With great fanfare, and another bizarre statement from Donald Trump, the White House announced an ambitious and actually good set of proposals to improve care for the millions of Americans who have kidney disease.
"The kidney has a very special place in the heart," Trump pronounced, before signing the order directing federal agencies to create new education and treatment programs for people with early-stage kidney disease, to make transplants easier to get, and to weaken financial incentives for the facilities that rely primarily on dialysis. It really is all great, except for one thing: It all goes away if Trump prevails in federal courts in getting the Affordable Care Act struck down.
That's just one example of the profound effect the ACA has had on the healthcare system. Trump’s kidney program, like so many other health projects, is made possible by a provision in the law known as the innovation authority, which allows public programs—Medicare and Medicaid—to test various strategies for providing treatment more efficiently, with better quality, and for less money. Before it passed, this kind of program would have to be authorized legislatively. Which was a major hassle. So while Trump was, well, trumpeting this new program in an Oval Office ceremony, his Department of Justice was celebrating a successful outing in the 5th Circuit, the end result of which could kill this program.
There's a pretty easy way out of the whole mess, should Congress decide it needed to take it. All it has to do to make the lawsuit moot is to repeal the individual mandate entirely, and leave the rest of the law standing. That's a card House Democrats should be willing and ready to play if the court does what everyone is expecting. They'd be heroes, and would jam Mitch McConnell and Donald Trump.