Trump's new attack on Obamacare leads the GOP down a midterm path of doom

Despite new polling that shows Democratic voters most motivated by health care, Trump picks up Obamacare fight

By Matthew Rozsa

Staff Writer

Published June 8, 2018 1:43PM (EDT)

Kevin McCarthy; Paul Ryan; Mitch McConnell; Donald Trump (AP/Getty/Shutterstock/Salon)
Kevin McCarthy; Paul Ryan; Mitch McConnell; Donald Trump (AP/Getty/Shutterstock/Salon)

A new poll reveals that, as Americans prepare for the 2018 midterm elections, the biggest obstacle facing the Republican Party is the fact that the current president is Donald Trump.

Forty-eight percent of voters say they would be more likely to support a candidate who says he would be a check on the president, while only 23 percent said they would be less likely to do so, according to a recent NBC/Wall Street Journal poll. Among voters who live in competitive states and congressional districts, more than 50 percent said they would support a candidate who can serve as a check on Trump.

"The big picture is: You've got two forces colliding. One force is the economy is doing well, and a good economy is always a positive for the president and his party," Allan Lichtman, a professor of history at American University, told Salon. "On the other hand, you have a president who people don't trust, a president who people think is not fit to hold the office and a president who a substantial plurality — maybe not a plurality, but certainly somewhere around 40 percent of Americans — think should be removed from office. We have never seen anything like that since the days of Richard Nixon."

He added, "So there is this kind of 'force of the economy' versus the 'force of Trump' and right now the 'force of Trump,' expressed by this fervent opposition to this president and the need to check him to protect our democracy, seems to be the more powerful force."

Lichtman's views were echoed by another expert political scientist.

"I don't think we've ever had a president whose ratings are more in concrete than Trump's are," Larry Sabato, the founder and director of the Center for Politics, told Salon. "At least in the polls I follow, the ones I trust, he has never been above 50 percent. Never. At the same time he never fell below the mid-30s, at least in the polling averages."

Interestingly, the poll itself identified the economy and health care as the two issues which were most important to American voters. Considering that the unemployment rate is below 4 percent, this would seem to bode well for Trump — and yet on the generic congressional ballot, Democratic candidates beat Republican candidates by a whopping 10 point margin, 50 percent to 40 percent.

"You can have a low unemployment rate and still have some kind of reaction against the president," Sabato told Salon. "I remember 1968, I can remember thinking, 'How could Humphrey be doing so poorly with an unemployment rate around 4 percent?' Which was considered full employment back then and really was. Still is. So that was a good case, he could barely muster 43 percent of the vote. Even Bush in 2002 — the economy wasn't great, we had a recessionary dip after 9/11 — but other issues prevailed. In 1968 it was the Vietnam War, in 2002 it was 9/11. I wouldn't be surprised if scandal and corruption were the intervening factor that reinforced the view of many or most voters that Trump needs to be checked."

Sabato also expressed skepticism about the importance of how highly-ranked the economy and health care were in the poll, pointing out that analysts must remember the state of mind of the people they polled.

"I've learned over the years that people are asked an open-ended question about what bothers them or what is the most concern to them, and they'll grab for the obvious," Sabato told Salon. "Or they'll grab for a headline they saw in the morning. It's not like people are sitting there concentrating on a poll answer as if it was an exam. They want to get you off the phone."

Lichtman had a similar observation.

"I don't think they're irrelevant, but I don't think they're necessarily determinative at all. Although I do think Democrats would do well to play up the health care issue. That really does affect people's lives and the fate of the Congress is going to be critically important for health care policy in the future," Lichtman told Salon.

Trump made that clear earlier this week when his Department of Justice decided not to defend key provisions of the Affordable Care Act.

In a legal filing submitted on Thursday night, the Justice Department argued that the guaranteed issue and community rating provisions of the Affordable Care Act were unconstitutional, according to CNN. The guaranteed issue provision mandates that insurers must offer coverage to all American citizens regardless of their medical history, while the community rating provision states that insurers cannot establish premiums for patients based on their health history. As a result of these provisions, insurance companies can no longer discriminate based on pre-existing conditions or jack up premiums for individuals who were sick in the past, although they also increased premiums for young and healthy customers.

In deciding not to defend these provisions, the Trump administration has essentially cleared the way for a lawsuit brought by a coalition of Republican-led states, including Texas, that has challenged the Affordable Care Act's constitutionality. Their argument hinges on the notion that, because Congress removed the penalty for the individual mandate in 2017 (to be effective in 2019), other parts of the Affordable Care Act have been so destabilized that the law itself is no longer viable.

"I think this is an underappreciated story — that is, the ongoing sabotage of a law passed on his predecessor's watch by President Trump and his administration, with the Congressional Republicans abetting this course of action," Will Marshall, president and founder of the Progressive Policy Institute, told Salon. "It's very underhanded; the president and Republicans tried and failed to repeal Obamacare. So now they're trying to pick apart the law in a way that I think is underhanded and contrary to the spirit of democracy."

