Republican efforts to repeal the Affordable Care Act and replace it with a thin tissue of dubious reforms hurt the GOP badly in the 2018 midterm election. So you might think that President Trump would drop the repeal effort and find a more substantive way to address high insurance premiums and the rising cost of care this year.
You would be mistaken.
On Monday, the administration doubled down, urging a federal appeals court to uphold a federal district judge’s bizarre ruling tossing out the entire Affordable Care Act as unconstitutional. In other words, Trump is still pushing to repeal the law (better known as Obamacare), and still without anything concrete planned to take its place.
On Tuesday, Trump told reporters, “The Republican Party will soon be known as the party of healthcare.” And on Wednesday he declared, “If the Supreme Court rules that Obamacare is out, we'll have a plan that is far better than Obamacare.” Those promises, however, merely echoed the empty statements Trump made during the 2016 campaign, when he pledged to replace the healthcare law with “something great” — and, as we learned, imaginary.
House Democrats laid out their own, considerably more substantive plan this week to lower premiums and shore up the Affordable Care Act. Yet the bill states that it’s seeking to undo the Trump administration’s “sabotage” of President Obama’s signature healthcare law. That’s no way to attract Republican support.
There are a number of good ideas in the Democrats’ proposal, as well as in their bills to reduce the cost of prescription drugs by increasing competition between branded and generic medicines. But like Trump, Democrats too often seem to view healthcare as a wedge issue — a differentiator to campaign on, not a problem to be solved by finding common ground and legislating.
Given how crucial access to care and affordable insurance coverage are to ordinary Americans, it’s troubling that members of both parties seem willing to cynically game the issue in their perennial search for votes. Although there are fundamental differences in how Democrats and Republicans think about healthcare and health insurance, there is broad agreement among lawmakers of both parties about the need to rein in the cost of care and lower insurance premiums, as well as some of the ways to accomplish those goals. There is also a strong consensus — reflecting the overwhelming public support — for protecting the millions of Americans with preexisting conditions against discrimination by insurers.