The worst thing that Attorney General William P. Barr did last week arguably had nothing to do with possible contempt of Congress or the Mueller report.
It had to do with health care.
On Wednesday, amid the circus over alleged special counsel snittiness, the department that Barr oversees formally asked a federal appeals court to strike down the entire Affordable Care Act, jeopardizing access to health care for tens of millions of Americans.
If the Trump administration prevails, everything in the law would be wiped out.
And I do mean everything: the protections for people with pre-existing conditions, Medicaid expansion, income-based individual-market subsidies, provisions allowing children to remain on their parents’ insurance until age 26, requirements that insurance cover minimum essential benefits such as prescriptions and preventive care, and so on.
The administration’s rationale was laid out in a policy brief supporting a lawsuit challenging Obamacare by 20 red states.
Their logic: When Congress, as part of President Trump’s 2017 tax cuts, set the penalty for not carrying health insurance to zero, that effectively made it no longer really a “tax,” and therefore made it unconstitutional. Somehow, that rendered the rest of the law unconstitutional, as well — including lots of provisions having nothing to do with the mandate.
This reasoning has been rejected even by conservative legal scholars otherwise opposed to the law.
But legal merits (and demerits) aside — which are likely to be ultimately adjudicated by the Supreme Court — it’s also not clear what political upside Republicans could possibly see in mounting yet another overt attack on Obamacare.
The GOP’s November congressional losses were largely motivated by voter rage over the party’s attacks on Obamacare, after all.
Trump has, of course, more recently proclaimed the GOP the “party of health care,” and he and other party leaders continue repeating the obvious fiction that they’re cooking up “something terrific” to replace the ACA.
Yet Trump’s party has never been able to come up with (let alone pass) a viable replacement plan, even when it had unified control of government.
There are more productive things Trump and lawmakers could do to improve the health-care system that don’t involve dismantling the ACA. Obamacare, after all, did a lot to expand coverage and not nearly enough to improve affordability.
For instance, the latest version of a plan known as the Medicare for America Act — introduced Wednesday by Reps. Rosa L. DeLauro, D-Conn., and Jan Schakowsky, D-Ill. — would create an expansive public insurance option to compete with the employer-sponsored system. The public option would cap premiums and out-of-pocket costs and have no deductibles. The bill would allow employer-sponsored plans to continue, as long as they covered a minimum average share of enrollees’ health expenses.
Other options might include refundable tax credits to offset out-of-pocket spending, as have been proposed by Democrats before.
Trump administration officials may not like these alternatives. Fine. But if they’re going to persist in trying to blow up the current system — through administrative sabotage, funding cuts and bogus court challenge — the onus remains on them to propose better ways to rebuild it.