A man holds a sign directing people to an insurance company where they can sign up for the Affordable Care Act, also known as Obamacare in Miami, Fla in 2015.
Photo by Joe Raedle/Getty

Donald Trump appears to have no idea what ‘Obamacare’ is

One of the day’s big headlines is both true and good news for Republicans: premiums for some consumers covered through the Affordable Care Act are going up sharply. With this in mind, Donald Trump and his campaign team, desperate to go on the offensive and talk about something new, decided it’d be a good idea to have the candidate put “Obamacare” up front and center today.

What didn’t occur to the Republican campaign, however, was something more basic: no one told Trump what the Affordable Care Act is, what it does, or how it works. So, more than six years after Obamacare was signed into law, Americans learned today that the GOP presidential nominee apparently has no idea what he’s talking about when he condemns the health care reform measure.

Here’s what Trump told Fox News this morning:
“Well, I don’t use much Obamacare, I must be honest with you, because it is so bad for the people and they can’t afford it. And like, for instance, I’m at Trump National Doral in Miami, and we don’t even use Obamacare. We don’t want it. The people don’t want it and I spend more money on health coverage, but we don’t use it.”
Trump went on to say that the Affordable Care is “gonna destroy the country.”

He seems to be under the impression that the entirety of the law is the availability of coverage through exchanges. That’s wrong. When he said, for example, that he his employees “don’t even use Obamacare” – an apparent reference to the subsidized marketplaces – what Trump may not realize is that consumer protections built into the ACA benefit everyone with private coverage, whether they realize it or not.

The Republican nominee, appearing with employees at the Trump National Doral Club near Miami, added today, “All my employees are having tremendous problems with Obamacare.”

Of course, if “all” of his employees are having “tremendous problems with Obamacare,” it suggests Trump’s workers don’t receive health coverage through their employer (namely, him). The club’s manager soon after clarified that the venue already provides insurance for nearly all of the facility’s employees, which means the premium increases won’t affect them.

Trump himself acknowledged soon after that almost none of his employees are “on Obamacare,” which is pretty much the opposite of what he’d said this morning. What explains the contradiction? By all appearances, the GOP candidate just doesn’t know enough about the Affordable Care Act to criticize it properly, so he made something up, not knowing how little sense it made.

For good measure, the Republican nominee also argued this morning that the administration’s figures on premium increases are actually “phony” – part of a plot from the White House to hide bad news from the public – despite the fact that the data is quite real. (In some areas, premiums are going down, in other areas, up. The average works out to an increase of about 25%.)

OK, so Trump is clueless in this area, but what about the underlying substance? The Republican nominee’s ignorance notwithstanding, don’t the premium hikes point to a serious problem for the ACA?

No one should characterize this as good news, but some of the details are getting lost in the shuffle. For example, the vast majority of Americans are covered through their employer, Medicare, Medicaid, or the VA. Those on the individual marketplace may face steep increases, but (a) it will depend a lot on where they live; (b) federal subsidies are also increasing, which will soften the blow and insulate most of those covered through the individual market; and (c) this will be a concern for a tiny percentage of the population.

Of course, if you’re in that sliver of the population, it doesn’t much matter whether or not you have a lot of company. All that matters for these consumers is that coverage is going to be a lot less affordable. The question then becomes what happens next.

For Republican policymakers and candidates, the solution is to repeal the Affordable Care Act, eliminate the subsidies and consumer protections, scrap the marketplaces, and move towards … well, no one really knows. Democrats, meanwhile, are eager to approve some patches and reforms, including some combination of tax credits and expanded subsidies for those affected by rate hikes, and it’s obvious this will be a major priority for Dems if they’re in a position to govern in 2017.

As for the broader Republican indictment against the law – it’s “blowing up” – the Affordable Care Act would benefit from some fixes, just like every major reform law that’s preceded it. But to argue that Obamacare is failing just isn’t true, as recent pieces from Jon Chait, Noam Levey, and Bob Kocher and Ezekiel Emanuel make clear.