In his speech to Congress tonight Donald Trump once again showed that he lacks the basic understanding of policy issues expected of a president of either party. While this lack of understanding comes through in every area of public policy he addresses, nowhere is it clearer than in his discussion of the Affordable Care Act (ACA).
Throughout his campaign he denounced the ACA in the strongest possible terms. He routinely pronounced it as a disaster and used other equally strong terms. He promised the public that he would replace the ACA with something terrific.
In the course of the campaign he never gave any specifics of a replacement for the ACA. Nor did he produce any specifics in the period between the election and his inauguration. Now, more than a month after he has taken office as president, he still has not produced even an outline of how he intends to replace the ACA, although he continues to affirm his commitment to ending the program.
This is an incredibly cruel hoax on the American people. More than twenty million people now have insurance through the ACA. Many of these people have serious health conditions that would have made it difficult or impossible to get insurance in the pre-ACA market.
However, the importance of the ACA goes well beyond the number of people who have insurance at any point in time. Five million people lose or leave their jobs every month. These people often leave jobs with employer-provided insurance and either go through a period of unemployment or get a new job that doesn’t provide insurance.
The ACA provides security to these workers and to tens of millions of others who know they now have the option to get insurance if they leave their job. This is the reason that the number of people choosing to work part-time has risen by more than two million since the ACA effect. The impact has been strongest among young parents and older workers who are still pre-Medicare age.
President Trump and the Republicans in Congress are threatening to take away this security with their promise to repeal the ACA. People need to make plans – some are considering retirement, others want to start a business. Unfortunately, President Trump still has not given even an outline of what his final plan might look like.
It is inconceivable that any prior president would have been so irresponsible in dealing with an issue that is both enormously important to the American people and that he himself has put front and center in his political agenda.
Trump and his Republican supporters must start to put some concrete proposals on the table. If Donald Trump isn’t prepared to be serious about health insurance then the adult Republicans in Congress will inevitably take the lead.