The DHHS leadership supports Trump, and that includes besmirching former President Obama and his achievements. That, then, includes letting him get away with claiming, for 2020, that he accomplished getting rid of the ACA. That is their goal, too.
So please spare me the accolades about what DHHS and CMS are trying to do—the agency’s leadership want to keep their jobs and couldn’t care less about the catastrophic effects of their policies on a large percentage of the US population.
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Wait... the GOP has health initiatives? No- it doesn’t ....it has offered bandaids to a crisis. These ‘bandaids’ use aspects of the ACA which the GOP wants to completely repeal, —-without having a clue, or a single policy idea to replace it with. This is the best they come up with after years of trying to repeal the ACA. How pathetic. Vote them out!!!
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Mr. Trump is completely clueless about healthcare policies and how they work and furthermore he doesn’t really care.
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Innovative payment schemes for health care.....by the GOP?
All they do is raise our premiums, legislate for Pharma and insurance companies....because.....they told us ....they need to pay back their donors.
(Almost all of Congress is elected by out of state money.)
2
trumpCARE: Make the US population the most unhealthiest
on the planet. Bankrupt them in the process.
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Once again, the Trumpians will destroy the medical village in order to save it. Their concern for medical care is dictated by political contributors, not the healthcare needs of America.
5
Trump has a health initiative?
5
If the courts strike down the ACA, Trump, being the authoritarian he is, will recreate by executive order the parts of Obamacare he likes. Declaring "I'm the only one" who fixed it!
4
Pardon the skepticism but the GOP replacement bill has been a work in progress for almost 12 years. Nothing and whatever initiatives Trump envisions should the Courts find Obamacare unconstitutional inadequate times a large multiple.
4
I wonder when the average American voter, particularly Trump supporters will notice that Trump and the entire Republican party have no intention of providing them with meaningful health care for them and their families. This is a dire need for moderate income voters;yet people like Mitch McConnell tell voters they will NOT allow anyone to change their Kentucky care and when the election is over, McConnell worked hard to stop Obamacare which is the basis of Kentucky care.
McConnell and other Republicans have no interest in financially helping their fellow citizens afford health care. All Americans should have the same health care insurance that the US Senate gives its members.
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@Frank Stone It's been years now since Republicans announced they would offer an alternative to the ACA, but we've seen next to nothing. The point is, they have no plan and really wish to return to pre ACA times. That was when health insurance was available through an employer or through astronomically high rates for individuals. Self employed workers saw rates go through the roof.
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Understandable amount of ranting here. But sometimes the lieutenants working for Trump do some worthwhile stuff - the initiatives around payment for kidney care, for example, and other reforms introduced by HHS Sec. Azar and CMS Dir. Seema Verma. This isn't to overall support Trump but to highlight that - kinda like everything in life - the picture in mixed. Meanwhile, I think Trump is backing the court case against Obamacare with the expectation that it will not be successful (so that he can manipulate his position going into the election). Not sure what happens if he is wrong and the courts actually let Obamacare unfold (but unlikely in my view, and according to a lot of court observers).
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I don’t know of any civilized country that puts so much effort in denying health care to its residents. USA exceptionalism.
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The Democrats wiped the Republicans in the 2018 House races on the issue of healthcare. So go ahead Republicans wipe out healthcare for 21 million in the run up to the 2020 elections. I double dog dare you.
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@mr.d
Exactly! And that is why the Democrats should stay on message about this.
However, if they swerve and concentrate on immigration, they might turn 2020 into an enormous Red Tide.
They need to worry about Americans who are suffering and struggling at different levels: Health care, housing, hunger, employment, poverty.
They also need to do something about the impeachment conundrum. Either drop it, or do it.
1
Exactly. Dems should shut up about immigration. It’s Trump’s only issue. When the republicans had all three houses, they did not vote for, or pay for the wall. Let him start the wall. Even republicans won’t pay for it. The effort will founder (flounder?) Take the wind out of his sails. Pull the rug out from under him. He really has nothing to offer but his prejudices, anger and hatred.
