In recent years, health care advocates had a trump card to play when asked if the Affordable Care Act was working: the uninsured rate had dropped to the lowest point on record.
There were all kinds of reasons to tackle health care reform, but at the core of the ACA was the goal of bringing health security to Americans who lacked it. And on this aspect of the debate, progressives have enjoyed the better hand: once "Obamacare" became law, the number of insured Americans improved, and kept improving throughout Barack Obama's second term.
A new report on the uninsured rate, compiled by Gallup and Sharecare, suggests we've started to replace progress with regress.
The percentage of U.S. adults lacking health insurance rose in the third quarter of 2017 to 12.3%, up 0.6 percentage points from the previous quarter and 1.4 points since the end of 2016. The uninsured rate is now the highest recorded since the last quarter of 2014 when it was 12.9%.
To be sure, this may look like a modest uptick, affecting a relatively small percentage of the population. But (a) that doesn't make bad news good; (b) if your family is part of that increase, you probably don't care how small the percentage is; and (c) there is widespread concern throughout the health care sector that the uninsured rate will continue to move in the wrong direction as a direct result of Donald Trump's aggressive antics, each of which appear designed to deliberately make the U.S. system worse.
The politics of this may seem bizarre, since political leaders generally don't take an issue, make it one of the centerpieces of their governing agenda, and then leave the nation worse off on purpose. But Trump World doesn't seem to think this will be a problem -- because they'll just blame the deterioration of the health care system on the Affordable Care Act itself.
It's like watching arsonists set fire to a sound structure and then blaming the building for being flammable.
It's likely the president doesn't understand any of this. Indeed, pointing to higher consumer costs this week, Trump declared, "Any increase in ObamaCare premiums is the fault of the Democrats for giving us a 'product' that never had a chance of working."
That's a nice try, I suppose, but we know he's wrong, in large part because insurers are acknowledging the simple fact that Trump is forcing costs higher through his deliberate efforts to destabilize markets.
The president's plan, in a nutshell, is to effectively tell the public, "Blame Obamacare for the damage I've done to Obamacare." That's nearly what Trump said earlier this week, arguing initially that the ACA is dead, before adding, “I think the Democrats will be blamed for the mess. This is an Obamacare mess.”
He was referring, of course, to the mess Trump himself created, in part by ignoring everyone in the industry and cutting off cost-sharing-reduction payments (CSRs).
Ezra Klein had a good piece on this the other day:
The problem with this theory is that Democrats no longer hold the White House, or anything else. Republicans, led by Trump, hold total power. They are the governing party, and they stand to absorb the blame for the state of the country. According to an August poll by the Kaiser Family Foundation, by a margin of 60 to 28 percent, Americans now say Republicans are now responsible for the Affordable Care Act. [...]
Trump’s view, as I understand it, has been that Obamacare is so thoroughly associated with Democrats that any problems it faces will be blamed on them. Ten months ago, he might have been right. But he is president now, and his compulsive monologuing of his own master plan has ensured that the country knows he is actively undermining the law, and is prepared to blame him for the results.
A Washington Post report added, "The Pottery Barn rule comes to mind: You break it, you own it. Yes, the plate you just shattered had some cracks in it. But if you dropped it on the ground, the store is going to blame you."
Even some in the president's party are acknowledging what is plainly true. Rep. Charlie Dent (R-Pa.) said this week, "We, the Republican Party, will own this."
Someone probably ought to let Trump know before too many more Americans get hurt.