Trump gives Democrats a big health care opening for the midterms

Axios ^ | 6/11/18 | Drew Altman

[DoodleDawg]

Most of the discussion of the Trump administration's decision not to defend the Affordable Care Act — and to urge the courts to throw out its protections for people with pre-existing medical conditions — has focused on what happens to the individual insurance market. But the political impact may be even greater.

Why it matters: Protections for people with pre-existing conditions are hugely popular, and the administration may have handed Democrats their strongest health care weapon yet — because now they can make the case that the administration has gone to court to take away protections for people with pre-existing medical conditions.

The case is also likely to drag on, so it could be the political gift that keeps on giving through 2020, even if it is eventually thrown out.

[DoodleDawg]

I’ll wait until facts come out not some lefty’s speculation.

What facts are you looking for?

[9YearLurker]

Actually a number of the GOP have—right up until they had control of the presidency, house and senate going into 2017.

And agreed. Though Trump sometimes campaigned on free market healthcare reforms, he seems to default to telling us what great “plans” he’s going to provide us. It’s an area where he unfortunately seems to revert to his inner Democrat. But of course he’s fighting so much and being so great in so many other areas.

Those who have had their rates skyrocket because of this preexisting coverage aren’t necessarily such great fans of it. And the GOP’s more enlightened side, including Trump, has been advocating and moving to minimize the preexisting issue by allowing the small business and individual pooled plans that Obamacare expressly made illegal. Then, there have been plans of allowing states to have (or go back to, if they had them previously) high-risk pools for the remaining tough cases.

There messaging hasn’t been good, I agree.

[Alberta's Child]

Attacking what is just about the only really liked feature of Obamacare could come back to bite the GOP.

It's also the feature of Obamacare that is one of the biggest factors in skyrocketing premiums for medical coverage.

The administration isn't attacking the pre-existing conditions feature. It's supporting the authority of a state government that wants to allow insurance carriers to sell plans that don't cover pre-existing conditions.

This -- along with the elimination of lifetime caps on coverage -- was one of the worst features of Obamacare. The fact that it's "just about the only really liked feature" of Obamacare tells you that the whole monstrosity was built on delusional expectations.

[DoodleDawg]

So an 8 year old is diagnosed with diabetes. His parents have had insurance on him since he was born. He goes to a company which has insurance for their employees. He's not eligible?

Currently, yes. Prior to Obamacare, not necessarily. It was up to the employer.

Pre-existing condition is a difficult dilemma. Let's call it destiny which makes ALL conditions are pre-existing.

The DOJ has declined to defend a lawsuit by several states with eliminate that possibility. Whether they win or not, it's bad optics for the GOP.

[arthurus]

I am sure DJT has this calculated. He will win with it and it will not hurt in November. We don’t see yet how it will be done and what he will follow with.

[Alberta's Child]

They will either be forced to stand with the administration or stand against it.

They already made their stand.

After seven years of promising to overturn Obamacare, they failed. Nobody gives a sh!t what they think anymore, so we're all willing to accept whatever empty promises they make.

[9YearLurker]

So you understand that mandated coverage for preexisting conditions via Obamacare assures the end of a free market in healthcare—and still you don’t want the GOP to tinker with it?

[DoodleDawg]

I am sure DJT has this calculated. He will win with it and it will not hurt in November.

Hope you're right.

We don’t see yet how it will be done and what he will follow with.

He said a couple of weeks ago his healthcare plan would be out by now. I'm sure the Singapore summit has delayed that a bit.

[DoodleDawg]

So you understand that mandated coverage for preexisting conditions via Obamacare assures the end of a free market in healthcare—and still you don’t want the GOP to tinker with it?

Depends on the tinkering I guess. What's their proposal?

[DoodleDawg]

It's also the feature of Obamacare that is one of the biggest factors in skyrocketing premiums for medical coverage.

A major reason, true.

The administration isn't attacking the pre-existing conditions feature. It's supporting the authority of a state government that wants to allow insurance carriers to sell plans that don't cover pre-existing conditions.

The lawsuit that 20 states filed will strike down Obamacare completely. Allowing states to eliminate the pre-existing condition requirement if Obamacare is ruled unconstitutional is only part of it. But it's a part the Democrats will fix on.

This -- along with the elimination of lifetime caps on coverage -- was one of the worst features of Obamacare. The fact that it's "just about the only really liked feature" of Obamacare tells you that the whole monstrosity was built on delusional expectations.

Perhaps. But it's expectation that voters really, really like.

[Alberta's Child]

We've heard all this sh!t before.

Let me guess ... the Democrats are going to run ads showing Republicans throwing Grandma in her wheelchair off a cliff?

If the GOP can't deal with this issue they deserve to lose -- badly.

I think voters are smart enough to figure out that the Democrats don't have the answers. That's why Donald Trump was elected.

[Alberta's Child]

Over the years I've learned that there are two different types of people who are really focused on health care as a major issue in elections. They generally fall into two different groups:

1. The person with $50,000 in annual health care costs who complains that his monthly medical "insurance" premium has escalated from $500 to $1,500 over the last ten years.

2. The person with $0 in annual health care costs who complains that his monthly premium has escalated from $500 to $1,500 over the last ten years.

Person #1 is a delusional fool who sees "insurance" as nothing more than a mechanism to make other people pay his medical bills. Person #2 is tired of being the damn fool who pays everyone else's medical bills.

