You’re not insane. The congressional Republicans and the White House are absolutely lying about the impact of Trumpcare, and as with their lies about the Trump-Russia scandal, the lies are glaringly obvious. As you observe these lies while they sail past virtually unchallenged, it’s not surprising if you might feel a little crazy. You’re not. They know they’re lying and they know you know they’re lying. But here’s the critical distinction: The pro-Trump GOP isn’t talking to you.
Over the weekend, Vice President Mike Pence delivered one of the most obvious lies about the embattled, possibly doomed legislation. Speaking to the National Governors Association, Pence said, “When it comes to Medicaid, not only does the health care bill expand state flexibility, it ensures that every state in America has the resources you need to take care of your most vulnerable.”
He also tweeted the following message -- twice: “Let me be clear: The Senate health-care bill strengthens and secures Medicaid for the neediest in our society.” And he added, “We're saving Medicaid for the sake of our most vulnerable and providing all Americans with access to high-quality, affordable health insurance.”
Meanwhile, Trump’s Health and Human Services secretary, Tom Price, appeared on Fox News Channel’s “Sunday Morning Futures” program and said, “We're going to be able to cover more individuals on this bill than are currently covered.”
None of that is true. None of it. The Congressional Budget Office will hand down its verdict on the latest version of the bill sometime on Monday, but it’s not expected to significantly revise the numbers revealed in previous scorings of the Republican health care legislation, either the House or Senate versions. In the June report based on the more moderate Senate version, we learned that 3.3 million Americans -- disabled people, children and senior citizens, mostly -- would have their Medicaid coverage stripped away due to Trumpcare’s $774 billion cuts to the program, including the phase-out of the Affordable Care Act’s Medicaid expansion. That’s 3.3 million people out of a total 22 million people who will have their health insurance stolen from them by President Trump and the GOP. Twenty-four out of the 31 Medicaid-expansion states would roll back coverage to pre-ACA levels.
In other words, and to repeat, Pence lied to America’s governors and, of course, to the American people when he preposterously guaranteed that Trumpcare “strengthens” and “secures” Medicaid. Nor does it save Medicaid, as Pence promised. In reality, it’ll do exactly the opposite. Likewise, Secretary Price lied when he confoundingly promised that Trumpcare will cover more people. Not only will 22 million more people lose their coverage, according to CBO estimates, but Americans on the periphery of the system -- those with pre-existing conditions and the like -- will be forced onto pointless, dodgy plans with massive deductibles that cover virtually nothing.
As I’ve been saying for months now, this “repeal and replace” strategy is turning out to be nothing more than a repeal. A “replacement,” on the other hand, suggests something comparable or at least vaguely similar. Trumpcare fails on that front, too, and the Republicans aren’t even trying to create a lateral alternative to the ACA, chiefly because modern conservative ideology is incompatible with creating affordable, universal health care. It can’t be done.
So there are a pair of reasons for the GOP’s shockingly transparent lies about this bungled and botched legislation.
First, Republicans understand that the Obama administration didn’t do enough to educate the public on how health care works or the benefits of the ACA. Health care, as Trump once said, is complicated -- though almost everyone except the president already knew that. Consequently, for its first several years, few Americans understood the full scope of Obamacare, allowing the GOP to fill the gaps with lies and disinformation -- making the ACA all about the Healthcare.gov website and the marketplaces.
Notice how Trump never mentions the historically successful Medicaid expansion, nor does he talk about the consumer protections, such as the elimination of lifetime or annual limits. He also doesn’t talk about the essential health benefits: the array of mostly preventative treatments that must be covered, whether by marketplace plans or employer-based coverage. He doesn’t mention these things because they compose roughly two-thirds of the ACA and they’re, to repeat, hugely popular and thriving.
Second, the Republicans aren’t talking to you, or to any anti-Trump voters of either party. The GOP’s messaging, and especially the White House’s messaging, is aimed squarely at the 35 percent: the cult-like voters who will support Trump until the bitter end. Trump’s base. This is their micro-targeted “moneyball” gambit. Trump and the GOP are betting they can retain their current majorities, as well as the White House, by exclusively marketing to the 35 percenters who will believe literally anything their Scientology-like auditors tell them.
Whether the message is that it’s perfectly normal to conspire with a hostile foreign government while it attacks and invades American sovereignty, or whether it’s that the ACA is “imploding,” the pro-Trump loyalists will believe anything they’re told. We can fact-check all we want and it simply doesn’t matter. Facts don’t matter, reality doesn’t matter, and for Trump and his disciples, words have no meaning. As long as the 35 percent, with their “MAGA” hats and “fuck your feelings” T-shirts, are energized, the Republicans can hang onto their seats.
How do they make up the additional 10 or 15 percent of the vote required to win elections? That part’s easy, and it’s the part of the plan that’s been underway for a while now. First of all, bear in mind that Trump won the White House with only 46 percent of the vote. The Republicans have designed this plot so that the extra several percentage points can be made up through gerrymandering, voter suppression, voter ID, voter purges and, of course, the Russians with their bots, hacking, malware, social media targeting and other active measures. In other words, they can pick up the votes they need over and above the base simply by continuing to cheat. It’s that simple.
By weaponizing these subversive tactics, Republicans can continue to feed their cult followers a steady diet of conspicuous disinformation with virtual impunity -- bread and circuses for the base. It must be seriously liberating for certain Republicans to to be afforded the latitude to entirely sidestep the awkward drudgery of compromising and forming old-school coalitions that included moderates, independents and conservative Democrats. If they already enjoy a built-in captive audience that will forgive them anything, including losing their own health insurance or childish tweeting, sexual assault and treason, the GOP’s messaging can be untethered from objective reality. Trump and his allies can sell their people on literally anything. And they can still win.
As with many of my observations about the Trump era, I hope I’m wrong about this. But I don’t think I am. Yes, we exist in a post-fact era, and Republicans are exploiting it while they can. The 35 percent is allowing Trump and his imitators to say and do whatever they want as long as it successfully trolls Democrats, and the Republicans are well aware of this new and deeply abnormal reality. As we careen toward the midterm elections and closer to accountability on the Trump-Russia conspiracy, we can expect the disinformation to get a lot worse before it gets better. So, no, you’re not insane.