There has perhaps been no more frequently promised product than Trump’s comprehensive proposal on health care. Over and over, Trump has insisted there will be something to replace the Affordable Care Act. Over and over, he has set deadlines for when it will come. Over and over, those deadlines pass.
On Tuesday, White House press secretary Kayleigh McEnany was asked when Trump’s proposal would appear, given that he promised it by Aug. 2 and then by Aug. 21 and then by Aug. 31.
“The president, in the next week or so, will be laying out his vision for health care,” McEnany said in response to a reporter’s question. “Some of that has already been put out there, like telemedicine and lowering the cost of drugs … and protecting preexisting conditions. But the president will be laying out some additional health-care steps in the coming, I would say, two weeks.”
Sure, Okay. It’s not like we’ve heard that before.
A review of a past Post compilation and from Kaiser Health News identifies more than two dozen occasions on which Trump alone has said either that a new proposal is coming at some point (without saying when) or that one is coming at a set time. Often, that set time is two weeks. Or the end of the month. Or “soon,” which we figured meant about a month for the purposes of the graphic below. At other times it’s been pegged to specific events such as the 2020 election.
Of the moving deadlines Trump set for release of his health-care proposal (which he described as “all ready” on Sept. 15), none is more important at the moment than the one he established in March 2019.
“If the decisions are held up, if we win on the termination of Obamacare,” he said of a challenge to the Affordable Care Act that’s in front of the Supreme Court, “we will have a plan that’s far better than Obamacare, including, very importantly, preexisting conditions, which I’ve always been in favor of.”
That case that’s before the Court would, in fact, eradicate protections for preexisting conditions.
But the broader point here is that the Obamacare case is yet to be determined — and could be resolved only after Trump nominates a replacement to Ruth Bader Ginsburg. In other words, there could be a new conservative majority on the bench, a third of them Trump nominees, which votes to dump the law. And, therefore, forces Trump’s hand on his always-two-weeks-away health-care proposal.
This is actually risky for Trump, the ostensible political goal of tossing Obamacare aside. A Fox News poll released last week showed that former vice president Joe Biden has an 8-point advantage over Trump on voter confidence to handle health care — a bigger margin than Biden’s overall lead in that poll. A 2020 campaign that’s centered on health care and the protection of affordable coverage for those with preexisting conditions is almost certainly a campaign in which Trump is at a disadvantage.
You’ll note that McEnany, like Trump, tried to argue that various piecemeal changes to how health care is provided serves as some sort of introductory latticework for a full health-care proposal. It doesn’t of course; the issue isn’t the availability of things like telemedicine but, instead, how those without employer coverage can afford to protect and care for themselves. This is the Achilles’ heel in Trump’s “I will save preexisting conditions” line: assuring people that they can buy coverage even with preexisting conditions but failing to control how much that coverage costs is like saying everyone can fly into space if they can buy or build their own rockets. It’s true, but it’s not really helpful.
It’s clear Trump is much happier with the “a great plan is coming soon” pledge than with actually unveiling a great plan. That’s because the former leverages the same optimism that got him elected president: maybe this undefined thing actually will be great! Once you put it on paper, though, you invite a lot more critical analysis.
This isn’t a problem that’s new to Trump, of course. Ever since the Affordable Care Act first passed, Republicans have been promising to replace it with something else — without specifics on what that might be.
I remember distinctly participating in a panel discussion on CNN in October 2016 in which I pointed out that Trump’s promises on health care mirrored his party’s failure to develop a comprehensive plan.
Then-House Speaker “Paul Ryan has actually put forward a very detailed, very good plan,” one of the other panelists insisted, “involving health care savings accounts.”
That was Kayleigh McEnany, then, as now, doing her best to create political space for Donald Trump.