The Trumpcare Scam

I wanted to take a break from writing hair-on-fire warnings of the coming stolen election. But first I have to link to Dana Milbank’s column today, because now Milbank’s hair is on fire too. This is not a drill. The Reichstag is burning.

For five years, my colleagues and I have taken pains to avoid Nazi comparisons. It is usually hyperbolic, and counterproductive, to label the right “fascists” in the way those on the right reflexively label the left “socialists.” But this is no longer a matter of name-calling.

With his repeated refusals this week to accept the peaceful transfer of power — the bedrock principle that has sustained American democracy for 228 years — President Trump has put the United States, in some ways, where Germany was in 1933. That is when Adolf Hitler, the appointed leader, used the suspicious burning of the German parliament to turn a democracy into a totalitarian state.

And so on. And Milbank is not normally a hair-on-fire kind of guy. See also David Siders and Holly Otterbein, Pollitico, ‘Everyone sees the train wreck coming’: Trump reveals his November endgame.

But now I want to back off from the apocalypse and focus on something less threatening, which is the possible meltdown of our health care system. The Affordable Care Act comes before the Supreme Court in November, after the election. With a new right-wing nutjob justice on the bench, it’s entirely possible the Court will nullify the entire law. John Roberts might rather they didn’t, but he’s not going to be able to be a swing vote any more. Anything is possible.

Trump thinks he has his ass covered by signing an executive order that allegedly protects insurance coverage for pre-existing conditions. He’s been talking about signing such an order for weeks, and yesterday he finally did it.

President Trump on Thursday signed a largely symbolic executive order aimed at protecting people with pre-existing conditions as he takes fire for a lawsuit seeking to overturn ObamaCare, which enacted those protections.

“The historic action I am taking today includes the first-ever executive order to affirm it is the official policy of the United States government to protect patients with pre-existing conditions,” Trump said during a speech in North Carolina, a key swing state. “So we’re making that official.”

Trump noted “our opponents, the Democrats, like to constantly talk about” health care and pre-existing conditions, but “now we have it affirmed, this is affirmed, signed and done.”

The White House did not immediately release the text of the order, but from Trump and other officials’ descriptions it simply states that protecting people with pre-existing conditions is the policy of the government, something that does not have the force of law on its own.

Whether Trump understands that the Affordable Care Act already protected people with pre-exising conditions, or even that he understands why “pre-existing conditions” is an issue, is not clear. And, of course, “the policy of the government” doesn’t mean beans to the private insurance companies, who are the ones who will refuse to cover people with pre-existing conditions if the ACA is dead.

The executive order must have been released. See Paul Waldman, today.

Trump has a “better” plan. Just like the better future you’ll have once you give your life savings to Trump University to learn his real estate secrets.

In the software industry they call this “vaporware” — a product announced with great fanfare that never actually exists.

I would point out that the ACA is over 900 pages long, as befits a law that sought to re-engineer an impossibly complex system. As Trump himself marveled when he first tried to repeal it, “Nobody knew health care could be so complicated.” Everybody knew that, except for him.

Trump’s executive order, on the other hand, is not complicated at all, nor is it a “plan.” After a few pages extolling the fantastic work his administration has done on health care, it says it will do things like lower costs and expand access. How? Don’t ask.

That’s it. That’s Trump’s health care plan, apparently. As Waldman says, it’s like releasing a plan to become a billionaire, consisting of “Step One: Become a billionaire.”

Here’s another bit of weirdness. A few days ago, the New York Times reported that Trump and the pharmaceutical industry were very close to a deal that would have lowered prescription drug prices. This would have been a major coup, had it not fallen apart at the last minute.

The breaking point, according to four people familiar with the discussions: Mark Meadows, Mr. Trump’s chief of staff, insisted the drug makers pay for $100 cash cards that would be mailed to seniors before November — “Trump Cards,” some in the industry called them.

Some of the drugmakers bridled at being party to what they feared would be seen as an 11th-hour political boost for Mr. Trump, the people familiar with the matter said.

But the “Trump cards” were nonnegotiable, as far as the White House was concerned. So the pharmaceutical industry backed out of the negotiations.

“We could not agree to the administration’s plan to issue one-time savings cards right before a presidential election,” said Priscilla VanderVeer, the vice president of public affairs at PhRMA, the industry’s largest trade group. “One-time savings cards will neither provide lasting help, nor advance the fundamental reforms necessary to help seniors better afford their medicines.”

Then this happened yesterday, Waldman says:

Trump said in his speech that in the next few weeks the government will be sending $200 prescription drug discount cards to 33 million Medicare beneficiaries. “Nobody has seen this before,” he said. “These cards are incredible.”

Given that doing so would cost $6.6 billion and the president can’t simply do that without an act of Congress, if it actually happened it would almost certainly be illegal (the White House claims they can do it through a program they’ve proposed but that does not yet exist, I kid you not). Furthermore, a one-time $200 payment does nothing to solve the enormous problem of high drug costs.

There’s no Trump health care plan, there’s no program to issue discount cards, it’s all just a scam. Trump is promising the moon to get himself re-elected.

Unfortunately, “health care” is not one of the announced topics to be covered in the upcoming presidential debate. A damn shame.