‘An act of un­fath­omable cru­elty’

San Francisco Chronicle - - BUSINESS -

House Speaker Nancy Pelosi called it “an act of un­fath­omable cru­elty.” The Trump ad­min­is­tra­tion’s move to per­suade the U.S. Supreme Court to re­peal the Af­ford­able Care Act in the midst of the worst pan­demic in a cen­tury sim­ply makes no sense as a mat­ter of pol­i­tics or pub­lic health.

In do­ing so, the Trump White House has just as­sured that the land­mark health law that is pro­vid­ing cov­er­age to 130 mil­lion Amer­i­cans with pre­ex­ist­ing con­di­tions will be a sig­nif­i­cant is­sue in the Novem­ber elec­tion.

Why the pres­i­dent would pick such a bat­tle — es­pe­cially in the ab­sence of a plau­si­ble al­ter­na­tive to re­place it — is in­ex­pli­ca­ble. Did he and his strate­gists some­how miss the mes­sage of the 2018 midterms, when the law was in the thick of the de­bate, and Democrats won big?

It’s dou­bly puz­zling be­cause the Trump ad­min­is­tra­tion is tak­ing a more ag­gres­sive stance when the law­suit brought by 20 Repub­li­can at­tor­neys gen­eral was in trial court. At that point, the ad­min­is­tra­tion was fo­cused on elim­i­nat­ing pre­ex­ist­ing con­di­tions rather than the en­tirety of the law. The case now go­ing to the Supreme Court with the ad­min­is­tra­tion’s sup­port ar

gues that the law be­came void when Congress elim­i­nated a tax penalty for Amer­i­cans who fail to buy in­sur­ance, com­monly known as the in­di­vid­ual man­date.

Did some­one for­get to re­mind Pres­i­dent Trump that, de­spite his op­po­si­tion to the in­di­vid­ual man­date, he has re­peat­edly said he would de­fend a re­quire­ment for cov­er­age of pre­ex­ist­ing con­di­tions?

Most im­por­tant of all is the ab­sur­dity of peel­ing back ac­cess to health care dur­ing the coro­n­avirus pan­demic in which more than 125,000 Amer­i­cans have died — and in­fec­tions con­tinue to surge in many states with nei­ther a vac­cine nor ef­fec­tive treat­ments in sight.

It is no­table that the Amer­i­can Med­i­cal As­so­ci­a­tion, along with many doc­tors and hospi­tals, op­poses the law­suit.

Cal­i­for­nia has taken the lead among the 17 states that have come for­ward to de­fend the law.

“Now is not the time to rip away our best tool to ad­dress very real and very deadly health dis­par­i­ties in our com­mu­ni­ties,” state At­tor­ney Gen­eral Xavier Be­cerra said in a state­ment last week. “This fight comes at the most crit­i­cal time. The death toll from the coro­n­avirus to­day is greater than the death toll of the Viet­nam War.”

The job losses from the shut­down­in­duced eco­nomic shock also must be con­sid­ered. In fact, a new re­port from the Cen­ters for Medi­care and Med­i­caid Ser­vices showed 487,000 Amer­i­cans en­rolled on Health­care.gov in April and May — a 46% in­crease from the pre­vi­ous year.

In his brief on be­half of the Trump ad­min­is­tra­tion, Solic­i­tor Gen­eral Noel Francisco ar­gued that the ab­sence of a tax penalty —up­held by the Supreme Court — un­rav­eled the core of the law. He sug­gested the in­di­vid­ual man­date was “in­sev­er­able” from the re­quire­ment on cov­er­ing pre­ex­ist­ing con­di­tions.

His logic would be laugh­able if the stakes were not so se­ri­ous.

“Noth­ing the 2017 Congress did demon­strates it would have in­tended the rest of the ACA to con­tinue to op­er­ate in the ab­sence of th­ese ... in­te­gral pro­vi­sions,” Francisco wrote.

Pure non­sense. If the then­repub­li­can­con­trolled Congress had in­tended to re­peal the Af­ford­able Care Act, it would have done so. It lacked the votes. One vote, to be pre­cise. Many will re­call Sen. John Mccain’s piv­otal thumb­s­down vote in the early morn­ing hours of July 28, 2017, to pre­serve the law com­monly known as Oba­macare.

For­mer Vice Pres­i­dent Joe Bi­den, the pre­sump­tive Demo­cratic nom­i­nee, in­stantly sig­naled that he would be press­ing the is­sue. He should. Amer­i­cans need the law more than ever.

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