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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.

Catherine Rampell mug

Catherine Rampell

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.

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Washington Post columnist Catherine Rampell can be reached at crampell@washpost.com.

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(35) comments

oldhomey

More of the same fatuous but dangerous behavior from the Trump administration, now aided by his completely exposed personal attorney, Mr. Barr. Mr. Barr will be crucified and thrown into the ash heap by his champion, Mr. Trump, just as Trump has thrown more than half of his White House staff into ignominy and disgrace in the last two and a half years.

johnnybragatti

Take Obama"s name off and everything is cool, with Trump"s jealousy of the United States" last real decent, president, notwithstanding.

PhysicsIsFun

Trump's secret healthcare plan reminds me of Nixon's secret plan to end the Vietnam War which Nixon would reveal as soon as he was reelected. When the election was over and he won (with the Watergate burglary as part of the equation) the plan was revealed as more of the same nonsense that had never worked before. I'm sure if Trump and the Republicans had a plan that would actually work, like he famously promised in 2016, they would bring it forward now.

Cassandra2

republicans simply don't care how many people get sick or die, as long as insurance companies are making huge profits.

DMoney

I hope you stay healthy and live a long time. Just don't ask me to pay for it.

PhysicsIsFun

Ditto for you D.

DMoney

Oh, I won't be. If I get sick/hurt I'll be tapping my well funded and expensive insurance.

oldhomey

D, you pay for the treatment of poor people every time you go to the doctor or are admitted to the hospital. They charge those who have insurance inflated fees to cover for their pro bono costs. That is one of the reasons why we have the most expensive healthcare system in the world, even though it does not deliver healthcare as well, as equitably and as efficiently as comparable wealthy nations that spend half of what we do on healthcare.

DMoney

So a pool of extremely wealthy liberals should launch a network/fund for poor/uninsured to receive bas.ic stabilization and care. With the billions contributed at start-up, and the billions collected annually from donors (I'd contribute), there would be enough to help millions of people. Would be a network of free clinics/hospitals with volunteer staff. Why hasn't that been done?

oldhomey

D, what you propose is essentially the Obamacare plan, which is not perfect but a giant step in the right direction. We will get there yet, I am sure you will agree, and we will be a much better, stronger nation and economy because we got there.

DMoney

The key is voluntary and not compulsory. A charity rather than a mandate. Obamacare made it punishable for a citizen NOT to engage in commerce. That is absolutely appalling and completely against everything this country stands for.

oldhomey

D, we are talking about health insurance. If you work for a business that has a company healthcare plan, you pay into it. At your age, your premiums probably would be covering the cost for older policy holders and younger ones unlucky enough to have experience bad health or a serious accident. But you would be covered for any emergency, and you will get older, and as you get older, you will have need for more medical attention. You would not be able to afford the insurance if it was a policy only for old people. For Pete's Sake, we are all brothers and sisters in God's eyes, so we are our brothers' (and sisters') keepers in His eyes, and health insurance is the most painless accommodation to that reality. Have you no soul?

DMoney

A soul, I'm not sure. Seems pretty fantastical to me to have a ghost inside me. I DO have free will. Whether granted by God or just our constitution.

Your example lacks the key point: options. Freedom. Liberty. I can pick and choose what I want from an employer. I can choose nothing at all. With nationalized care, it's mandated and punishable. There's one option, zero choice.

oldhomey

You seem bent on denying others the same options you have in order to protect your own options, D. If you don't believe in God, perhaps you could agree to be a humanist, which in spirit shares to same sense of generosity that Judeo-Christian ethics preach. It would make you a much happier person.

DMoney

Ok but if these problems can be fixed by being godly and humanistic, why the need for government mandate? Why are "popular" programs enforced and punishable by penalty?

oldhomey

D, I repeat, we are talking about health insurance. If you work for a business that has a company healthcare plan, you pay into it. At your age, your premiums probably would be covering the cost for older policy holders and younger ones unlucky enough to have experience bad health or a serious accident. But you would be covered for any emergency, and you will get older, and as you get older, you will have need for more medical attention. You would not be able to afford the insurance if it was a policy only for old people. It is mandatory because even they are not participating in the plan for the moment, the moment they or a family member becomes ill or is badly injured, they will sign up for the insurance with little or no penalty, gaining all of its benefits. Unfair is in the eye of the beholder here, I guess.

PhysicsIsFun

Here is a truism for you to chew on Dball. Not a one of us avoids a fatal illness or injury in our lives.

DMoney

Obviously. When that time comes for me I'll pay for the treatment, cleanup and disposal. Because, after all, it was my life.

