The Washington PostDemocracy Dies in Darkness

Opinion President Trump and Republicans are the radicals on health care

House Speaker Nancy Pelosi speaks about President Trump's attempt to overturn the Affordable Care Act at the Capitol on Friday.
House Speaker Nancy Pelosi speaks about President Trump's attempt to overturn the Affordable Care Act at the Capitol on Friday. (Jim Lo Scalzo/EPA-EFE/REX/Shutterstock)

THE TRUMP Justice Department asked the Supreme Court on Thursday to kill Obamacare. This has long been a foolish, foolhardy obsession for President Trump. Even in the middle of a widening pandemic, he seeks to eliminate health-care coverage for some 23 million Americans.

In so doing, the president betrays his responsibility to defend in court a statute that Congress passed, resorting to bizarre legal arguments that liberal and conservative legal experts have denounced. The reasoning is so far-fetched that the Justice Department initially shuddered to embrace it. Even Attorney General William P. Barr tried last month to soften the Justice Department’s stance. Government lawyers had argued that only parts of the Affordable Care Act had to go. Now they insist that if part of the law is flawed, the courts must dismantle the whole structure.

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Mr. Trump claims that he would maintain protections for people with preexisting conditions and other popular elements of Obamacare. But he has no plan to do so. His position is for health-care chaos.

Anticipating the Trump administration’s court filing, House Democrats offered on Wednesday a different vision. Discrediting Mr. Trump’s attempts to paint them as unhinged socialists, the Democrats eschewed a revolutionary health-care agenda. Instead, they offered the Affordable Care Enhancement Act, a package of changes that would dramatically improve the existing system.

The Democrats would not touch the employer-sponsored health insurance that most non-elderly Americans depend on. Instead, they would bolster the system meant to help those without access to employer-based coverage. The centerpiece is an increase in federal subsidies that would enable low-income Americans to pay little or nothing in health insurance premiums and protect middle-income Americans from the high premiums and cost-sharing that have made it difficult for some to participate in Obamacare, particularly in rural areas. The plan would pump money into state-based “reinsurance” programs that have already proved to restrain premium costs in the states that have tried them. It would also undo some of the damage Republicans have inflicted, pressing more states to expand Medicaid and rolling back the Trump administration’s efforts to allow junk insurance plans. The result would be millions more covered Americans.

The Democrats would fund the bill by lowering prescription drug spending, a policy that requires further debate. But the overall package is solid. Unlike Republicans — who never had a plausible replacement for Obamacare, despite years of braying about its defects — Democrats are showing that they have a detailed plan to fill in the system’s gaps, in specific legislative text, that they could take off the shelf should they have the opportunity to govern. Their plan also refutes those in their party who argue that nothing but radical reform can bring progress.

Mr. Trump and Republicans, not Democrats, are the health-care radicals.

Read more:

Letters to the Editor: Striking down Obamacare would also nix generic biologic drugs

The Post’s View: The latest court battle over Obamacare is the most outrageous yet

Paul Waldman: Why William Barr wants the GOP to stop trying to destroy Obamacare

Neal Katyal: Trump’s indefensible refusal to defend Obamacare

The Post’s View: The country is paying a lot for the GOP’s Obamacare sabotage

Paul Waldman: A health insurance crisis is coming. So here’s an idea.