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With Joe Biden sworn in as president, the long wait for Donald Trump’s health care plan is now officially over. If he ever had one, no one ever saw it.
Trump began promising the plan shortly after the official launch of his first campaign. “I am going to take care of everybody,” he told “60 Minutes” in September 2015, adding in a January 2016 interview with the Washington Post, “We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”
After taking office, the realities of overhauling a system that makes up one-fifth of the U.S. economy settled in as Republicans attempted to hammer out a replacement for the Affordable Care Act, or Obamacare.
“Now, I have to tell you, it’s an unbelievably complex subject,” Trump said in February 2017. “Nobody knew health care could be so complicated.”
Anyone with even a passing interest in or experience with health care knew how complicated it was, but apparently not the president, who went ahead to promise the insurers in the same meeting, “We have a plan that I think is going to be fantastic. It’s going to be released fairly soon. I think it’s going to be something special. … I think you’re going to like what you hear.”
Since they never got to hear it, it’s hard to say how they might have reacted.
The insurers never heard a plan from the president, but the public was not thrilled with the American Health Care Act, the replacement legislation proposed by congressional Republicans. A May 2017 Quinnipiac poll found support for the AHCA at just 21 percent. A July 2017 study by an MIT professor found that the AHCA was the least popular legislation in three decades, with studies finding that the party’s proposal would cause millions to lose their health insurance. The AARP estimated it would raise health care costs for older Americans by thousands of dollars. Researchers also found that thousands more Americans would have died prematurely if the Obamacare replacement had passed.
The repeal-and-replace efforts failed, and Democrats ran on health care in the 2018 midterms to great success. Undeterred by the prior failure and still yet to produce a plan of his own, Trump promised Sean Hannity in a March 2019 interview “incredible health care that the Democrats, frankly, wouldn’t know how to do.”
The use of “incredible” — whose literal meaning, contrary to Trump’s intention, is “not to be believed” — should have been a tip-off.
In April 2019, he said in a tweet: “Republicans are developing a really great HealthCare Plan with far lower premiums (cost) & deductibles than ObamaCare. In other words it will be far less expensive & much more usable than ObamaCare.” In June 2019, he said he would be introducing a “phenomenal” plan that would “be less expensive than Obamacare by a lot” and that he’d be presenting that proposal “in about two months. Maybe less.”
Two months from June 2019 was August 2019.
It didn’t come in “maybe less” than two months, but more than a year later Trump returned to that refrain. In July 2020, he told Fox News’ Chris Wallace that he’d be “signing a health care plan within two weeks, a full and complete health care plan.” Two weeks later, he reiterated the claim at an Aug. 3 White House briefing.
“I do want to say that we’re going to be introducing a tremendous health care plan sometime prior, hopefully prior to the end of the month. It’s just about completed now,” Trump said. “We’ll be doing, sometime during this month, the health care plan, and I think that’ll be before the end of the month and I think it will be very impressive to a lot of people.”
August passed with no plan, but in September the White House held a campaign event where Trump touted an executive order that would protect Americans with preexisting conditions from losing the protections that were created under the ACA.
White House officials admitted that Trump’s “protections” for preexisting conditions represented a “defined statement of U.S. policy,” but without a legal mechanism to enforce (or pay for) them, it was a hollow promise. The protections would essentially lapse if the ACA were repealed (as Republicans had been saying they’d wanted to do ever since it passed) or overturned by the Supreme Court, which had a lawsuit pending seeking to do just that.
The lawsuit had been brought by a number of Republican-run states, and the Trump administration had joined it. Two justices, soon to be joined by a third, had been appointed by Trump, from a list vetted by the Federalist Society, a right-wing judicial organization.
Without the protections for preexisting conditions provided by Obamacare, the Kaiser Family Foundation estimated in 2016 that up to 52 million people could be denied coverage. Millions more would lose insurance if the optional Medicaid expansion in the ACA, which was adopted by dozens of states and Washington, D.C., were killed.
Trump’s effort to replace Obamacare with a nonexistent plan of his own did have one clear effect: It made his predecessor’s signature achievement more popular. A Fox News poll last summer found that a record high of 56 percent of Americans had a favorable view of Obamacare; a September Morning Consult poll pegged it at 62 percent; and December tracking from the Kaiser Family Foundation found 53 percent in favor. A September New York Times/Siena College poll showed not only majority support (55 percent) for the ACA but also 67 percent backing for the plan supported by Biden, supplementing Obamacare with a “public option” of a government-run health care plan.
During the first presidential debate, on Sept. 29, Biden attacked Trump for having no health care plan. The incumbent responded by saying, “We want to get rid of [the ACA] and give something that’s cheaper and better.”
He did not say what the cheaper and better plan would be, and now it seems we’ll never know.
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