SCOTUS Fight Will Highlight GOP’s Health Care Liability

On Monday, President Trump promised his familiar fiction of a surprise health care policy in a tweet storm from Walter Reed medical center. A barrage of nearly 30 all-caps, Trump-style campaign sloganeering included this gem: “BETTER & CHEAPER HEALTH CARE. VOTE !” Laughable as it was, he topped himself on Wednesday. In a video boasting he had been cured of the coronavirus (there is no cure) and was blessed to have been infected by it, Trump announced he would be making an experimental antiviral medication produced by Regeneron available to everyone free of charge. 

Just as a medicine not even cleared for emergency-use authorization, and which only 10 people have taken, will most certainly not be accessible to all Americans suffering from COVID-19 — let alone for free — Trump has not and will not provide cheaper and better health care. 

There are many things Republicans, desperate to hold on to their Senate majority, don’t want to talk about right now — our president possibly being Patient One at a super-spreading event at the White House; his erratic behavior since getting sick and beginning a steroid; shutting down stimulus talks, then starting them up; his refusal to attend a virtual debate next week.  But how politically exposed the president and his party are on health care, while Democrats enjoy double-digit polling leads on the issue, is also high on the list of things Republicans don’t want to talk about just weeks before the election. 

In hearings starting Monday to confirm Judge Amy Coney Barrett to replace the late Justice Ruth Bader Ginsburg on the U.S. Supreme Court, Democrats will be talking about the case coming before the court that the Trump administration supports, which would dismantle the 2010 health care law. Oral arguments begin Nov. 10, one week after Election Day, and Barrett is expected to provide an additional vote against the ACA. A ruling is anticipated by June of 2021. 

Democrats on the Senate Judiciary Committee, and in campaigns across the country, are united in keeping the central argument against Barrett’s confirmation Republican plans to invalidate the health care program, leave 20 million Americans uninsured and destabilizing the entire system. During a once-in-a-century pandemic, it’s an argument worth making.

The defining issue of the 2018 midterms, which gave control of the House of Representatives back to Democrats, was health care reform. Republicans not only hadn’t repealed and replaced the Affordable Care Act, a more than seven-year-old vow, but they had undermined what was left of it — eliminating the individual mandate to purchase coverage. Without younger and healthier people in the exchanges, costs rose and options dwindled for the remaining subscribers. In poll after poll to this day, the ACA remains more popular than President Trump.

Even before coronavirus, the GOP watched the issue of Medicaid expansion grow more popular everywhere, including among their own voters. Republican losses in gubernatorial races in Kentucky and Louisiana in 2019 – largely because of this issue — energized Democrats to campaign on it this year in swing states where Medicaid expansion has yet to pass, including Wisconsin, Georgia, Florida, Texas and North Carolina.

Earlier this year, Republican health care messaging was to rail against “Medicare for All,” assuming Sen. Bernie Sanders as the Democratic nominee, but the campaign against socialized medicine ran aground when Joe Biden suddenly sewed up the nomination in March. Without that target, many Senate Republican incumbents are avoiding the issue in their campaigns, talking up helpful pandemic response measures they were involved in coordinating for their states, such as the delivery of personal protective equipment. 

It’s not as if Republicans haven’t known this was coming, but they’re really trying to keep it quiet, unlike the president. Trump’s instinct has been to continue to draw attention to this consequential weakness by repeatedly promising skies full of pies and branding the GOP “the party of health care.” Trump told Chris Wallace in an interview July 19 he was preparing not only to introduce but to sign into law a finished plan — in two weeks. “We’re signing a health care plan within two weeks, a full and complete health care plan,” he said. 

The fantasy health care plan stands atop Trump’s Greatest Hits list; it is always just around the corner. “You’re going to have great health care, at a tiny fraction of the cost — and it’s going to be so easy,” Trump promised during his campaign in 2016. It was anything but easy, and when they failed to deliver, the president and Republicans cut bait.

In May of 2018, it was four weeks away. Again. Then, a year later Trump told George Stephanopoulos on ABC News that “there was a concept of a plan” and his administration “would be announcing that in about two months, maybe less.” Last spring Trump continued to promise that a plan was coming that would be voted on “right after the election” and that would be “on full display during the Election as a much better & less expensive alternative to ObamaCare” – a plan Senate Republicans said didn’t exist. Once again they refused, no matter the tweets, to propose a bill. 

Last month Trump told Stephanopoulos at an ABC town hall, “I have it all ready. I have it all ready.” The full and complete failure came into view on Sept. 24 when Trump announced an executive order saying it was the policy of the administration to protect people with preexisting conditions. No plan, no policy, and no details on how those patients would be protected against discrimination from insurance companies. No surprise, you’re not hearing Republicans touting the executive order on the campaign trail. 

A recent Commonwealth Fund poll found that in 10 battleground states a majority of voters said former Vice President Joe Biden is more likely to protect insurance coverage for people with preexisting conditions. And a new Navigator survey found 51% of respondents wanted Congress and the president focused on the COVID-19 pandemic, while 40% of them wanted the government to focus on health care policy. 

Trump’s erosion of support among seniors, loyal voters he won in 2016, could be the linchpin to a Biden victory. So they got more than a toothless executive order — the administration announced $200 drug discount cards are being mailed to 33 million seniors, the cost for which is estimated at $6.6 billion. After Trump couldn’t convince the pharmaceutical industry to pay for $100 coupons, the administration is moving forward with nebulous authority to locate the funds in the Medicare program. Or maybe we will never hear of it again. But the candidate was quite excited about them in making the announcement. “Nobody’s seen this before, these cards are incredible,” Trump said. “I will always take care of our wonderful senior citizens. Joe Biden won’t be doing this.”

Just as his shambolic response to the coronavirus pandemic made seniors feel expendable, Americans of all ages are far more likely to be focused on their health care after the pandemic than they were before. 

After Election Day, we will know just how much. 

A.B. Stoddard is associate editor of RealClearPolitics and a columnist. 

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