What was that about "Trump's own health initiatives"?
From the NYT: "(Trump) killed a proposal on Thursday that would have reduced out-of-pocket costs for older consumers out of concern that it would raise premiums heading into his re-election campaign."
So much for THAT Upshot claim!
11
How else can you pay for tax cuts to the richest of rich in America if you don't cut spending at the same time. What's left are critical social programs (being funded by wage earners tax withholdings) and the well connected outsourced Pentagon. If the rich don't pay taxes, there just isn't enough money to go around.
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Am one who hopes that The Affordable Health Care Act gets overturned. Chaos in healthcare will be the result. Hopefully enough chaos to tilt the 2020 election to the Democrats. Maybe even the despicables and deplorables will finally realize that their vote for Trump in 2016 put the country on a downward spiral that needs to be reversed quickly.
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@Terry And if you get your wish, how many Americans will suffer and/or die before the 2020 election rolls around and Trump would still be in office until 20 Jan 2021. Even after that it would take a Democratically-led WH and Congress a while to get a new healthcare program up and running. How many more people would suffer and die before healthcare was restored? Be careful what you wish for in your desire to wipe out GOP control.
1
JRB, I get your point but, I am sick of white rural Americans voting against American’s best interests, and then wondering why things aren’t better, but getting worse. Farmers voting for Trump? Are they serious? There is no global warming? Trade wars are easy to win? I have very little sympathy. Where do they get their news? Fox. The news organization run by an Australian hustler.
1
Any fool can see that even the Trump base, if they have health insurance, loves certain provisions of the ACA, like preventative care and coverage of pre-existing conditions, to say nothing of keeping kids on parents' insurance longer. Seniors like the improved Medicare coverage.
Trump will rue the day if he is successful in repealing the ACA.
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Only intent on undoing Obama, Trump gets lost trying to do anything positive.
It may take decades to undo Trump and Putin and to restore American Decency.
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If the Republicans decided a Supreme Court ruling against the ACA were too much for them to bear, could they just reimpose the penalties for not signing up for insurance? The reimposed penalties could be less than what they were before. In doing this the "tax" upon which Roberts based his opinion affirming the ACA would again be in place, rendering the whole issue moot.
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@Tom Cluster
That's kinda what I was thinking. It also justifies the appellate court keeping Obamacare in place. Congress can change the penalty from $0 to any other amount at any time.
1
Any USA Senator or Congressman HAS guaranteed lifelong HEALTH INSURANCE.
Including #45
None of them give a hoot about voters!
Take away their PERK and see what happens.
Don't get fooled again...
42
Trump’s administration has no back up plan if the courts rule in their favor in overturning Obamacare. This is all driven in the Republican Party’s obsession with repealing Obamacare, never mind a replacement. Republicans from Donald Trump on down will rightfully reap what they’ve sown if after a decade of opposition to healthcare reform they finally get their way. But the 20 million Americans covered will pay the price.
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@Eric I do not believe Republicans want to replace the ACA at all, or they would be seriously working on an alternative. It's been years, after all. They would prefer we return to the pre ACA days when insurance was even MORE expensive than under the ACA, when it was likely you'd be dumped from your health insurance for a pre-existing condition (and who doesn't have any?), and the self employed like myself were nearly bankrupted by increasingly expensive individual plans. Republicans should just be honest about their intentions, but of course they will not be.
2
Really. I recall thinking the same about Paul Ryan’s health plan, or lack of one. Why didn’t he just come out and honestly say: I don’t think poor people deserve healthcare, unless they can pay. Come on, if you believe that, have the guts to come out and say it.
The administration actually DOESN'T HAVE any health initiatives, so I don't know what this piece is all about. It only has a blithering idiot going to rallies and lying about having one involving some sort of preexisting protections (a lie) in a health care "plan" not even on paper.
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I think Trump’s utter opposition to Obamacare is a manifestation of his total hatred of Barack Obama.
Hatred that deep—it is shared widely for Obama in the GOP leadership—is seldom rational.
