Trump struggles to embrace ‘lousy’ Obamacare, calling again to replace it
Donald Trump won the White House in 2016, pledging to “repeal Obamacare,” the sweeping law that helped tens of millions of Americans get health coverage. Trump ran for reelection in 2020, still vowing to replace the measure - widely known as the Affordable Care Act - despite his administration’s failures to do so.
“Obamacare is too expensive, the premiums are too high,” Trump said in an ABC News town hall in September 2020. “It’s a total disaster.”
Four years later, and on the same TV network, the former president tried out a new message: He will safely shepherd the Affordable Care Act, Trump grudgingly pledged to voters, even as he struggled to praise a “lousy” law he spent more than a decade deriding.
“I’d run it as good it as it can be run,” Trump said in Tuesday night’s presidential debate, casting himself as a defender of a law that he long called an unconstitutional monstrosity and that he says he still hopes to replace. “It’s still never going to be great. … We can do much better than Obamacare.”
Tuesday’s debate offered the latest, highest-profile evidence of the Affordable Care Act’s political metamorphosis - and how that shift has confounded Trump, who emerged as the biggest threat to the law since its 2010 passage.
Initially perceived as a weight around Democrats that helped cost the party control of the House, the Senate and eventually the White House during the next six years, the Affordable Care Act has since become one of Democrats’ more popular achievements, partly because Trump’s failed attempts to overturn the law in 2017 helped catalyze new support.
Sixty-two percent of adults had favorable views of the law in April, up from 38 percent a decade earlier, according to polling by KFF, a nonpartisan health-care think tank.
Tuesday’s debate also provided further evidence of how Democrats are wrapping themselves in a law that many prominent lawmakers - including their presidential nominee - deemed insufficient heading into the last presidential election. When Vice President Kamala Harris was pressed by ABC News moderator Linsey Davis on her past support for Medicare-for-all, a proposal that would have upended the U.S. health system and a position pilloried by the Trump campaign, Harris quickly pivoted to her current pledges to build on the Affordable Care Act.
“Access to health care should be a right, and not just a privilege of those who can afford it,” Harris said. “And the plan has to be to strengthen the Affordable Care Act, not get rid of it.”
The Biden administration Tuesday released data showing that nearly 50 million Americans have obtained health coverage through the Affordable Care Act’s health insurance exchanges since they were established more than a decade ago, helping lower the national uninsured rate to record lows in recent years.
Republicans have charged that Affordable Care Act enrollment has been inflated by fraudulent sign-ups and overly generous subsidies. White House officials this week dismissed those claims of fraudulent enrollment as driven by a “handful of bad actors” who have wrongly enrolled ineligible people in coverage and not a widespread problem.
In a statement released before the debate, President Joe Biden touted his work with Harris to further subsidize the cost of plans sold through the Affordable Care Act and do away with red tape, drawing a contrast with Republicans who voted dozens of times to repeal the law and nearly succeeded under Trump.
“Vice President Harris and I have worked tirelessly to protect and build on the ACA,” Biden said. “We know Republican officials will stop at nothing to get rid of the Affordable Care Act.”
Harris reminded debate watchers that a Trump-backed plan to do away with the law fell one vote short, when then-Sen. John McCain (R-Ariz.) dramatically voted against Republicans’ repeal bill in the middle of the night seven years ago.
“The late, great John McCain, I will never forget that night,” Harris said, recounting the senator’s surprise decision to block the bill, as she needled Trump. “Walked onto the Senate floor and said, ‘No, you don’t.’”
Trump insisted he had been a good steward of the Affordable Care Act during his time in the White House, blaming Democrats for preserving a law that he inherited and immediately deemed to be flawed.
“I had a choice to make when I was president. Do I save it and make it as good as it can be?” he said Tuesday night. “And I felt I had an obligation, even though politically it would have been good to just let it rot.”
Current and former Trump aides have insisted the former president deserves credit for some of his changes to the Affordable Care Act’s programs.
“President Trump did inherit an ACA market with rapidly rising premiums and insurers withdrawing from markets leaving many enrollees with choices of plans from only one or two insurers,” Brian Blase, a former Trump White House policy official, wrote in a commentary published Wednesday.
“His policies helped stabilize that market while opening options for small businesses to offer more affordable coverage (association health plans and individual coverage health reimbursement arrangements) and middle-income families to buy less regulated and more affordable coverage,” Blase wrote.
But the Trump administration also supported efforts to overturn the law in court while rolling back advertising and outreach to help people sign up for Affordable Care Act plans. Public health experts have criticized the skimpy, less-expensive health coverage options introduced under the Trump administration, which provide more-limited benefits than required under the Affordable Care Act.
Pressed by debate moderators, Trump admitted he has only “concepts of a plan” to replace the Affordable Care Act, despite spending years calling for the law’s repeal.
“If we can come up with a plan that’s going to cost our people, our population less money and be better health care than Obamacare, then I would absolutely do it,” Trump said.
The Harris campaign said Trump’s vague comments were intended to hide his intent.
“Trump knows how unpopular his position is, which is why he’s hiding behind ‘the concept of a plan’ and refusing to provide any details,” Mia Ehrenberg, a Harris spokesperson, said in a statement. “We all know what that ‘concept’ is because it’s the same concept he spent his entire presidency on: gutting and replacing the ACA.”
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Graphic:
https://washingtonpost.com/documents/521e9848-fa4b-40ad-aa80-5fe03f86c7b1.pdf
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