Democrats Should Run on Defending Obamacare in 2018

During his remarks prior to a cabinet meeting yesterday, Donald Trump said something truly extraordinary.

Let’s take a minute to unpack that one. First of all, as Michael Grunwald writes, repealing the individual mandate damages Obamacare, but doesn’t repeal it.

“The death of Obamacare has been exaggerated,” says Larry Levitt, who oversees health reform studies at the Kaiser Family Foundation. “Eliminating the mandate creates uncertainty, but all the benefits for people remain in place.”…

Repealing the tax penalties for Americans who don’t buy insurance would not repeal Obamacare’s perks for Americans who do—like the ban on annual and lifetime caps that insurers previously used to cut off coverage for their sickest customers, or the provision allowing parents to keep their children on their plans until they turn 26. And it would not repeal Obamacare’s “delivery reforms” that are quietly transforming the financial incentives in the medical system, gradually shifting reimbursements to reward the quality rather than quantity of care. The growth of U.S. health care costs has slowed dramatically since the launch of Obamacare, and the elimination of the mandate should not significantly affect that trend.

Grunwald is specifically highlighting the Obamacare provisions that affect the entire healthcare system, not those limited to the 6 percent who buy insurance on the exchanges. He goes on to explain that the individual mandate is the one part of Obamacare that doesn’t enjoy majority support among Americans. So the repeal of that element poses a political problem for Trump and Republicans going forward.

…repealing the unpopular mandate could make it even harder for Republicans to pass legislation repealing insurance protections, Medicaid expansions and the rest of Obamacare, because the rest of Obamacare is popular. It’s not surprising that Republicans managed to kill the law’s vegetables, but it won’t be as easy to kill dessert.

It’s also worth noting Trump’s admission that he told people to be quiet about including the repeal of the individual mandate in the tax cut bill. His sentence dropped off after he started to say that he didn’t know how people would respond. For those of you who think that reading body language tells us something, take a look at how Trump sat back in his chair and pulled his crossed arms over his belly when he talked about this. That is clearly a defensive posture. He knows there will be political consequences to his efforts to sabotage Obamacare.

In previous midterm elections a lot of Democrats showed that they were hesitant to defend Obamacare. I hope they’ve been paying attention to what has been happening over the last year because it has been the Republican assaults on it that have fueled much of the resistance. At this point, Obamacare is damaged but not broken, and Trump just clearly signaled his intentions to kill it. Running to defend it would be a smart move for Democrats.

Nancy LeTourneau

Nancy LeTourneau is a contributing writer for the Washington Monthly.