The Trump administration is backing an effort to overturn the Affordable Care Act, the health care law that lets people sign up for private insurance on public marketplaces and protects people with preexisting conditions.
And the Trump administration just told the Supreme Court that they want the court to vote to get rid of the law — despite the pandemic. Democrats don’t want that to happen, but they also think this could be a winning campaign issue for them, and perhaps Trump just elevated it.
Trump holds a campaign rally in Michigan in 2019. (AP Photo/Manuel Balce Ceneta)
A quick look back at how we got here
During the Obama administration: A linchpin for Obamacare is that if you don’t have health insurance, you pay a tax penalty. That mandate has been challenged in court, and the Supreme Court upheld it.
2017: When Republicans held the White House and all of Congress, they tried to repeal Obamacare and replace it with their own law, but they failed.
Later 2017: When Congress passed a tax law a few months later, Republicans added in something to kneecap Obamacare: The penalty for not having health insurance is now zero dollars.
Shortly after: Republican attorneys general from 20 states saw an opportunity to get rid of the law. They argued that Obamacare is unconstitutional now that the government basically can’t tax people. It’s possible that a ruling in favor of their argument could wipe out preexisting conditions or even the entire law itself, potentially kicking more than 20 million Americans off health care.
2020: Coronavirus hit and tens of millions of Americans lost their jobs. Tens or even hundreds of thousands lost their health insurance, too. Nearly 500,000 Americans have signed up on HealthCare.gov as the economy shuttered. The Supreme Court agreed to hear the case on Obamacare, potentially in October. That probably means any ruling will come after the election.
Late Thursday night: The Trump administration filed a brief to the Supreme Court on this case, asking the justices to get rid of the entire law. “The entire ACA must fall,” they wrote of the Affordable Care Act.
So what happens now?
“Were the law to be invalidated it would obviously be catastrophic for a lot of people,” Gary Claxton with the Kaiser Family Foundation told me last year as this case was making its way to the Supreme Court. The Kaiser Family Foundation says nearly every American would be affected in some way, since the law reshaped how we receive health care (like that young adults can stay on their parents’ health insurance until they’re 26) and what companies can and can’t charge patients for.
Now we’re in a pandemic, and millions more are relying on their health insurance to help cover them when or if they get sick.
Trump is likely pushing this now in part because the court case is happening now, and because he campaigned four years ago on getting rid of Obamacare and still hasn’t done it.
Trump and Republicans have argued that they don’t want to leave people without protections to preexisting conditions. But that’s just what the Trump administration is urging the Supreme Court to do, and they have yet to put a new law together to replace it.
“I think the important thing for the public to know is there is nobody in the Senate not in favor of covering preexisting conditions … nobody,” Senate Majority Leader Mitch McConnell (R-Ky.) said around the time the court decided to look at this law. “And if it were, under any of these scenarios, to go away, we would act quickly on a bipartisan basis to restore it.”
But it’s not clear how or when they would replace the law with something else. Trump and congressional Republicans tried in 2017 when they had full control of Washington. We don’t know what the makeup of Congress or the White House will be by the time the Supreme Court rules on this, but any branch or chamber having Democratic control would be a roadblock for their plans.
Setting aside the health-care concerns, the politics of this could be a gift to Democrats
House Speaker Nancy Pelosi (D-Calif.) (AP Photo/Patrick Semansky)
Democrats won back the majority in the House of Representatives in 2018 after campaigning as the party that wants to protect people’s access to Obamacare. They specifically tried to focus on health care and not Trump.
They were helped by the fact that Obamacare got more popular as Republicans tried to repeal it. As Republicans grumbled at the time, it’s hard to be on the side arguing to take something away, even if they thought it was for the betterment of Americans.
Ask any Democrat in Congress today and they’ll still tell you that access to health care is among many constituents’ top priorities — and thus a valuable thing to campaign on. The pandemic has likely heightened people’s health care concerns.
From their perspective, Trump played right into their hands. If Democrats can elevate this as an issue, they could potentially set up a situation like the 2018 midterm elections again, but with a pandemic as the backdrop. And this time, the Senate majority and White House are in reach for them, too.
Scheduling note: Your 5-Minute Fix author will be off next week, but other Fix writers have you covered. Then the newsletter is taking a break entirely the week of July 6-July 10.