Donald Trump’s administration has stepped up its legal efforts to scuttle Barack Obama’s Affordable Care Act, setting the stage for a brutal fight over the future of US healthcare in the 2020 election.
While Mr Trump’s administration had previously argued that only a portion of the Affordable Care Act should be dismantled, this week it reversed that stance, arguing that the whole law should be overturned, according to a brief filed with a US federal appeals court.
Should the appeals court agree with the Trump administration’s position, the Supreme Court would be all but certain to review the case. Roughly 20m Americans are currently covered under the Affordable Care Act’s insurance exchanges or by the Medicaid expansion provided under the law.
If we can put a man on the moon, we can certainly have universal healthcare for every man and woman.
The move highlights the ongoing debate over the Affordable Care Act — also known as Obamacare — which has become a political football for both parties.
In 2016, Republicans and Mr Trump made repealing and replacing the law a key campaign promise, but ultimately failed to secure enough votes in Congress to push through the measure.
Democrats, meanwhile, have credited a continuing focus on healthcare as one of the main reasons the party was able to retake the House of Representatives in the 2018 midterm elections, pointing out that the Trump administration’s repeal plan would remove the protections provided for Americans with pre-existing medical conditions.
On Tuesday, Democrats seized on the Trump administration reversal, seeing an opportunity to shift the US political debate from Robert Mueller’s Russia investigation.
“[T]he Trump Administration endorses taking health coverage away from millions of Americans and eliminating consumer protections for tens of millions more, including the law’s protections for those with pre-existing health conditions,” said Steny Hoyer, the Democratic House majority leader.
In the presidential race, the current crop of 2020 Democratic candidates has been vigorously debating the merits of switching over to a single-payer healthcare system, and whether that new system should afford Americans the possibility of keeping their existing private healthcare plan — a policy debate that is sure to become a defining feature of the primary.
Several candidates, including Bernie Sanders, Elizabeth Warren, Kamala Harris, Kirsten Gillibrand and Cory Booker, have advocated switching to a single-payer universal healthcare model.
“If we can put a man on the moon, we can certainly have universal healthcare for every man and woman,” Ms Gillibrand, a senator from New York, recently told voters at The Barrel House pub in Davenport, Iowa.
After Ms Gillibrand’s event, Elesha Gayman, head of the Democratic party in Scott County, which includes Davenport, said healthcare was one of the issues that Iowa Democrats cared about most. “I think definitely we have a mental healthcare crisis, and mental healthcare and healthcare in general is a huge issue for us,” said Ms Gayman.
A Kaiser Family Foundation health tracking poll released this week found that nearly eight in 10 Democrats support a national Medicare-for-all plan, compared with 56 per cent of the overall population.
Support for the Affordable Care Act, meanwhile, also falls closely along party lines. Overall, 50 per cent of Americans have a favourable opinion of the law, the poll found, while 39 per cent have a negative opinion of it.
While the Trump administration had previously argued that only some of the elements of the law should be dropped — such as the individual mandate — the administration altered course on Monday, agreeing with a decision from a federal district court judge in Texas that the law, as a whole, should no longer be sustained because the law’s “unconstitutional” individual mandate rendered the entire statute invalid.
That move, Democrats were quick to warn, could quickly derail the Affordable Care Act and all who depended on it.
House Speaker Nancy Pelosi noted that while many Republicans lawmakers had campaigned in 2018 on the promise that they would not do away with every aspect of the law, including getting rid of the exception for pre-existing conditions, Mr Trump’s administration had now gone and done the opposite. “They say one thing and do another.”
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