
The context is that Trump knows little and apparently cares less about the actual policy: He always has viewed ObamaCare as a political weapon to gin up his base.
That was when the measure was less popular.
It’s not inconceivable the administration might seek to delay the June 25 date, using COVID-19 as an excuse. It’s doubtful John Roberts would accede to such a blatantly political request.
Al Hunt is the former executive editor of Bloomberg News. He previously served as reporter, bureau chief and Washington editor for the Wall Street Journal. For almost a quarter century he wrote a column on politics for The Wall Street Journal, then the International New York Times and Bloomberg View. Follow him on Twitter @AlHuntDC.