Donald Trump doesn’t give a damn about what’s in the GOP health-care bill. He doesn’t know, and he doesn’t really care. He has people who tell him what’s supposedly in it, and since those people tell him whatever he wants to hear, and since he wants to hear that the health-care bill covers everybody beautifully, that’s what they tell him: “The health-care bill covers everybody beautifully, Mr. President.”
And he smiles and believes it.
He believes it because what Trump really wants is to feel popular, loved and admired. He wants people to think that he’s a tough guy with a good heart, a great heart. That’s everything to him. His father, he says, was “a tough guy who had a good heart, a great heart.” His favorite president — great president, tough guy, Andrew Jackson, “a very tough person, but he had a big heart” — Jackson was so tough, Trump says, with such a great heart, that he could have stopped the Civil War (if only he hadn’t died 16 years before the war started).
Of course, a president with a heart as great as the Trump heart needs a health-care plan that protects the people who elected him. Who could be so heartless as to hurt his own people, those who invested so much faith in him? So Trump says that he has a health-care plan that protects the people that elected him. “The health care bill is going to help my supporters,” as he claimed to John Dickerson on “Face the Nation” over the weekend.
But it will not help his supporters. It will do significant, serious harm to many of those supporters, financially and health-wise. Those who have gained insurance through Medicaid expansion will lose that coverage. Older Americans who use subsidies to buy private coverage will see those subsidies shrink and their out-of-pocket cost of policies soar as rate controls are lifted, making their coverage unaffordable. As the Congressional Budget Office estimated, 24 million Americans, many of them older and in rural areas, would lose their coverage as a result of the GOP bill, and the latest version of that bill is even more punitive and restrictive than the version that was analyzed.
A tough president with a great heart would also fight to make sure that the bill guarantees coverage of pre-existing conditions. Who could be so heartless as not to cover pre-existing conditions? So Trump claims that his plan guarantees coverage of pre-existing conditions.
“Pre-existing conditions are in the bill. And I mandate it. I said, has to be,” he told Dickerson.
But it isn’t.
The bill significantly weakens coverage of pre-existing conditions. That’s the price that House conservatives demand in return for supporting the bill, and our tough president with a great heart, such a great heart, caved in and gave it to them, although he continues to claim otherwise. He gave it to them because he needs a bill to pass so that he can look productive and powerful, and he needs to look productive and powerful more than he wants to protect his supporters, so he agreed to provisions guaranteed to hurt those supporters as long as his aides keep letting him believe that it won’t.
But every nonpartisan expert in the field says otherwise.
For example, the American Medical Association strongly opposes the latest version because it significantly weakens coverage of pre-existing conditions. AARP also strongly opposes it, warning that under the bill, “Insurance companies would be able to charge you higher premiums if you have a preexisting condition such as cancer, diabetes or heart disease.” According to the AARP, it would “end protections for 25 million Americans between 50-64 with preexisting conditions like cancer, heart disease, and diabetes” and “represents a dramatic change from current law.”
But again, that’s not what Trump’s aides tell him.
Trump’s aides also tell him that the House plan lowers deductibles. As Trump told Dickerson, “We’re going to drive down deductibles, because, right now, deductibles are so high, you never — unless you’re going to die a long, hard death, you never can get to use your health care…”
That’s what he said. It isn’t true. It’s the opposite of true. Under the GOP health-care plan, deductibles will go up, probably by a lot. That is not a matter of dispute. They go up by design, on purpose, because that’s the way conservatives want it. Their one big idea is that making people pay more out of pocket makes them use less health care. Their plan is to ration health care by making it unaffordable, while claiming that they would never ever attempt to do such a thing.
And of course, let’s remind ourselves of the real game here. By kicking 24 million Americans off their insurance, Trump and his GOP colleagues will be able to finance an initial, massive $880 billion tax cut, most of which will benefit the wealthy. In addition, passage of the legislation would also set the stage for the even larger tax-cut package announced last week, again to the benefit of the richest of Americans.
That’s not the act of a tough president, a president with a good heart, a great heart. That’s the act of a populist charlatan out to benefit the very elites whom he pretends to condemn. Andrew Jackson was a man of many flaws, but he was right to warn that “the rich and powerful too often bend the acts of government to their selfish purposes,” and to argue that when they use the law to “make the rich richer and the potent more powerful, the humble members of society — the farmers, mechanics, and laborers — who have neither the time nor the means of securing like favors to themselves, have a right to complain of the injustice of their government.”