“Spectacular.” For me, that word always evokes a particular moment in American television history. In the present, it’s the word The Man Who Lost The Popular Vote used to describe Trumpcare, i.e., the alternative healthcare plan his party was supposedly developing to replace Obamacare: “We've put together a group of four or five … they are going to work together to come up with something that's really spectacular … it's going to be far better than ObamaCare.” This spring Trump has also said that the Trumpcare plan would be “really great” and “wonderful.”
Shortly thereafter, the “four or five” men (what, you thought he’d let women work on something as important as health care?) indicated that they were not exactly anxious to get started. More recently, a week ago the Daily Beast interviewed the three senators Trump actually named: John Barrasso of Wyoming, Rick Scott of Florida, and Bill Cassidy of Louisiana. Afterward, its reporters divined a new description of the would-be Trumpcare plan: It has been “totally abandoned.”
Mitt Romney is apparently developing his own alternative plan to replace Obamacare (which was, as you may know, modeled on the Romneycare plan passed in Massachusetts, but, hey, that was back when Mitt was pretending he was a moderate). Maybe this is how Romney thinks he’s going stand up to Trump.
On health care, the Trump campaign has no specific plan. Instead, it’s sent out its national press secretary, Kayleigh McEnany, to spout right-wing pablum about Individual 1’s “free market policies” and support for “healthcare choice.” Nevertheless, Mr. 46% of the Popular Vote and his Republican buddies have changed our healthcare system in profoundly negative ways. For example, they got rid of the individual mandate as part of their Rich Man’s Tax Cut scheme. That’s the one that the Republican who pushed it through the House in 2017 now admits is not paying for itself as his party promised it would—however, he says it still might someday. Might? On that prospect I’ll refer you to the noted “economist” Wayne Campbell.
But back to Trumpcare. On its “Sabotage Watch” page, the Center on Budget and Policy Priorities has put together a terrific, comprehensive list of the harmful changes to Obamacare that Trump has wrought. And beyond those, the Trump administration is now on record calling for the Supreme Court to find the whole of Obamacare unconstitutional, following a ruling from a Texas federal court that the law should be tossed out.
Of the actions that have already taken effect, there’s one element of Trumpcare in particular that has been in the news recently. The details of how it has hurt Americans are really going to piss you off.
Remember the aforementioned pablum from the Trump campaign about the wonders of “choice” and the “free market” in health care? Those were at the heart of a Trumpcare policy that became official last Oct. 2. Here’s how the CBPP described it:
New federal rules take effect that let a parallel market for skimpy plans operate alongside the Affordable Care Act’s (ACA) market for comprehensive individual health insurance. The rules allow short-term plans exempt from the ACA’s pre-existing condition protections and benefit standards to last for up to one year, compared to three months under prior rules, and to be renewed. While a number of states have taken action to block short-term plans, in most places, consumers are exposed to new risks. Healthy people who enroll in these plans may face benefit gaps and be exposed to catastrophic costs if they get sick and need care. And because short-term plans will likely offer lower premiums to healthy people (because the plans include reduced benefits), they will lure healthy enrollees away from the individual and small-group markets, leaving behind a group that’s costlier to insure. This dynamic, known as adverse selection, will raise premiums for traditional, more comprehensive health coverage and undermine ACA protections for people with pre-existing conditions. [Emphasis added.]
Isn’t that grand? Under Trumpcare, Americans will have more “choices” in the healthcare “free market.” They’ll have the choice to buy health insurance plans that cost them less (yay!) but don’t actually cover, you know, the costs of health care that people incur if they get sick or injured (what the fuck?). If you don’t get sick, you’re golden, but if you do, well, er, freedom! And, as the CBPP noted, not only does such a scenario have the potential to absolutely ruin people who get sick after buying junk insurance, but it also harms those who don’t buy it and instead buy actual, decent insurance that comports with standard Obamacare guidelines—because it raises their premiums.
There are real Americans suffering with this junk insurance Trumpcare created. One of them is Elizabeth Belin of Columbus, Ohio. She needed her knees replaced. She was paying $240 a month for a Trumpcare junk insurance policy. Of course, that’s not how the sales agent marketed the policy to her. Remember that Trump and the Republicans say we shouldn’t want big bad government passing regulations that burden businesses with requirements such as telling the truth about the products they sell. Government should get out of the way of companies, right? Again: freedom!
As for Ms. Belin, the procedure left her with $48,000 in uncovered medical expenses, more than she earns in a year. Oh, and that’s for just one of her knees. Unsurprisingly, she has not had the second one done as of yet. “It’s been devastating to me,” she said. Christopher Mitchell of Kansas bought a Trumpcare junk insurance policy as well. Two years after buying it, he was diagnosed with breast cancer. He found out that his Trumpcare policy did not cover the surgery he needed. “This could happen to anyone,” Mr. Mitchell noted. “People need to be aware of these scams.” Mitchell and Belin are part of a class-action suit filed against Health Insurance Innovations. The New York Times reports:
They say they believed they were purchasing Affordable Care Act plans that include coverage guarantees. But they were sold much less comprehensive coverage that left them vulnerable to tens of thousands of dollars in unpaid medical bills, according to the lawsuit.
Their complaints underscore problems with some types of cheaper health insurance alternatives that the Trump administration has expanded. Critics of the government’s decision, including the Association for Community Affiliated Plans and the National Alliance on Mental Illness, are also suing the Trump administration over relaxation of rules for these plans.
“This isn’t real insurance,” said Jason Kellogg, one of the lawyers representing the individuals in the Florida case. They are seeking class-action status, estimating that as many as 500,000 people may have bought these policies.
The White House pushed hard for this new Trumpcare policy, defending it with the same kind of language the Trump 2020 campaign is using now. When the rule was announced, a top official in the Department of Health and Human Services said it would “help increase choices for Americans faced with escalating premiums and dwindling options in the individual market.”
When it comes to health care, the one thing Americans need more than choice is protection. We need protection from junk Trumpcare policies that cash our premium checks yet provide no coverage. We need a lot more than that, of course, but it’s a good place to start.
But don’t believe me. Just ask Elizabeth Belin and Christopher Mitchell how they feel about the “choice” that Trumpcare provided them.
Ian Reifowitz is the author of The Tribalization of Politics: How Rush Limbaugh's Race-Baiting Rhetoric on the Obama Presidency Paved the Way for Trump (Foreword by Markos Moulitsas; forthcoming on June 25).