Shefali Luthra, Kaiser Health News
President Donald Trump tried to take credit score for one of the crucial widespread components of the Affordable Care Act: Its safety for individuals who have preexisting medical circumstances.
“I was the person who saved Pre-Existing Conditions in your healthcare,” Trump tweeted Monday.
The safety for individuals with medical issues has been a rallying cry for Democrats, and so they used the problem to assist propel their widespread election victories in 2018.
Trump repeatedly has sought to align himself with this concern — in May, as an example, claiming he would “always protect patients with preexisting conditions.” We rated that claim False. His reelection marketing campaign has made comparable claims, which specialists debunked.
Trump’s latest declare that he “saved” that assure of protection provides a brand new twist, although. We contacted the White House to seek out out the idea for this assertion.
Judd Deere, a White House spokesman, advised us, “President Trump has repeatedly stated his commitment to protect individuals with preexisting conditions and his track record shows that he has consistently done what is necessary to improve care for the vulnerable.” Deere additionally pointed us to a spread of different coverage initiatives — akin to efforts on kidney well being, approving generic medication and loosening restrictions on short-term well being plans.
But none of these addressed the idea of Trump’s tweet.
The well being coverage specialists we consulted, nonetheless, have been unambiguous: The president’s declare has no factual foundation and flies within the face of his ongoing coverage efforts.
“I feel like we’re being gas-lit,” stated Linda Blumberg, a well being economist on the Urban Institute. “You can’t tell me you’re the savior of people with preexisting conditions when every single thing you’ve said or done is the opposite of that.” (Gaslighting means manipulating the telling of occasions in such a means it leads individuals to query their recollections.)
This skepticism endured throughout the political spectrum.
“That’s a rather extended version of aspirational rhetoric short of any evidence,” stated Tom Miller, a resident fellow on the conservative American Enterprise Institute.
The Preexisting Condition Protection
Under the Affordable Care Act, or ACA, medical insurance plans can not cost individuals greater costs as a result of they’ve a medical situation. This safety has been intact because the regulation took impact, underneath then-President Barack Obama.
As a 2016 candidate, Trump promised to repeal and substitute the well being regulation. That got here to a head in 2017, when the regulation got here inside one vote within the Senate of being undone.
“That tweet is part fantasy, part delusion, part politics and all lie,” stated Jonathan Oberlander, a well being coverage professor on the University of North Carolina-Chapel Hill. “The president is lying about preexisting conditions. He supported, and continues to support, efforts to repeal the ACA that would take those consumer protections away.”
After that effort, Blumberg stated, the president boasted that he had dismantled Obamacare — which isn’t solely unfaithful, however, she added, confused many shoppers.
Since then, the president has maintained his want to undo the ACA and substitute it with one thing new.
Neither his administration nor congressional Republicans have but supplied a substitute plan. None of the payments they’ve endorsed would preserve the ensures of protection for individuals with medical issues.
“By supporting repeal of the ACA, they’re supporting repeal of protecting preexisting condition prohibitions,” Robert Berenson, one other analyst on the Urban Institute, beforehand advised us.
Texas V. Azar
Meanwhile, the Trump administration’s work elsewhere may undo the safety.
A gaggle of Republican-led states are suing to have the whole ACA dismantled. Their argument stems from a regulation Trump signed: the Tax Cuts and Jobs Act of 2017.
That regulation gutted the person mandate — the ACA’s requirement that everybody have protection or pay a penalty — by lowering the penalty to $zero.
In this case, often called Texas v. Azar, the Republican states are arguing that the person mandate was central to the ACA and that, with out it, the whole regulation should be taken down. That would include the protections for individuals with preexisting circumstances.
The administration has declined to defend the regulation in courtroom, a transfer authorized analysts have known as nearly unprecedented. The case is broadly anticipated to go to the Supreme Court. Since the White House has unveiled no substitute, placing the regulation would go away a coverage vacuum, permitting well being plans to revert to discriminating in opposition to individuals with medical points.
Miller argued that the still-pending courtroom case and former repeal efforts don’t essentially imply there’s any imminent menace of the president gutting the ACA’s preexisting situation protections.
“For pure public opinion purposes, you want to say you’re protecting against preexisting condition protections,” Miller stated. “Does he know how to do it? No. Is he doing anything trying to change it? Not really.”
But others famous that the administration’s stance is firmly in opposition to sustaining the ACA’s prohibitions.
“The Democrats have correctly said the Trump administration has in fact opposed protections for preexisting conditions by endorsing the lawsuit,” Berenson stated.
Trump tweeted that he “was the person who saved Pre-Existing Conditions in your healthcare.”
The president had nothing to do with the ban on medical insurance plans discriminating in opposition to individuals with preexisting circumstances. This shopper safety is a core a part of the well being care regulation that grew to become regulation in the course of the Obama presidency. Trump has expressly supported the repeal of this regulation with out providing a substitute that might maintain the safety intact.
And to at the present time, his administration is arguing in courtroom that the regulation — together with this provision — ought to be undone.
The president’s tweet shouldn’t be solely unfaithful, nevertheless it misrepresents his administration’s efforts to repeal the well being care regulation with out providing any substitute that may preserve its core protections. We fee this declare Pants on Fire.
Kaiser Health News (KHN) is a nationwide well being coverage information service. It is an editorially unbiased program of the Henry J. Kaiser Family Foundation which isn’t affiliated with Kaiser Permanente.