When Donald Trump was seeking the presidency, he promised the American people would have "great healthcare." He won. The Republicans controlled Congress. But all they did was attempt to subject President Obama's Affordable Care Act to death by a thousand cuts.
Now, Trump is making the same promise again. In an interview yesterday with TIME Magazine -- during which he threatened a reporter with prison time if he published a photo of letter he showed him -- Trump bragged about scuttling the individual mandate, which required people to purchase health care coverage or pay a penalty. And then he said this:
"We got rid of, as I said, we got rid of the individual mandate, which was by far the most popular thing in Obamacare. We’re managing Obamacare much better. But Obamacare is a very — it’s very bad. And if we win, I will do healthcare. If we get the House. If we get back the House — you can’t do it without the House.
"If we get the House, we get the Senate, we get the presidency, we will have a great health care plan, we will have tremendous healthcare. But we’re doing a good job on that anyway. Doing a very good job."
So once again, a new promise: Re-elect me, put Republicans back in charge in Congress, and you'll have "a great health care plan." Really? You couldn't do it before, why should we think you can -- or will -- do it again?
What Trump and his Republican sycophants are doing is not even a very good job of disabling the ACA, even though that's what they are trying to accomplish. Yes, they've gotten rid of some regulatory burdens physicians have complained about for years, but they've really done nothing to improve the delivery of healthcare as it affects patients.
The mantra in his 2016 campaign was to "repeal and replace Obamacare," as it came to be called, but instead Trump could only manage to achieve repeal in the House of Representatives. He was thwarted in the Senate, largely because of opposition from his arch enemy, the dying Republican Sen. John McCain (R-AZ) and two other GOP senators.
There never was a viable plan ready to replace the ACA had it been repealed. Millions of Americans would have lost their healthcare coverage, causing a healthcare catastrophe of massive proportions.
Every step of the way, Trump and his GOP supplicants in Congress took whacks at what they derisively labeled Obamacare. They killed the individual mandate, striking at the heart of the program and was the most visible attack on the law. But there have been many, many more. Here's an analysis from the Center on Budget and Policy Priorities.
Much of it has been behind the scenes, not widely known or reported, but nonetheless, has been aimed at sabotaging the program now relied upon by millions of Americans. As of last year, eight years after passage of the ACA, the uninsured rate among U.S. adults ages 19 to 64 was 12.4 percent, statistically unchanged from 2016 — despite actions taken by the Trump administration and Congress to weaken the law.
However, because of the administration's determined efforts to undermine the law, many, many Americans are underinsured and do not have coverage that they really need. According to the Commonwealth Fund, 45 percent of U.S. adults ages 19 to 64 are inadequately insured — nearly the same as in 2010.
So today as we look towards the 2020 election and consider candidates to support, who do we believe? The president who brags and puffs up his chest about his phony accomplishments and makes false promises? Or candidates who actually are committed to improving our healthcare system and making it as affordable as possible for as many people as possible?
The choice really isn't that hard.