The cognitive dissonance of the Republican National Convention reached an especially clangorous point Wednesday night when White House Press Secretary Kayleigh McEnany said President Trump supported her “as an American with a preexisting condition.”
I get that conventions are laden with hyperbole, especially when describing how the other party’s candidate will destroy America as we know it (or as we pretend it is). But time and again, speakers at the GOP's surreality TV show have ascribed traits and achievements to Trump that are so far removed from reality, you wonder what they’ve been watching for the last four years.
This goes beyond giving Trump sole credit for things Congress passed, such as the First Step Act — a criminal justice reform effort that Trump backed, but still a piece of legislation, not a royal writ. It’s speakers flatly declaring that Trump stands for or is doing the exact opposite of what he's actually said and done.
In McEnany’s case, the preexisting condition was a genetic mutation that made her dangerously susceptible to breast cancer — a fate, she said, that has befallen eight of her female relatives. She told the convention about the difficult choice she made in 2018, long before going to work in the White House, to have a preventive mastectomy.
“As I recovered, my phone rang,” McEnany said. “It was President Trump, calling to check on me. I was blown away.”
It impressed McEnany that the leader of the free world, whom she said she’d met only on a few occasions, would care enough to do that. “I know him well now,” she said, “and I can tell you that this president loves the American people, stands by Americans with preexisting conditions and supports working moms.”
She must mean “stands by” in the physical sense, as in he’s often surrounded by people with preexisting conditions. They are quite common, after all; according to the Kaiser Family Foundation, more than a quarter of U.S. adults younger than 65 have the kind of condition that, before the Affordable Care Act, would have made them “uninsurable.”
That's because Trump’s actions, and those of his administration, certainly haven’t supported people like McEnany.
Americans with preexisting health conditions are protected against insurance-company discrimination by a handful of federal laws that bar insurers from denying them coverage, limiting their benefits or charging them higher premiums. For people not covered by a group insurance plan, that protection comes from the Affordable Care Act — which Trump sought from his first day in office to wipe off the books or, failing that, to undermine to the point of uselessness.
Instead, Trump has backed a series of alternatives that would give insurers more ability to avoid covering expensive conditions. These include allowing business groups and trade associations to offer health plans that exclude some of the ACA’s essential benefits — presumably, the costliest ones — and letting insurers sell less expensive “short-term” plans that cover a limited set of conditions and flatly refuse to pay for treatments related to preexisting conditions. Such plans are often called “junk” insurance, and not for nothing.
Oh and yes, the Trump administration has encouraged states to kick impoverished Americans off of Medicaid by adopting more stringent work requirements. Happily, the federal courts have frustrated states’ efforts to do so, ruling that they violate the purpose of Medicaid — namely, to enable poor Americans to obtain healthcare.
Meanwhile, the administration continues to try to persuade the courts to jettison the ACA’s protections for people with preexisting conditions. It’s backing an implausible legal challenge by a number of Republican state officials that has somehow managed to make it all the way to the Supreme Court. Luckily for Trump, that case won’t be argued until after the Nov. 3 election.
For her own sake, McEnany should hope the court rejects her boss' argument. Come to think of it, she probably should hope Trump stops having any say at all in healthcare policy as of January. After all, she has a pretty serious preexisting condition.