PRESIDENT TRUMP’S PRE-EXISTING CONDITION

With all the attention given the Donald J. Trump-Kim Jong Un summit and the president’s pie-in-the-sky, ridiculously false claim on Twitter that “There is no longer a Nuclear Threat from North Korea,” it would be easy to overlook Trump’s sudden rewrite on health care. In a carefully worded letter, Attorney General Jeff Sessions revealed that the administration “with the approval of the President of the United States” no longer supports a provision of the Affordable Care Act that requires insurance companies to cover applicants regardless of whether they have a pre-existing health condition.

The reversal comes in the context of a Republican-led lawsuit (Texas v. United States) in which the federal government has been defending the constitutionality of the ACA. It means the Justice Department, and Trump, are essentially choosing to side with the plaintiffs and abandoning a position that Trump has been touting since the early months of his candidacy. Whatever the legal arguments, the facts of the ACA haven’t changed, only Trump’s interpretation of that reality has.

Remember the Republican presidential primary debates of 2016? Voters should. The GOP candidates were scrambling to one-up each other over how much they hated “Obamacare” and how quickly they’d put the health care reform law that expanded health insurance to millions of Americans 6 feet underground once they landed in the Oval Office. Trump had a slightly different take. Oh, he hated the ACA all right but he sure liked that pre-existing conditions were covered. “I would absolutely get rid of Obamacare. We’re going to have something much better, but preexisting conditions, when I’m referring to that, and I was referring to that very strongly on the show with Anderson Cooper (of CNN), I want to keep preexisting conditions. I think we need it. I think it’s a modern age. And I think we have to have it,” Trump said at the CNN-Telemundo debate in Houston in late February that year.

An aberration? Hardly. Trump said something similar a week earlier during an interview with Cooper as well as during a debate with Hillary Clinton, the Democratic nominee, in early October eight months later, advocating for “getting rid of those lines (meaning interstate competition among insurers) and “keep pre-existing” to help the poor because “we are going to have people protected,” he said in the second presidential debate held at Washington University in St. Louis.

Now, perhaps the president has simply had a change of heart and wasn’t lying all those times he said he would support coverage of pre-existing conditions — a provision that consistently polls well with Americans — but that explanation doesn’t show up anywhere in Sessions’ letter. Naturally, Democrats in Congress are salivating at the prospect that the GOP is going all in with their disdain for health insurance coverage provided by the ACA. Without the pre-existing conditions requirement, millions of Americans are going to find themselves back on the outside of decent medical care looking in. “If Republicans are serious about maintaining protections for people with pre-existing conditions, they should join us in urging the Trump administration to reverse their shameful decision to not defend the constitutionality of that vital provision that is already the law,” Senate Minority Leader Chuck Schumer, D-N.Y., tweeted last week.

But what truly elevates Trump’s reversal is that, whether as a candidate or president, Trump has been merciless in his criticism of Barack Obama for suggesting that the ACA would ensure that Americans could keep their health care providers. And while it’s true the ACA didn’t require Americans to change their doctors (and most didn’t), it generated such an upheaval in the individual market that many people had to change coverage and as a result, change providers. Obama was seen as someone who makes stuff up. Will political conservatives be far more forgiving of Trump’s misrepresentations of the past? You’d better believe it. If they can tolerate his claims of a nuclear-threat-free North Korea, despite the absence of any real progress beyond a handshake in Singapore, anything is possible.