Opinion writer

What are we gonna do, let people die in the street? Maybe! (Reuters/Lucas Jackson)

We keep hearing that Donald Trump is vastly different ideologically from Congressional Republicans, but the reality is considerably less dramatic. Whatever Trump actually believes in his, er, heart, he is running on a range of conventional GOP positions: Tax cuts for the rich; hostility to Democratic efforts to solve the immigration problem; and, of course, repeal of Obamacare.

And on that latter front, here’s another data point: On the very same day that we learned that the Affordable Care Act has brought the uninsured rate down into single digits, it emerged that Trump thinks advocating for the repeal of the ACA will be a big political winner for him in the presidential campaign.

Today the Centers for Disease Control and Prevention released new data showing that the uninsured rate has fallen to 9.1 percent. Some 7.4 million previously uninsured people got coverage in 2015 on top of another 8.8 million who got covered in 2014, the ACA’s first full year — for a total of 16.2 million newly insured people.

Also today, the Hill reported that Trump privately agreed with GOP Senators that he is certain, absolutely certain, that Obamacare will be a big political albatross for his general election opponent, Hillary Clinton:

At a private strategy meeting on Thursday, Trump and Senate Republicans agreed that President Obama’s signature law could be a millstone around Hillary Clinton’s neck….

At Thursday’s meeting, where Trump largely reassured GOP senators that he is one of them, ObamaCare became a rallying point. Senate GOP leaders at the meeting predicted that fast-rising health insurance premiums would spark a public backlash. Trump chimed in that he expects the administration might attempt to postpone the start of the ACA enrollment period until after the elections, according to lawmakers who attended.

According to GOP lawmakers, Trump reassured Republicans that he is one of them, by reiterating his opposition to Obamacare — he has repeatedly said he’d repeal it — and by agreeing with them that the law will be devastating to Clinton in the general election. It is certainly possible that rising premiums could present a political problem for Democrats. But as Margo Sanger-Katz details, the hikes were to be expected, and there are reasons to be skeptical that their impact will be that dramatic or that they portend serious problems for the law.

And beyond that, the law — in particular, its dramatic drop in the uninsured rate — could also present a political problem for Trump and Republicans. For one thing, the new CDC numbers show that the law is succeeding at one of its core aims — i.e., expanding coverage of the uninsured. As Steve Benen puts it: “When was the last time more than 90 percent of Americans had health insurance? Never.”

For another, the drop in the uninsured rate is particularly dramatic among Latinos, a demographic that Trump is already on his way to alienating in numbers that could prove catastrophically high for the GOP. As the CDC report notes: “Hispanic adults had the greatest percentage point decrease in the uninsured rate between 2013 (40.6 percent) and 2015 (27.7 percent).”

“We sometimes lose sight of the fact that the ACA has had a tremendous effect on the number of people who are uninsured, which was its main goal,” Larry Levitt of the Kaiser Family Foundation tells me. “The percentage of people uninsured has never fallen into single digits, and that’s due to the ACA. Low-income working people, including Latinos in particular, have gained the most under the ACA and stand to lose the most if it’s repealed.”

Trump would repeal the ACA. True, he has laid out ideas for replacing it, but (and here he is also just like many other Republicans) those ideas would cover far fewer people. A recent report found that Trump’s replacement scheme would cover all of five percent of the millions and millions of people who would lose coverage if Trump got his way and the ACA were repealed.

“Repeal of the ACA would reverse these big gains in coverage, and there is nothing so far in Trump’s plan that would replace that coverage,” Levitt tells me.

The media coverage portraying Trump as ideologically at odds with many fellow Republicans focuses in part on this claim he made during the primaries: “We do need health care for all people. What are we gonna do, let people die in the street?”

Trump’s implication was that other Republicans would let people die in the streets. But, by Trump’s own definition, he, too, would “let people die in the street,” since his own plan would not provide “health care for all people,” it would repeal it for millions. Or, as Jonathan Cohn recently put it: “Trump likes to say he’s different from other Republicans — that he wouldn’t let people die in the streets because they don’t have health care. Trump is lying.”

In that context, the new heath care data should theoretically create problems for Trump. Now that he is the nominee, you’d think he’ll be pressed to square his own claim during the primaries — that the failure to cover people is the equivalent of letting them die in the streets — with the fact that his own plan would remove coverage for millions. You’d think that the media scrutiny of his position would intensify, now that we’ve learned the uninsured rate has dropped into single digits, due to the law he’d repeal. You’d think, anyway.