Curing Health Care

The health-care market received a jolt from the Justice Department when it declared that it will seek a wholesale scrapping of the Affordable Care Act (ACA, or Obamacare) following a circuit court ruling that it’s unconstitutional in its entirety.

The issue received a powerful presidential prod as well, when President Donald Trump gave Republican leaders marching orders to produce a replacement for Obamacare, as he pledged to make the GOP the “party of health care.”

Much as many federal lawmakers in both parties dread the thought of a second apocalyptic struggle over health care, no one dared turn off this wakeup call and go back to sleep.

The most urgent question suddenly looming on the horizon like a tornado without warning: If the appeals court, where the case is headed, and the Supreme Court after that, agree that ACA is not what the Founding Fathers had in mind, what will happen to 60 million Americans with pre-existing conditions who are currently covered, and the millions under 26 who are entitled to stay on their parents’ plans?

When White House chief of staff Mick Mulvaney was asked this uncomfortable question on ABC this Sunday, he stated that he could guarantee that people would not lose the coverage they now have under Obamacare.

The “debate about pre-existing conditions is over,” Mulvaney said, adding that every replacement for the ACA supported by the White House or Congress since Trump took office included protections for people with pre-existing conditions.

“Both parties support them, and anyone telling you anything different is lying to you for political gain. Pre-existing conditions are going to be covered,” Mulvaney said. “The debate becomes: How do you best do it?”

A few moments later, presidential candidate Sen. Amy Klobuchar (D-MN), in an interview with ABC, charged that in effect, Mulvaney was the one not being truthful.

“Contrary to what Mr. Mulvaney just said, people will be kicked off their insurance for pre-existing conditions.”

Presidential advisor Kellyanne Conway tried to bat down the naysayers. If the opposition seeks to frighten people by saying that repealing Obamacare is a frightening step into the unknown, Conway said Democrats weren’t exactly models of moderation as they float “Medicare for All,” which she branded the “health version of the Green New Deal.”

Faced with such polarization, the first order of business would be verify the facts. And if possible, to furnish the public with a reliable estimate of what, if anything, replacement of Obamacare would cost. It is the most important task yet for the legions of fact-checkers in the media, dwarfing the usual “gotcha” stuff in political speeches and interviews.

The difficulty here is that that depends on the adequacy of the Republican plan to replace Obamacare — which is subject to partisan interpretation, as well as the Democrats’ willingness to cooperate to produce something workable.

It’s impossible to disentangle politics from health care. Both Trump and Klobuchar and half the Democratic party are running for president in 2020. Obamacare may push aside almost every other issue.

As Klobuchar put it, “This is something that Americans care deeply about. I may not have been asked about the Mueller report at town hall meetings, but I was sure asked about health care.”

Charting a way forward that will yield “a plan that is far better than Obamacare,” as the president promised (providing the courts go in that direction), will require an above-average effort by lawmakers on both sides, as well as their constituents, to make a fair evaluation.

Studies cited in the media appear to back up the critics, even if the numbers were not as dire. A study by the Urban Institute’s Health Policy Center estimated that almost 20 million Americans could lose their coverage if ACA is thrown out. The nonpartisan Congressional Budget Office said that losses would be dramatic. But their numbers are also matters of interpretation and analysis.

As laudable as it might be to rid the country of the problematic parts of Obamacare, it must be done without stripping millions of citizens of adequate coverage. And it must be done with bipartisan backing. There is no other way.