Hearing Trump and Vance trying to…sane-wash isn’t the right term…re-write history about Trump’s attempt to repeal the Affordable Care Act, Democrats are right in jumping on their history of subverting the popular program. It demonstrates how, once again, Republicans are disconnected from how their lives actually work.
I worked in the health insurance industry before the ACA passed, when insurance companies could deny claims based on a previously undiagnosed “pre-existing condition” or because some reinsurer “lasered” (or put a cap on spending for) a specific patient who was expected to have a major medical claim. I cannot imagine the industry if the ACA protections are ever revoked and commercial insurers can go back to specifying conditions that trigger higher premiums, and imposing Big Brother oversight on tobacco use, or blood pressure, or a prescription that signals a chronic condition like diabetes, and decide suddenly–BAM–higher rates or worse–BAM–policy cancelation.
Post-COVID, who doesn’t have a pre-existing condition? You had COVID, I have long COVID, they have depression, and we all have anxiety. Contrary to what JD Vance says, Donald Trump does want to revoke the Affordable Care Act, not because it’s not effective and not because it’s not liked by voters. He wants to revoke it just… because. Like so many things, Trump doesn’t know why something must get done, but he damn well wants to do it, and goddamn it, he’ll do it. Whatever it is. Especially if it screws with Obama. Or Hillary. Or Biden.
Here’s the thing: revoking the ACA would end up doing three things. First, it will increase uninsured rates among the population, from 9% to at least 25%. Second, a whole lot of middle-aged white male Trump voters will learn about pre-existing conditions for the first time because they didn’t have high blood pressure when the ACA passed, and damn, they’ll be pissed that Biden canceled their insurance (or some such cult excuse) or made their rates triple. But no more Obamacare, so victory, lib.
The final thing is a little bigger: Insurance leads to better health. If you’re covered, you’re cared for: your annual exams are covered. There’s coverage for pre-existing conditions, medication are available, and providers/insurers understand the system. There are different plans with different benefits at different costs, all serving the entire market. Consumers have choices; you’re not stuck at your employer for fear of losing coverage. Pregnant patients get help (except in Texas, apparently).
The 20-something bros Trump and Vance want to vote for them have never lived away from their mothers’ homes when they couldn’t get insured. You didn’t have to consider if you, or your kid with autism, would get covered by the new insurance plan. And if the authors of Project 2025 get their way, you’ll get penalized or kicked off your plan for failing to comply with a treatment plan whether you’re insured by Medicare or a private insurer.
Believe it or not, but businesses love the ACA. It provides more certainty of costs for those who buy commercial plans and those who self insure. Their workforces are healthier. Employees also love it because they’re not tied to employers; some economists believe it helped fuel the worker independence/gig economy (with may or may not be a bad thing, depending on your perspective).
Revoke the ACA and lifetime claim caps will return, and they sure as hell won’t keep up with insurance. And don’t forget Mr. 55-year-old MAGA Man, your insurance company decides if they will keep you, not if you will keep them, so choke down that third Big Mac in honor of Donald because it’ll be cheaper to die a quick death. It sounds *SO* good on the campaign trail, but if you think about it, you’re *SO* screwed, like *SO* many Trump plans.