USA TODAY US Edition

Health ruling inflicts pain on America

Trump calls it ‘great news.’ Which part?

- Andy Slavitt

President Donald Trump apparently hasn’t had enough of the health care fueled butt-kicking handed to him and his party in the midterm elections. He heralded as “Great news for America!” a Texas judge’s ruling Friday that found the entire Affordable Care Act unconstitu­tional. Once again, Trump and Republican­s have put taking away health care at the top of the agenda, this time for the 2020 presidenti­al election.

What part of this ruling would be great for America, as Trump claims?

❚ Seventeen million people would lose coverage in a single year. Not great.

❚ Americans with pre-existing conditions — as many as 130 million — would lose protection­s against unaffordab­le insurance policies and denials of coverage. Also not great.

❚ The expansion of Medicaid to more low-income families would end — causing real damage to millions of people, states and community hospitals that have made so much progress since it passed. Again, not great.

❚ Insurance companies would no longer have to offer coverage of kids up to age 26 on their parents’ plan. Annual and lifetime limits would be back. Women and people over 50 would see higher prices and discrimina­tion would be legal again. Is that great?

❚ The closing of the Medicare prescripti­on drug coverage gap (the “donut hole”), which has saved seniors thousands of dollars on their medication­s, would be gone. Is it great yet?

Which part, Mr. Trump, is the great part, other than the opportunit­y for you to send out a nasty tweet and put people in agony?

Republican­s in Congress, starting with Senate Majority Leader Mitch McConnell, have defended this lawsuit even as Republican candidates all over the country “pledged” their support for pre-existing condition protection­s during the midterms. Now that those campaign ads are over, we get to see them wink at the camera.

The part of “repeal and replace” Republican­s never liked was the “replace” part. The Republican health care posi- tion is to let insurance companies charge as much as they like and cover as little as they like. They voted to kill or sabotage the ACA over 70 times with no replacemen­t, and their preferred approach after Trump was elected was “repeal and delay.” Now a judge in Texas would deliver all that Republican­s couldn’t deliver in Congress.

Conservati­ve legal scholar Jonathan Adler, no ACA supporter, calls the Texas judge’s ruling “weak,” “insane“and so full of legal holes that appellate court judges and even the more conservati­ve Supreme Court wouldn’t support it. Fortunatel­y, one judge in Texas doesn’t get to undo the Affordable Care Act. The case will be appealed and could end up in Chief Justice John Roberts’ Supreme Court in 2020 during the throes of an election year.

By supporting the lawsuit, Trump has ensured that the deeply unpopular GOP position to strip away pre-existing condition coverage will stay in the news. These reminders will be loud enough to break through all the other noise and turn the 2020 election into yet another referendum on health care.

Even if this case goes nowhere, as most observers expect, it causes damage. Trump and the Republican­s are inflicting a kind of nonstop terror on Americans. Year after year, millions of people wonder whether eventually, by hook or by crook, Republican­s will succeed in overturnin­g the ACA.

Sleepless nights are supposed to be reserved for crying babies, not wondering if your own government will pull the rug out from under you.

Alison Chandra, whose son Ethan was born with a rare genetic disorder, spoke for many when she lamented on CNN that the president, in his tweet, “celebrated the fact that so many of the most vulnerable potentiall­y will not be able to access life-saving care.” It’s what Allison said next, as she held 4year old Ethan on her lap, that should haunt Trump and his party: “And I will never forget that.” Trump is making sure of it.

Andy Slavitt, a member of USA TODAY’s Board of Contributo­rs, is a former health care industry executive who oversaw the Affordable Care Act and ran the Centers for Medicare and Medicaid Services from 2015 to 2017.

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