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Why Trump can’t stop attacking the Affordable Care Act

Donald Trump has little to gain from his incessant attacks on the ACA. It’s worth considering why the Republican is keeping the offensive going anyway.

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After leaving the White House in January 2021, Donald Trump spent nearly three years ignoring the Affordable Care Act. It’s not that the former president somehow became a convert to the merits of the ACA, but rather, the Republican took a far greater interest in lying about his election defeat and his successor than the landmark policy breakthrough from 2010.

But it was a month ago when Trump, seemingly out of nowhere, rediscovered his contempt for Obamacare, vowing to replace the nation’s existing health care system with an alternative he hasn’t shared. In the days and weeks that followed, the former president kept at it, attacking the reform law in increasingly strident terms online and at public events.

Late last week, the Republican posted a video to his social media platform vowing to “replace” the nation’s health care system with something “better” — he didn’t elaborate — while attacking the late Sen. John McCain for not helping him “terminate” the ACA in 2017. As The Hill reported, Trump kept the offensive going on Christmas day.

Former President Trump vowed Monday to replace the Affordable Care Act (ACA) with his own “much better” alternative program, reviving his push to slash the now-popular health care option used by millions of Americans. ... “I will come up with a much better, and less expensive, alternative! People will be happy, not sad!”

By any sensible measure, this entire line of attack is bizarre. Indeed, every time the former president renews his offensive against the ACA, it offers his opponents an opportunity to note that the Affordable Care Act is working very well and it’s about as popular as it’s ever been.

What’s more, it also offers an opportunity to note that Trump has been talking about presenting an alternative to Obamacare for roughly eight years now, and every time he’s tried to follow through on his vows, the Republican has failed in humiliating fashion.

While we’re at it, let’s not forget that Trump’s attacks also set the stage for a debate Democrats are desperate to have: The more 2024 focuses on a fight over health care, the worse it will be for the GOP and its candidates.

So why is Trump doing it anyway? Why draw attention to one of his glaring weaknesses? Why remind the political world of one of his most embarrassing failures? Why pick a fight his own party is eager to avoid?

There are a handful of possibilities. The first is the Republican Party’s 2024 presidential frontrunner hates admitting mistakes, and if he were to back off his anti-ACA crusade, it might be an implicit acknowledgement that it was wrong to have picked this fight in the first place.

The second is that Trump’s fixation on Barack Obama has become increasingly weird in recent months, and it’s possible that the Republican is targeting the ACA over its totemic value: To attack one of Obama’s most important accomplishments is to attack the Democrat who signed the policy breakthrough into law.

But the other possibility is that Trump has simply rediscovered his intention to tear down his own country’s health care system, no matter how many families get hurt in the process. He might genuinely believe that it’d be easy to come up with a cheaper and superior alternative to the ACA — Trump learned surprisingly little from his time in the White House — which leads to misplaced promises he’ll never be able to keep.

Whatever the motivation, the former president continues to move the Affordable Care Act into the 2024 spotlight, which is exactly where Democrats want it to be.