No doubt encouraged by the president's recent victory over the Russia truthers and his roughly 42 percent approval rating, the Trump administration decided last week that the best way to prepare for next year's election is to challenge the constitutionality of the Affordable Care Act in the Supreme Court.
This apparently includes arguing against the ACA's expansion of Medicaid, which has brought coverage to 25 million Americans. It is one of the only unambiguously successful parts of ObamaCare. If it disappeared, nearly one in 10 Americans would lose their health care overnight.
This has the potential to be the easily the stupidest unforced error of Trump's presidency. Looking ahead to 2020 it is nothing short of suicidal. Killing Medicaid expansion is probably the only clear path we have to President Robert Francis O'Rourke. Even President John "Mom Loved Deepthroat" Hickenlooper is probably a shoo-in if his messaging is disciplined.
It has long been rumored that there are good reasons to vote for Republicans. Not among them is the GOP's position on health care. Between 2008 and 2016 deductibles increased at eight times the rate of wages. More than 40 percent of Americans say they cannot afford their current health-care expenses. To these and dozens of other similarly staggering statistics the Republican response has been to suggest that maybe people would like to open special bank accounts to keep the money they don't have to pay for health insurance. Another surefire winner is the idea that perhaps in addition to being able to choose between 9,000 different in-state health care plans with names like BronzeCareShieldPlusAct Network Lite — not to be confused with the BronzeCareShieldLiteAct Network Plus or the Silver, Gold, Platinum, Diamond, and Sapphire iterations of the various Cares and Shields and Plus Networks — the American people would like to sort through millions of rival versions currently available outside their home states.
Why in the world is Trump doing this? According to The New York Times, it is largely at the urging of Mick Mulvaney, the clownish White House budget director who has also called for eliminating food stamps or replacing them with things like broccoli vouchers, a vegetable totalitarianism of which even Michelle O never dreamed.
It is difficult to see why Mulvaney believes or wants these things. In this spendthrift administration it cannot have anything to do with saving money. Nobody else in the country actually wants to replace the Affordable Care Act with anything except some form of single-payer. It has been obvious for years that the GOP does not actually believe any of their think tank-approved talking points, which is why in 2017 they repeatedly torpedoed their own attempts to repeal and repeal ObamaCare. Vice President Pence opposed the move carried out by the Justice Department at Mulvaney's behest, as did William Barr, the attorney general. Republicans in Congress agree with them and are quietly praying for the Supreme Court not to side with the administration.
What is the endgame here? Is this another ploy to convince a certain element of the Republican base — which overlaps with the segment of the American people who have benefited from the expansion of Medicaid and from the regulations governing provision of care to those with pre-existing conditions — that Trump and co. are sticking it to the libs without actually taking anything from anybody? Gestures like these are what make all of us sick of politics.
This is why a perverse part of me almost wishes that John Roberts would play against type and side with the administration here. A decision that got rid of the ACA by judicial fiat would force us to have a more serious and focused national conversation about health insurance. At the very least, the GOP would finally be punished for the irresponsibility of the bad-faith arguments it has been making for nearly a decade now.
No rhetorical point is actually worth the price of denying medical care to millions of people — but it would be exactly what Trump and his party deserve if their cynicism cost them an election they are otherwise capable of winning handily.