Meanwhile, in your bowels …
by Tom Sullivan
The worst thing the sitting president’s new Roy Cohn did this week, Catherine Rampell believes, was neither dissembling in a Senate hearing room nor refusing to appear before a House Judiciary Committee hearing. Attorney General William Barr asked a federal appeals court to strike down the Affordable Care Act. In toto. For millions of Americans.
Why an administration dismissive of law would bother striking this one down is almost, but not quite a puzzle. Like Loki going to war with the Avengers in New York, Donald J. Trump, another man who would be king wants to be seen destroying it.
Rampell explains:
If the Trump administration prevails, everything in the law would be wiped out. And I do mean everything: the protections for people with preexisting conditions, Medicaid expansion, income-based individual-market subsidies, provisions allowing children to remain on their parents’ insurance until age 26, requirements that insurance cover minimum essential benefits such as prescriptions and preventive care, and so on.
The Party of Trump’s historic losses last November were a product of its enmity for Obamacare. But no matter. No matter that the proposed rationale for striking down the law is rejected by conservative and legal scholars opposed to Obamacare. No matter that Trump’s “party of health care” shows no flicker of interest in crafting a replacement. No matter that there seems no political advantage in destroying access to health care for millions. Such delicious revenge.
Meanwhile, half of Americans still receive health coverage though employer-based plans. The four in 10 people with those plans are in high-deductible policies that still make actually accessing care unaffordable, Rampell adds. Half of such households reported delaying getting care or filling prescriptions because of cost in the last 12 months. Obamacare expanded coverage but did too little to make it more affordable.
But it is something to build on:
For instance, the latest version of a plan known as the Medicare for America Act — introduced Wednesday by Reps. Rosa L. DeLauro (D-Conn.) and Jan Schakowsky (D-Ill.) — would create an expansive public insurance option to compete with the employer-sponsored system. The public option would cap premiums and out-of-pocket costs and have no deductibles. The bill would allow employer-sponsored plans to continue, as long as they covered a minimum average share of enrollees’ health expenses.
Inevitably, there are also refundable tax credit proposals that offer nothing to people who pay no taxes, have no savings, and live paycheck-to-minimum-wage-paycheck even if some manage to log enough hours weekly to receive an employer-based plan. Democrats have proposed those too.
Speaker Nancy Pelosi has a point in trying to keep her caucus focused on more than Trump’s autocratic fantasies. Trump wants to be seen destroying Obamacare. Yet, being seen after the fight is won is preferable to being seen fighting and losing. So long as Democrats wage public battle against his minions, they may not notice he has been mucking around in their bowels while they are distracted.
Republicans regularly amp up their base with the fiction that Democrats are coming for their guns. Democrats may want to take a lesson. Republicans really are coming for their health care. Democrats are working to save it.