He added, "If you want to get rid of something, you have to muster the majority, you have to build the public support to get rid of it. This is kind of an undemocratic act of sabotage that is really injuring Americans who need health care and is particularly hitting Trump voters hard."

As University of Michigan law professor Nicholas Bagley explained in a blog post on Thursday, the Trump Justice Department has established a potentially dangerous precedent by refusing to enforce the Affordable Care Act:

The laws that Congress passes and the Presidents signs are the laws of the land. They aren’t negotiable; they’re not up for further debate. If the Justice Department can just throw in the towel whenever a law is challenged in court, it can effectively pick and choose which laws should remain on the books. That’s as flagrant a violation of the President’s constitutional duty to take care that the laws are faithfully executed as you can imagine.

Bagley also debunked the notion that this could be compared to the decision by President Barack Obama's Justice Department to not defend the Defense of Marriage Act:

Indeed, is there any precedent for this? Odds are we’re going to hear a lot in the coming days about the Obama administration’s decision not to defend the Defense of Marriage Act. There, however, we had a question about the meaning of the Constitution that struck deep on questions about fundamental values. Just as we no longer believe it’s constitutional to offer federal mortgage insurance only in white neighborhoods, the Justice Department concluded that we, as a country, had come around to the view that it was no longer constitutionally tenable to deny equal rights to gay people.

By contrast, Bagley points out, the central question in terms of the Obamacare case is severability. "No one thinks that severability strikes at the heart of who we are as a people and a country," Bagley argued. As a result, the Trump administration's position is not about respecting the constitutional rights of citizens facing discrimination (as was the case with Obama and the Defense of Marriage Act), but rather "rule by whim."

On a deeper level, the Trump administration's stance on the Affordable Care Act could indicate a move to try to repeal the landmark bill once again before the 2018 midterm elections take place. Conservative activists like former Sen. Rick Santorum, R-Pa., have been working to present another Obamacare repeal option even though the last two major efforts by the Republican-controlled Congress to repeal the law have failed, according to New York Magazine. The White House has reportedly been quietly supporting these efforts and trying to provide assistance in terms of strategic coordination and communications, with Vice President Mike Pence being particularly involved in these efforts. Although congressional Republicans faced significant blowback at town hall meetings in 2017 during the thick of the Obamacare repeal effort, recent polls indicate that health care is still a major issue among voters.

Consequently, the hope among conservatives is that, even if a new Obamacare repeal effort doesn't succeed, merely raising the issue again in the public's awareness will help mobilize their base to turn out and vote in November.

Indeed, earlier this week insurers in several states asked to be able to significantly raise their rates as a result of the policies implemented by Trump and Republicans in Congress. According to a report by CNN:

New York insurers want to hike rates by 24%, on average, while carriers in Washington are looking for a 19% average premium increase. In Maryland, CareFirst is asking for an average 18.5% rate bump for its HMO plans and a 91% spike for its PPO policies (which have far fewer enrollees), while Kaiser Permanente wants to boost premiums by more than 37%, on average.

Many insurers cite two key drivers of the increases: Congress' elimination of the penalty for the individual mandate — which requires nearly all Americans to have coverage or pay up — and the Trump administration's expected expansion of two types of health plans that don't have to adhere to Obamacare's regulations.

"It's important that Democrats to remind them [the voters]: Their premiums are going up because of these relentless efforts by Trump and the Republicans to undermine and sabotage the ACA [Affordable Care Act]," Marshall told Salon. "And it's profoundly counterproductive for Republicans because if they destroy the ACA, which is basically a private system (though there is an extension of Medicaid that goes along with it). These exchanges connect people to private insurers and if they make a hash of the attempts by Americans to access private health insurance, the public's going to demand a public takeover of health care. In a strange way, it's a foolish course for Republicans because it leaves single-payer or health-care-for-all as the only option."

He noted that, while he himself doesn't support single-payer health care, Marshall recognized that Republicans erred by trying to dismantle Obamacare without coming up with any "plausible, credible" private market-based solutions of their own.

None of this is to say that Democrats are guaranteed to retake both the Senate and the House of Representatives. Gerrymandering has significantly increased the margin by which Democrats would have to outperform Republicans in order to reclaim control of the House of Representatives, and Democrats are already at a disadvantage because they have to defend far more Senate races than Republicans. Nevertheless, if Republicans suffer a net loss in 2018, that will bode ill not only for Trump's ability to implement his agenda but also his reelection chances.

"Any loss of seats on the part of Republicans — and I think that's inevitable unless the political winds drastically change direction — is a bad sign for his reelection in 2020," Lichtman told Salon.

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By Matthew Rozsa

Matthew Rozsa is a staff writer at Salon. He received a Master's Degree in History from Rutgers-Newark in 2012 and was awarded a science journalism fellowship from the Metcalf Institute in 2022.

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