You dig holes with that kind of hatred, then accidentally fall into the holes you have dug.
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@Paul McGlasson Mitch McConnell, of evil fame, "named" "Obamacare", in order to bring it down. Had he kept his mouth shut, we would have an "Affordable Care Act" that everyone would love -- even Republicans! Imagine -- even Republicans like having health insurance -- as long as it's called Health Insurance. Affordable health insurance (as in "Affordable Care" -- loved by all. Put a loathsome name on it, though, and you can get otherwise sane people to run in the opposite direction. Chalk another one up to Mitch McConnell -- he knows how to win elections by denying people healthcare!!!!!
8
@sacques Sadly, headline writers at newspapers had more to do with renaming the Affordable Care Act as “Obamacare” — because it fit into short-count headlines — falling into the hands of Republicans who loved to demonize our first black president.
@Paul McGlasson
(Hatred that deep.....it’s called jealousy for a man who is everything Trump knows he’s not.)
1
Sounds more like a circular firing squad to me...except, of course, it's the people who lose the most
15
As an Australian who enjoys very good public healthcare I would love to try and understand what's happening with Public Healthcare in the USA...can anybody enlighten me?
7
@Paul deTorch The gnawing and all consuming fear that someone, somewhere and probably with darker skin than me is getting a sweet deal that I am not getting. It is the politics of spite and the culmination of centuries of American elites' de facto enslavement of the rest of us. Americans have been taught well that how you treat those with less than you have, that is what is going on.
27
@Paul deTorch Sorry Paul, we are just in a big mess over here......
7
@Paul deTorch Too many big-money vested interests trying to convince the uninformed that public healthcare is a give-away of their "hard earned dollars" to undeserving leeches. The system needs to go down in flames before it can be rebuilt. Half-hearted compromises and band aids to our private healthcare system will never work.
7
The Upshot claims that, "President Trump and his health officials are busily using the (ACA) to pursue key proposals."
But when reading closely, it turns out that virtually all of these pursuits are only intentions or experiments. Indeed, The Upshot should point out that overwhelmingly, the Trump administration has engaged in an all-out assault on the ACA, destroying the insurance mandate, eliminating critically important subsidies that were responsible for a major increase in insurance premiums shortly after Trump came into office, and repeatedly attempting to eliminate the entire law.
The Upshot's belief that Trump is "busy" advancing healthcare initiatives appears more akin to a belief in the Easter Bunny and Santa Claus.
40
Experimenting and testing proposals is precisely what the relevant section of the Affordable Care Act does. To quote the article, the ACA establishes this "innovation authority. It allows Medicare and Medicaid to test strategies for paying for medical care in pursuit of ways to lower costs and improve the quality of care."
1
As always, you need to follow the money. Invalidation of the ACA would eliminate the associated Medicare and capital gains taxes that form part of the law (for joint filers with AGI above $250,000, those amount to an extra 0.9% in Medicare taxes, plus an additional 3.8% in long term capital gains taxes, including on home sales). Those two taxes cost taxpayers over $37 billion in 2018, a cost borne exclusively by a core GOP constituency (married couples with AGI over $250K). 85% or more of the US population are covered by group health insurance, and those group plans do not impose preexisting conditions limits, and will voluntarily retain popular bits of the ACA (kids on parents cover until 26) for competitive reasons.
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@Richard
Thanks for pointing out another complexity. or rather series of consequences, that is missed in most commentaries.
It gets ever more convoluted. 85% of the population may be covered in some way by group plans, but the plans differ greatly in who is ultimately paying.
And by group: "Of those with insurance, most (67.2 %) had private coverage. More than half of the population—56 %—has employer-sponsored coverage, followed by Medicaid (19.3 %), Medicare (17.2 %), individual market coverage (16 %), and military coverage (4.8 %).Sep 13, 2018." from www.healthaffairs.org
7
Good article, though given how what you are describing is that what you explain here is slightly complicated the chances that Trump himself would understand any of it are exactly zero.
34