OP-ED: Trump health-care miss gives Democrats a perfect pivot
Just as things were starting to look better for President Donald Trump, he seems intent on squandering any political advantage.
Republicans lost big in the 2018 midterm elections due in large part to failed efforts to dismantle the increasingly popular Affordable Care Act. Instead of learning a lesson, the Trump administration is doubling down.
The Justice Department took a more extreme position in an ongoing legal challenge to the law Monday night, saying that the whole thing should be thrown out instead of just in part. If the lawsuit succeeds, millions would lose coverage and many millions more would again face discrimination and higher costs based on pre-existing conditions.
The decision is a gift for Democrats. It allows them to refocus on an issue they know is a winner and unite the party behind a common cause as they figure out where to go next in health care.
It’s hard to understand President Trump’s reasoning; he’s been hit over the head with evidence that his health policy positions aren’t popular. The ACA’s pre-existing condition protections poll well across party lines, and the midterms weren’t just a victory for Democrats who picked up seats. The law’s Medicaid expansion, which would be evaporated by the lawsuit, was approved via referendum in several Republican-leaning states. Even ruby-red Kansas is currently considering expansion.
The case in question stands on shaky legal ground and is unlikely to succeed. But fully supporting a lawsuit that would create widespread chaos makes the president’s priorities very clear.
This isn’t an isolated incident; the administration has consistently supported policies that would reduce coverage and protections for vulnerable Americans. Its recently released 2020 budget pushes a repeal of big parts of the ACA and massive cuts to Medicaid.
Democrats — still smarting from the completion of the Mueller investigation, which wasn’t as politically damaging to Trump as some of them had hoped — couldn’t have asked for better timing.
The bills House Speaker Nancy Pelosi and other Democrats highlighted on Tuesday afternoon aren’t earth-shattering and may stall in the Senate. They might even have been ignored, but the DOJ just offered a free amplifier. These proposals would have a substantial impact on Americans by improving the cost and quality of individual-market coverage. Even if they go nowhere, they put Republicans in an awkward spot. It’s important to remember that many voters, when asked, say they care more about health-care access and affordability than anything involving Russia.
Some Democrats, particularly those looking toward 2020, would rather focus on efforts to expand government coverage in more comprehensive ways, such as Medicare-for-All. But there are still substantial internal disagreements on exactly how to approach universal coverage. In the meantime, it’s nice to have an effort that the whole party should be able to get behind.
There’s a lot to be said for pushing for policies that would help people rapidly as ambitious longer-term plans are developed; it doesn’t inherently have to be either-or. Many expansion proposals use parts of the ACA or retain it as they’re phased in. Efforts to protect the ACA also could help the party target people that are less comfortable or familiar with these plans. Medicare-for-All is abstract; high premiums and the possibility of losing coverage are immediate.
Democrats will have to strike a difficult balance on health care. But the president’s inexplicable commitment to damaging and unpopular policy makes their job much easier.
— Max Nisen is a Bloomberg Opinion columnist covering biotech, pharma and health care. He previously wrote about management and corporate strategy for Quartz and Business Insider.