In Democratic and progressive circles, Americans' right to health security is a given, on par with citizens' rights to public education and access to clean water. But in Republican circles, the resistance to such an idea is strong. Once the public believes Americans are entitled to affordable health care, simply as a basic component of citizenship, GOP policy in this area becomes untenable.
It was therefore surprising to see Sen. Bill Cassidy (R) of Louisiana offer these comments
to the New York Times
"The folks who Hillary Clinton called the 'deplorables' are actually those who want better coverage, who we'd be hurting if we don't change this bill," Mr. Cassidy said, noting that Mr. Trump promised "he'd give them better care."The senator, a physician who once worked in his state's charity hospital network, bluntly said that the philosophical debate was over and that his party ought to be pragmatic about how best to create a more cost-efficient and comprehensive health care system."There's a widespread recognition that the federal government, Congress, has created the right for every American to have health care," he said, warning that to throw people off their insurance or make coverage unaffordable would only shift costs back to taxpayers by burdening emergency rooms. "If you want to be fiscally responsible, then coverage is better than no coverage."
that this is roughly in line with the attitudes of many Republican voters themselves: the latest Pew Research Center report found that most GOP voters who make below $30,000 a year "believe the federal government has a responsibility to ensure health coverage for all."It's an important development for a few reasons. First, it's a reminder as to why congressional Republicans fought tooth and nail to kill the Affordable Care Act in the first place: once Americans have an important social-insurance benefit, and families come to rely on it, scrapping the benefit becomes politically unrealistic.If "the right for every American to have health care" now exists, Democrats and Republicans can argue about the details of how best to recognize that right, not whether the right deserves to be recognized in the first place.Second, acknowledgements like these reinforce the impression that Barack Obama transformed the nature of the conversation. Indeed, much of the current health care debate is playing out on the terms the former president defined several years ago. The idea that a conservative Republican senator from a red state would acknowledge "the right for every American to have health care" would've been very hard to believe before the Obama era.And finally, comments like Cassidy's raise questions anew about whether Donald Trump and his team agree about Americans' "right" to affordable health care. The president, of course, is on record vowing to Americans
that his approach to health care will produce a specific result: "We're going to have insurance for everybody."But note what happened yesterday on CBS's "Face the Nation" when host John Dickerson asked Mick Mulvaney, Trump's far-right budget director, about this
DICKERSON: You mentioned getting care. The president has said as a candidate, he said about health care, "there was a philosophy in some circles that if you can't pay for it, you don't get it," meaning health care, "that's not going to happen with us." He's talking about universal care there. That's not -- you're not going to have universal care after these changes.MULVANEY: We don't have universal -- the only way to have universal care, if you stop to think about it, is to force people to buy it under penalty of law.
Asked again about Trump's promise to voters, the OMB director added
, "Again, universal -- the only way to get truly universal care is to throw people in jail if they don't have it."He seems to be referring to the individual mandate -- a policy many Republicans agreed with until Obama endorsed the policy -- and as Mulvaney should probably understand, the penalty for those who choose to go without coverage is a fine, not imprisonment.Regardless, the White House dispatched Mulvaney to the Sunday shows, where he effectively declared an end to the president's unambiguous vow to cover everybody.As for Sen. Cassidy's belief that "the right for every American to have health care" now exists, it appears Team Trump disagrees.