Our view: Where’s the beef? Meaty Biden plan tops Trump’s
2020
The difference between health care plans advocated by President Donald Trump and former Vice President Joe Biden is so stark that perhaps the best way to explain it is through analogy.
Suppose the two candidates are presenting their proposals like celebrity chefs in a cook-off. And you are the judge.
Biden comes up with a cheeseburger. You’ve had his burgers before. They’re fine, nothing special. “But look,” he says, “here’s the deal. I’ve made improvements. I’ve added grilled onions, craft cheeses, smoked bacon.”
Not convinced, you turn to Trump. You notice that his plate is empty and are about to adjudicate him the loser, but he proclaims that he has a great plan. You listen as he boasts and brags, flailing his arms to and fro. None of what he is saying makes any sense. Then it finally dawns on you that his plan is to pull out his meat cleaver and chop off your hands so you can’t avail yourself of Biden’s burger. “You’re gonna love it,” he says. “Believe me.”
Biden’s burger, if it is not obvious, is the Affordable Care Act, aka Obamacare, the 2010 law that has allowed millions of pre-retirement Americans to buy health insurance on private exchanges or obtain Medicaid coverage.
Because the law was never perfect, and because it has spent the past decade under siege from Republicans, Biden proposes a number of enhancements, including providing a government-run insurance plan as an option alongside private ones.
Trump’s plan is to terminate the ACA and replace it with a blizzard of tweets about nonexistent alternatives, typically to be announced two weeks hence. Trump tried to kill the ACA in Congress but fell one vote short. He has since followed a strategy of having Congress repeal part of the law with the expectation that sympathetic judges would repeal the rest.
That approach is scheduled to reach the Supreme Court, yet again, just after the election.
The Editorial Board opposes repealing the ACA for the same reason we oppose hacking people’s limbs off: Because it is pointless and cruel. Despite its flaws, the ACA has been a lifeline to millions who previously could not buy insurance unless they worked for government or large companies.
The global pandemic has only underscored its importance. When the shutdown in the spring led to mass layoffs, millions lost the insurance they got through their jobs. Trump responded by ignoring widespread calls to create a special ACA enrollment period so people without coverage could buy it on exchanges.
Now, as the world knows, he has contracted COVID-19. Like other federal government employees, he does not have to worry about losing coverage during the pandemic. And as president, he gets a special level of care, which only adds another layer of cruelty onto his determination to end insurance for Americans who don’t have access to gold-plated medical treatment.
As for Biden’s enhancements to the ACA, they are worthwhile. A “public option" insurance plan had been part of the original ACA, but it was cut out to pick up votes. It would help hold down costs and provide an option in places where few private insurance policies are available.
Biden would provide a number of tax breaks to make it easier to afford coverage. He would also make several major changes that impact the ACA, but go well beyond it. He would, for instance, allow Medicare to bargain for better prices when it is paying for prescription drugs. He would also lower the Medicare eligibility age from 65 to 60.
These costly changes have implications that need to be carefully considered. But retaining and enhancing the Affordable Care Act is by far and away the most appetizing option available.