Trump surprises Republicans — and pleases Democrats — with push to revive health-care battle

A surprise move by the Trump administration aimed at striking down the Affordable Care Act thrust the partisan battle over health care into the middle of the 2020 campaign on Tuesday, handing Democrats a potential political gift on an issue that damaged Republicans badly in last year’s midterm elections.

In a new court filing, the Justice Department argued that the ACA, also known as Obamacare, should be thrown out in its entirety, including provisions protecting millions of Americans with preexisting health conditions and allowing young adults to stay on their parents’ health-care plans.

President Trump praised the move during a lunch with Senate Republicans, and suggested the GOP should embrace a new congressional battle over health-care policy ahead of the 2020 elections.

“Let me tell you exactly what my message is: The Republican Party will soon be known as the party of health care,” he told reporters before the lunch. “You watch.”

.. Trump spent much of his time at the Senate lunch talking about health care, according to several senators present.

“If there’s a message to be learned from 2018 on policy, it’s health care,” Sen. Lindsey O. Graham (R-S.C.) told reporters after the lunch Tuesday. “Let’s become the party of health care.”

“He thinks that that’s the one area where we’ve fallen short and he wants to see us address it,” said Sen. John Neely Kennedy (R-La.). “He made that very clear.”

“If you’re a Republican thinking about 2020 right now, you want to be on offense on health care, not defense,” she said. “And the only way to do that is to make the focus on what Democrats want to do — on Medicare-for-all — rather than making it on what the president and the White House are suggesting.”

.. A federal judge in Texas ruled in December that the law’s individual mandate “can no longer be sustained as an exercise of Congress’s tax power” and further found that the remaining portions of the law are void. He based his judgment on changes to the nation’s tax laws made by congressional Republicans in 2017.

.. “It is highly unusual for the Department of Justice not to defend duly enacted laws, which the Affordable Care Act certainly was,” Collins said. “This decision to even go more broadly in failing to defend the law is very disappointing.”

.. “I think Obamacare should be gone,” he said. “We’ve got to cover people with preexisting conditions apart from Obamacare, which is what I talked about a lot.”

.. There would be ripple effects throughout the health-care industry and insurance landscape as well. Those with workplace plans could be affected, as employers would be allowed to scale back certain medical benefits, and people with preexisting conditions buying coverage on their own would no longer be guaranteed access to coverage at no extra cost.

‘Medicare for All’ Will Terrify Voters

It sounds good until people realize it means losing their existing plans.

Medicare for All becomes less popular when people hear more about its possible effects. Support dropped to 37%, with about 60% opposed, when respondents were told it would “eliminate private health-insurance companies” or “require most Americans to pay more in taxes.” Support fell to 32% when respondents were alerted it would “threaten current Medicare.” And it crashed to 26% if those polled heard it would lead to “delays in people getting some medical tests and treatments.”

.. Names matter, too. A November 2017 Kaiser poll found that, without mentioning negative effects, “Medicare for All” drew a 62% favorable rating. But labeling the same idea “single-payer health insurance” dropped support to 48%. Calling it “socialized medicine” produced a nearly even split, 44% favorable to 43% negative.

Medicare for everyone may sound good to voters at first. But after sustained reflection—and Republican attacks—it will likely be soundly rejected. Most Americans do not want to surrender control of their health-care decisions to an impersonal bureaucracy in Washington.

.. And the $32.6 trillion figure could be low. Mr. Blahous says the tab may “be substantially greater,” since his analysis accepted both the “significant administrative and drug cost savings” estimated by Medicare-for-all advocates and reimbursement rates 40% less than what private health insurance pays today, on average. Mr. Blahous, a former public trustee for Social Security and Medicare, believes the savings would not materialize fully and the cuts in reimbursements are unsustainable.
.. Congressional supporters of the plan fear that nearly doubling the federal budget could sink their proposal. That’s why Sen. Bernie Sanders, the father of Medicare for All, refuses to say how much it will cost.
.. Still, Republicans could lose the public-opinion battle unless they prepare an organized offensive. This will require the persistent involvement of a White House that has shown itself ill-prepared for extended campaigns of explanation and persuasion. It also requires Republicans to highlight the proposal’s weaknesses. For example, they should find a way to stage a Senate vote on abolishing private health insurance to show how few Democrats are willing to back that—isolating that party’s hard-core Sandernistas.
.. Nor can Republicans merely stand on opposition to Medicare for All; it’s hard to beat something with nothing. The GOP also must lay out ideas to make health care better, more affordable and more accessible with choice, competition and markets.The rush by Democratic presidential candidates to embrace Medicare for All—and measures like “free” college, guaranteed jobs and universal basic income—may make the 2020 election a contest between promise-them-anything democratic socialism and free enterprise. The stakes don’t get much higher than that.