On the Republican National Convention (RNC) stage Wednesday night, official mouth-of-Trump Kayleigh McEnany stood up to talk about how much Donald Trump cares about people with preexisting conditions. She has a compelling story, carrying the BRCA II genetic mutation that put her chances of having breast cancer at 84%, and a family history in which breast cancer was rampant. So she chose to have a preventative mastectomy in May 2018.
"As I came out of anesthesia, one of the first calls I received was from Ivanka Trump," she gushed. "Days later, as I recovered, my phone rang. It was President Trump, calling to check on me." That, she says, is enough evidence for her that he "loves the American people, stands by Americans with preexisting conditions, and supports working moms." He'd called her on the phone. Two years later, when she's officially on team Trump as press secretary, his Justice Department filed a brief in the Supreme Court arguing explicitly that the protections for people with preexisting conditions in the Affordable Care Act were unconstitutional and should be tossed.
Here's what Trump's lawyers wrote: "Once the individual mandate and the guaranteed- issue and community-rating provisions are invalidated, the remainder of the ACA should not be allowed to remain in effect." The guaranteed issue and community rating mentioned there are the things that make sure you can get health insurance regardless of preexisting conditions, and that insurance companies can't price coverage out of reach. They must be invalidated first thing, Trump argued, then with them the rest of the law must be tossed. That's the reality of how Trump feels about people with preexisting conditions. He. Doesn't. Care. If you're a blonde, female Fox News personality, current or former, you might get a phone call. In which he doesn't ask about your insurance coverage.
The only concrete idea that has emerged from the Trump administration thus far on preexisting conditions if he succeeds in his lawsuit is, well, that phone call. Remember his promise from July? "We're signing a healthcare plan within two weeks, a full and complete healthcare plan," he said. That was five weeks ago. When he was reminded that that didn't happen, he conjured out of thin air the possibility that maybe he'll issue an executive order that does ... something about preexisting conditions. Two weeks after that promise, crickets.
Here's what's real. If Trump has his way, all this is lost:
- Public Health and Prevention Fund
- Marketplace tax credits and coverage for ~10 million people
- Medicaid expansion currently covering ~17 million people
- Allowing kids to stay on their parents' insurance until age 26
- Ban on annual and lifetime limits
- Ban on insurance discrimination against women
- Limit on out-of-pocket costs
- Improvements to Medicare, including reduced costs for prescription drugs
- Essential Health Benefits
- Required improvements to employer-sponsored coverage
- Rules to hold insurance companies accountable
- Small business tax credits
None of that can be covered by a phone call.
