By way of introduction, here’s every single time Trump has tweeted about Obamacare since his inauguration:
Say what you will about Congress’s failure to repeal Obamacare — and there was a lot to be said about its reckless efforts — at least the process acknowledged one basic fact of America’s constitutional system: If Congress doesn’t like a law, it can change it. If the president does not like a law, he cannot be allowed to sabotage it.
Yet that is what President Donald Trump and Secretary of Health and Human Services Tom Price have been doing for months with the Affordable Care Act. For the sake of both his constituents and the Constitution, which requires the president to “take care that the laws be faithfully executed,” he needs to stop.
Just after last week’s congressional vote failed, Trump tweeted his desire to “let Obamacare implode.” He subsequently said that “bailouts” for insurance companies — by which he presumably meant the subsidies that enable insurers to offset costs for low-income consumers — would be terminated. For his part, Price said Sunday that “no decision’s been made” on whether to continue the subsidies that enable low-income Americans to afford insurance.
This continued sowing of confusion and doubt may be more tactical than strategic, or it may be neither; either way, it’s unconscionable. The ACA — for better and, in some instances, worse — is the health-care system America has. If Trump continues to try to destroy the law, he will not only erode his stature and the presidency’s, he will also hurt vulnerable Americans.
There is little dispute about what is needed to make sure the law is structurally sound. To begin, a lasting commitment to pay those cost-sharing subsidies is required. The individual mandate has to be strengthened and enforced — at least until such time as an alternative mechanism is found to persuade Americans to buy health insurance. And efforts to encourage the uninsured to enroll in Obamacare plans must be resumed.
Those steps, in turn, depend on the president abandoning his attacks on health insurance markets and committing himself to being a constructive force in providing access to health care.
House and Senate Republicans took their best shots at repeal. Their efforts failed because the ACA has succeeded in providing access to health care for millions more Americans, and even Republicans are wary of rolling back such tangible progress.
Trump should be, too. It’s time to move on from this battle. Trump has long spoken of delivering superior, cheaper health care. Better to focus on that goal rather than on an empty, partisan promise to “repeal” Obamacare. The ACA is not without flaws. It is those very flaws that offer the president an opportunity to recast the health-care debate in a more productive way.