Donald Trump signed the regressive Republican tax plan into law this morning, and in the process, repealed the individual mandate in the Affordable Care Act. The president, complaining at length about the policy that the GOP used to support, said this is “the end of Obamacare,” adding, “Essentially, I think Obamacare is over.”
Of course, Trump, who’s long struggled to understand the basics of the debate, has made similar assessments countless times this year – and in every instance, the president has been wrong. What I’m especially interested in now, however, is why he thinks this is “the end of Obamacare.”
“We – I hate to say this – but we essentially repealed Obamacare because we got rid of the individual mandate, which was terrible. And that was a primary source of funding of Obamacare.”
After a year and a half on the campaign trail, and 11 months in the White House, Trump really should have a better sense of basic details. The president thinks the “primary source of funding” for the Affordable Care Act is the individual mandate, which isn’t even close to being true.
But it does help shed light on the Trump’s confusion. He’s apparently under the impression that the ACA is “over” because he just took away the system’s funding source. That’s ridiculous, but it’s what the president seems to believe.
Trump may be disappointed, however, when someone tries to explain to him what’s actually happened.
What the president and Republicans did was weaken the American health care system, for purely political reasons, in ways that will destabilize markets, push costs higher, and increase the ranks of the uninsured.
But “Obamacare” isn’t dead. Medicaid expansion is intact, as are protections for those with pre-existing conditions and subsidies to consumers. The GOP policy will undermine the system, but it won’t kill the system.
Complicating matters is the politics of the fight. Trump and his party now own the mess they created, and in a 51-49 Senate, the odds of Republicans passing a far-right health care plan of their own are poor, at best. If Democrats take back the House, those odds drop to zero.
Indeed, Senate GOP leaders – no doubt feeling once bitten, twice shy – conceded this week that the push to repeal and replace “Obamacare” now appears to be over, as the party moves on to other priorities.
That leaves the party in an exceedingly awkward place: taking ownership of a health care system they’ve deliberately damaged and aren’t prepared to fix. The debate may be complex, but there’s one thing everyone will understand: Republicans have no one to blame but themselves.
Postscript: The repeal of the mandate will save the government billions, which GOP policymakers just handed over to the wealthy and big corporations in the form of tax cuts. If and when Republicans were to consider a serious attempt at health care reform, that will be vastly more difficult with far less money at their disposal.