Donald Trump has made “Repeal (and, I guess, Replace)” of the Affordable Care Act one of his priorities since Day 1 of his election. He’s tried (and failed) to wrangle Congress into doing it for him. He’s chipped away steadily at it through executive action, undoing implementation orders from the Obama era. He’s now escalated his efforts to do so on a judicial basis
Trump’s Justice Department has decided to file a brief in the appeal of a Texas judge’s ruling that the entire ACA (“Obamacare”) is unconstitutional because the GOP Congress got rid of the individual mandate. The brief is in support of that ruling, thus expanding the DoJ’s previous positions in the case that only portions of the law should be tossed out. Now, it’s Get rid of everything as the official Justice Dept. position.
Were the 5th Circuit to uphold that position, both the short-term and long-term effects would be catastrophic. On the short-term side it would throw private insurance and public assistance into turmoil. On the long-term side, it would mean a return to the pre-ACA days:
- Returning to Pre-Existing Condition restrictions that prevented millions of Americans from getting health insurance (at all, or at affordable levels), and locked people into jobs for fear that they wouldn’t requalify for health insurance if there was too long a gap between employment positions
- Returning to having lifetime and annual coverage limits
- Returning to letting insurance companies charge more for women’s health coverage
- Dumping 15 million people off Medicaid
- Eliminating no-charge preventative services for older Americans on Medicare
- Removing required minimal coverage standards for health insurance policies (ambulatory care, emergency care, hospitalization, maternity and newborn care, mental health and substance use care, prescription drugs, rehabilitative and habilitative services, laboratory services, preventive care, chronic disease management, and pediatric dental and vision care)
- Removing state exchanges that provided structured comparisons of medical insurance plans
- Removing medical loss ratio standards that required insurance companies to expend money primarily on coverage, not on executive salaries.
- Kicking off extended dependent coverage to age 26
- Etc.
The only “positive” aspect of this is that, regardless of how the 5th Circuit (and then the Supreme Court, one can assume) rules on this, Trump has prominently handed a huge issue to the Democrats in 2020. Protecting health care was a major component of the message in 2018 that won the Dems the House (and arguably staved off greater losses in the Senate). It polls as the most important issue for Democratic voters, while repealing the ACA is much further down the list for Republicans.
Trump has long touted “Repeal and Replace” as his goal, even though the replacements proposed have been weak beer in terms of actually helping those whom the ACA provided care for. With this move, Trump’s administration is seeking solely to Repeal; any “Replace” will be a long time coming, as we devolve to the far-more-Darwinian status quo of a decade ago, where health care was for those who could afford what insurance companies chose to charge.
But, then, despite claims to the contrary, that’s clearly been Trump’s desire all along.
Do You Want To Know More?
- Microsoft Word – texas v united states — letter
- Trump administration backs full repeal of Affordable Care Act in legal reversal – The Washington Post
- Trump’s DOJ says Obamacare is unconstitutional in lawsuit – Vox
- Summary of the Affordable Care Act
Please read the latest NY Times article regarding “affordable” heath care. FYI Americans had to borrow $88 billion and one in four postponed treatment because they couldn’t afford the procedures. Sure, you’ll say, that’s exactly why we should have “free” healthcare for all, just like the socialist counties. However, the main reason those socialist countries can afford “free” medical care is due to the fact that they rely on the good old USA to defend them-a.k.a. NATO and all of our camps around the world. Then, throw in the fact that our population is sooooo much larger than theirs, well, they can kind of afford “free” healthcare.
Remember, the bigger the government, the smaller the citizen, the family and the Church-see Europe for prime examples.
@Michael – I don’t think anyone thinks the ACA is the perfect system. Between problems with any complex legislation that weren’t allowed to be corrected because of GOP intransigence, and compromises necessary in order to get to the needed votes for passage, it’s definitely got gaps and issues. But it still remains better than what the situation was before the ACA.
Your argument seems to be that the only reason that Western Europe can afford to provide necessary medical care for its citizens (across the disparate versions of national health care they have) is because the US is providing their national defense cost. That sounds more like a budget management and national prioritization issue to me. It means that we could perhaps do the same thing if we didn’t spend as much on Defense as the next seven nations combined (https://www.pgpf.org/chart-archive/0053_defense-comparison), most of whom are our allies.
The size of our population has nothing to do with it. Medical expense, economic productivity, and tax income all scale with population size.
Europe’s “example” with religiosity and the size of “the Church” has nothing to do with government size and everything to do with centuries of established religion.