Trump’s Dumping On The ACA Will Only Net Single-Payer In The End

Are There Any Other Alternatives Available?
By Ron Shinkman

As the most ignorant and mean-spirited presidential administration since Andrew Johnson’s malignantly rolls along, it is methodically slicing into ribbons a healthcare safety net that has taken more than a half-century to build, and doing so out of wantonness and little else.

            It does not take anyone with an IQ higher than Donald Trump’s to figure out that the initiatives his underlings have undertaken are meant to destroy the gains under the Affordable Care Act. The annual open enrollment period for individuals inexplicably cut from 90 days to 45 days. Budgets all but eliminated for advertising and healthcare navigators. Add to that the infuriating decision by the U.S. Department of Health and Human Services that the website be shut down for “maintenance” on the first day of open enrollment and most Sundays after that – periods when consumers have the most time to shop for and determine their insurance options. And the even more infuriating lie from the Centers for Medicare & Medicaid Services that these maintenance periods are identical to those in the past.

            That’s on top of Trump’s planned executive orders this week that would allow businesses to band together and offer association-style health plans – essentially coverage without the ACA-mandated consumer protections, as well as short-term health plans (with coverage expanded from 90 days up to a full calendar year).

             All those executive orders might do is lure younger and healthier people away from the insurance exchanges and drive up premiums further. Not that they already haven’t zoomed up due to Trump’s coyness on continuing to pay out the cost-sharing subsidies intended to protect lower and middle-income consumers purchasing coverage on the exchanges.

            And let’s not forget former HHS Secretary Tom Price’s personal porn collection still on the HHS’ YouTube site – videos from individuals (a few of them Trump donors) who claim the ACA has hurt them. Jeez, Tom – couldn’t you have taken that stuff with you when you were drummed out? Most people don’t leave that kind of dirt hanging around their old workplace.

            Which almost makes me forget Congress is dragging its feet on reauthorizing the Children’s Health Insurance Program. And if they finally do pass a new CHIP bill, don’t be completely surprised if Trump actually vetoes it, particularly if one of his aides whispers in his ear that the program was originally Hillary Clinton’s idea.

            This ends only when Trump is removed or voted out of office, or when the ACA teeters and collapses from these malignant attacks. But what will that achieve? Fifty to 70 million or more Americans without health insurance? Hospitals going bust at a higher rate treating those uninsured? People dying for no reason other than the fact the GOP is still wedded to Ronald Reagan’s colossally stupid 1960 film equating healthcare with socialism?

            If that occurs, single-payer will be the law of the land much sooner than those right-wingnuts could imagine in their worst nightmares.

            The cackling idiots in Trump’s administration have failed to see all the warning signs around them. The fact that Bernie Sanders was able to tout “Medicare for All” both in his presidential campaign and today without coming close to being laughed out of the room. The fact that the Senate failed to repeal the ACA in multiple rounds, knowing full well the disastrous political fallout from doing so. The fact that the polling numbers of Americans both in favor of the ACA and single-payer continue to grow, and is inching toward the majority. Killing the ACA is not going to make them want to go back to the bad old days.

            No Republican wants to admit that the ACA was the Republican plan for healthcare reform. It was promulgated by the Heritage Foundation, a right-of-center think tank, and first employed in Massachusetts by Mitt Romney, whom the last time I checked, was a Republican. Had they kept their mouths shut over the past seven years, they could have eventually claimed this as their own.

            However, the GOP has been infuriated by the fact that the ACA was deployed federally by Barack Obama, whom the last time I checked is not only not Mitt Romney, but not a white male.

            If the GOP continues to pander to its baser, racially-tinged instincts and destroys the ACA, that leaves the Democratic alternative, single-payer. And since the GOP route will have been scorch-earthed by its own party, there will be nothing left to turn to, no other “Plan Bs.” California and some other liberal states will try it first, but it will become clear quickly what the rest of the country is missing out on.

            And I can guarantee you once all Americans are guaranteed access to healthcare services, once they finally join the ranks of every other nation in the developed world, there will be no turning back – no matter how much injurious propaganda is sprayed on the countryside.


Ron Shinkman is the Editor of Payers & Providers.