I'm going to go out on a limb here and suggest that there are a lot more people who fit the description of Person #2 than Person #1.

[DoodleDawg]

Let me guess ... the Democrats are going to run ads showing Republicans throwing Grandma in her wheelchair off a cliff?

Something similar probably.

If the GOP can't deal with this issue they deserve to lose -- badly.

The GOP can't make a deal amongst themselves over this much less with the Democrats.

I think voters are smart enough to figure out that the Democrats don't have the answers. That's why Donald Trump was elected.

Forty eight percent of the voters voted for Hillary. Don't be so quick to credit them with smarts.

[italianquaker]

Dont see it that way but we will see

[ConservativeMind]

Everyone who gets welfare removed has that same complaint.

Go find a policy that covers preexisting conditions and pay extra for that, all you want.

[Political Junkie Too]

Argue semantics if you want but that doesn't change the fact that this is one of the few popular features of Obamacare and the GOP is working to eliminate it without any alternative. Optics on this won't be good.

Here are my thoughts on "pre-existing conditions."

1. I see two "classes" of pre-existing conditions:
   • The "bad class" are those who wait until they get sick and then try to get insurance. These are the people who get into auto accidents without insurance and then complain about the costs, and who have house fires without insurance and then complain about the costs.
   • The "good class" are those with a history of continuous health insurance, likely provided through their employer, who contract one condition or another as many aging people do and have it treated through their plans, who then lose their jobs and employer-provided health care and suddenly find themselves with "pre-existing conditions" when seeking new health care coverage.
2. To the "bad class," I can see the immense popularity that pre-existing condition coverage would have for these people, as it rewards them for earlier irresponsible behavior. At this point, I haven't attributed motive to this class, but it could be that:
   • They are young and healthy and were willing to assume the risk,
   • They were unmarried and didn't feel the burden of family responsibility yet,
   • They were barely getting by and couldn't afford the insurance premiums.
3. To the "good class," I can see the popularity that might come from making pre-existing condition coverage available.
   • These people had plans they liked that were covering their conditions, and doctors they liked that were managing their conditions.
   • ObamaCare converted existing conditions into a pre-existing conditions when it set the framework for driving out he health care plans that Obama insisted people could keep. These people wouldn't have pre-existing conditions if there were no ObamaCare.
   • ObamaCare's "employer mandate" destroyed the 40-hour work week by converting full-time workers to part-time (under 30 hours per week) to avoid triggering the mandate. This caused people to either lose their jobs or lose wages, resulting in losing their health care insurance. Again, ObamaCare itself was the catalyst for converting existing conditions into pre-existing conditions through no fault of the person.

So, I think there are "semantic" arguments to be made here. At the least:

• One could express sympathy with the plight of the "good class" of people who were doing the right thing but were harmed by ObamaCare.
• One could offer potential solutions to the "good class," such as portable insurance options so that people don't feel tied to their employers or at risk when laid off from jobs.
• One could encourage the "bad class" to rethink their options, or offer other insurance packages like combining health and auto coverage together where the same premium covers whichever condition occurs first (illness or accident), or something else.

Personally, I would appeal to the responsible majority who didn't want ObamaCare, but wanted a solution to the pre-existing condition paradox they found themselves in because of ObamaCare. I would treat the appeal to the others as the "tail wagging the dog," offering some options but not making the whole health care system cater to them.

-PJ

[DoodleDawg]

Everyone who gets welfare removed has that same complaint.

Go find a policy that covers preexisting conditions and pay extra for that, all you want.

Well there's a winning campaign slogan. </sarcasm>

[Buckeye McFrog]

Insurance for those with pre-existing conditions is not insurance.

No, but for better or for worse society's expectation is that they are going to be paid for. Either by extending non-insurance insurance or via direct payments from a Federally funded pool. We are talking tens of millions of people so there's no turning that boat.

Pure Conservatism, like the Ideal Plane, does not really exist.

[ConservativeMind]

It is a near moot point.

Only 1 million people got 0care who didn’t already have insurance from other means, yet were forced into 0care because of the stupid mandate.

https://www.forbes.com/sites/scottgottlieb/2014/03/11/how-many-people-did-obamacare-really-enroll/#12aa186d59d0

Of those now covered that weren’t before, I would guess 200,000 across the country would make 0care their main “influencing” issue in an election. Out of those same 200,000, probably only 50,000 are people who will actually vote in a mid-term.

So, 50,000 spread across the whole of the US versus the tens of millions of people helped by Trump means the Republicans and Trump win, “big time.”

[Rockingham]

These days, the issues in a party's strategic campaign plan go through competitive polling, focus groups, and ad development. And with campaign plans already being executed, those would all now be hard to arrange and absurdly expensive because they are out of the normal timing and sequence. Trust me on this.

Moreover, if the courts deliver a dispositive ruling before the election, the spur of immediate political self-interest is one of the surest ways to get Congress or a legislature to act quickly. Individually and collectively, politicians respond to self-interest like even the laziest dogs hasten to the sound of kibble being poured into their dinner bowl.

Also, in the event the courts made a decision, Trump, not the Democrats, would have the greatest prominence and capacity for decision. His natural instinct would be to try to seize the initiative and steal the pre-existing condition issue from the Democrats. I would not bet against his being able to pull it off.