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Storm clouds gather above the White House on April 9, 2020.Oliver Contreras / Bloomberg via Getty Images file

Why the White House's health care promises are so hard to believe

The administration is fighting tooth and nail to strip millions of families of their health security, but we're supposed to trust them to fix it later.


At face value, the circumstances seemed rather insane: as a deadly pandemic grows more serious in the United States, Donald Trump and his team asked the Supreme Court to uproot his own country's health care system. If the justices agree, the Republican president and his allies will have successfully taken health security from tens of millions of families, even as the coronavirus crisis takes its toll.

Confronted with coverage of this bizarre and dangerous strategy, Trump turned to Twitter over the weekend to say, "Obamacare is a joke!" He added, "Deductible is far too high," before insisting that he will "always, always, always" protect Americans with pre-existing conditions.

The tweet came just a few days after the president asked the high court to specifically destroy protections for Americans with pre-existing conditions. His capacity for lying about his own efforts in this area appear to be limitless.

As for deductibles -- I'm convinced Trump has no idea what the word means, which helps explain his grammatical error -- let's also not forget that the Republican proposals in 2017, which enjoyed White House support, deliberately encouraged higher deductibles.

A day later, Health and Human Services Secretary Alex Azar had an opportunity to clarify matters. It didn't go well.

The Trump administration doesn't expect to release a detailed health care plan until the Supreme Court rules on the legality of the Affordable Care Act, said U.S. Health and Human Services Secretary Alex Azar. That would leave voters in November's election in the dark about how their health care, typically ranked as among the most important issues, might be upended in 2021 and beyond.

The cabinet secretary specifically told CNN's Jake Tapper that the public could expect to see the "exact details" of the administration's health care plan at some point in the future. It would depend, Azar added, on the Supreme Court's ruling and the composition of Congress.

The Washington Post's Catherine Rampell noted yesterday, "Republicans have had literally a decade to come up with a replacement plan for Obamacare." This wasn't hyperbolic. As regular readers know, it was on June 17, 2009 -- 11 years ago this month -- that then-Rep. Roy Blunt (R-Mo.) made a bold promise. The Missouri Republican, a member of the House Republican leadership at the time, had taken the lead in crafting a GOP alternative to the Affordable Care Act, and he was proud to publicly declare, "I guarantee you we will provide you with a bill."

And yet, there's still no bill. The bills Republicans managed to throw together in 2017 were (a) wildly unpopular; (b) wholly ineffective; (c) completely at odds with the party's campaign promises; and (d) ultimately rejected in the face of bipartisan opposition. A superior successor to this decade of failure is nowhere to be found.

To be sure, Azar and Trump are making a specific kind of pitch: they'll tear down the Affordable Care Act, uproot the existing system, and punish tens of millions of families. But, they argue, it's at that point that Republicans will deliver a magical plan that will do more and cost less.

Or put another way, the president and his allies are asking the nation to take a leap of faith: after Trump demolishes his own country's health care system in the midst of a pandemic, he'll rebuild it with something better.

What would the new system look like? How would it work? How much would it cost? How much would it cover? No one has any idea -- inside the White House or out.

We're simply supposed to trust that the president and his allies will figure something out. Later. Somehow. Eventually. Maybe.