PhysicsIsFun

You are so noble and so gifted. All those other leakers out there could learn so much from you.

martian2

so how you gonna pay for your last days when you are dead there D? Writing out a check seems out of the question. The medical bills won't be figured out till weeks later. You sure you will have enough to pay everything? Or will society have to kick in to help pay. Then we can put on your tombstone, "He cared about nobody else's life, but the rest of us cared for his medical bills. " That seems much more plausible and truthful.

DMoney

I'm sure I'll have enough, and a means in which to execute it, when that day comes. I would hope everyone has done the same, for their families. But I appreciate your concern.

No tombstone here, I'm going for the new green burial. I'll be food for a tree.

oldhomey

Well, isn't that fitting for D? Spreading noxious verbal fertilizer on these comment boards, he will become actual fertilizer when his days are done on this Earth.

martian2

well here I thought you were pro life D! You call yourself that anyway but now it is evident you don't mean all life, just a small part of life, that is up until someone is actually born, then its don't bother me with any health needs. And before they are born you don't want to help pay for them either. always trying to make it some one else's problem, not yours. Heck of a way to go through life, especially if you consider yourself pro life.

DMoney

It's telling how you link together "life" with someone else paying for something. I'm guessing you go every day with the mindset that you are owed. Either that or you've been supported by someone your whole life.

I am pro life. That means that every healthy living thing on this Earth has a right to be alive and stay alive and do the best it/they can. This living thing is owed nothing by nobody other than what's covered by God and local laws.

martian2

OK this "living thing" as you put it is owed nothing. That makes no sense to the sane mind. Yes you are strong and healthy now, you don't need a darn thing from nobody now how and never will! Well life has a way of teaching people like you the hard way. Better hope that insurance company you pay for doesn't go back on its policies and cancel you. By the way, why do you need insurance anyway. That is just another method of other people paying for your needed medical services. And you always say you don't need anyone's help, you can do it all by yourself. So why the insurance? You must go through life thinking you are owed!

oldhomey

Well, D, an awful lot of people and an awful lot of plant and animal species owe their lives to the efforts of federal, state and local laws and institutions that make sure to the best of their ability that this planet and its resources not only belong to all of us, their survival means our own survival. You owe some respect to those efforts. You support a president and seem to believe in his con-man patter that the institutions we must rely on for smooth operations of our society are corrupt and rigged against you. He has yet to produce any evidence that this is so, while there is a mountain of evidence of his own, monumental corruption. You pay lip service to God, but your cold, mercantile assessment of what you deserve in life and what others can suffer makes you appear to be a man without any sort of spiritual, humanistic impulses that define what it is supposed to mean to be a Christian.

DMoney

No, they don't. They owe their lives to whatever force compels their parents to reproduce, and whatever force created a perfect symbiotic habitat for them to live. I refer to this force as God. And while I'm not religious, there IS a higher power, a creator. Whether that's aliens, a true holy spirit or it's all an AI simulation.

WE, in our disgusting and cancerous nature, destroy this creation. When we then create policy to mitigate the damage, we're not creating a right for living things. They already had that. We're simply and feebly trying to cap our destructive nature.

oldhomey

Well, D, I could not have composed a better refutation of your argument that we are not responsible for the decimation of species than you did yourself:

"WE, in our disgusting and cancerous nature, destroy this creation. When we then create policy to mitigate the damage, we're not creating a right for living things. They already had that. We're simply and feebly trying to cap our destructive nature."

Cassandra2

The D-Bag shows his lack of compassion and his lack of understanding of "shared risk." It's just another example of the "I got mine" attitude of republicans.

capedcrusader

The insurance industry is the biggest fraud ever perpetrated on this country.

DMoney

Agreed, but not just healthcare. And federal government is starting to challenge this title of biggest fraud.

martian2

you big shots republicans always whine and whine about government and its cost. but when catastrophe hits, by golly guess who is first in line crying for a handout? And who are the ones wanting more tax loop holes so they can get away with paying their fair share of taxes. And who are the ones paying off politicians with big bucks so they get their way. Its always the whining cry baby republicans who always want it both ways.

martian2

"away without paying their fair share of taxes"

oldhomey

No, I believe it is the Russian intelligence campaign through American social media outlets to sow discord and uncertainty about our government that is making you look at the government as a fraud, D, helped along by that great patriot you helped put into the White House Donald "The Deep State is after me" Trump. If you were a little more careful about how you source your information, perhaps you would not be so confused.

crank

Yes.... it’s the Russians sowing discord. Sure... [rolleyes]

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