Trump Pivots to Health Care Ahead of 2020 Race

WASHINGTON (CN) - President Donald Trump put health care front and center Wednesday as he vowed to implement a new nationwide plan if the courts invalidate the entirety of the Affordable Care Act.

"If the Supreme Court rules that Obamacare is out, we will have a plan that is far better than Obamacare," Trump said during a press conference about Venezuela's humanitarian crisis.

The president offered no further details about the plan. But the timing of his comments - just three days after Special Counsel Robert Mueller apparently cleared him of colluding with Russia's 2016 election interference - could give Democrats further opportunity to highlight what will likely be a key issue among voters in 2020.

On Tuesday, House Democrats began shifting their momentum in that direction by introducing a bill that would bolster protections for those with pre-existing conditions, lower insurance premiums and curtail the availability of what they call "junk" insurance plans, which don't meet federal standards. 

Such plans, which often deny federally mandated essential health benefits like maternity care and prescription drugs, can destabilize the Affordable Care Act markets by enticing younger and healthier people out of those markets.

Dubbed the Protecting Pre-existing Conditions and Making Health Care More Affordable Act, the Democratic bill would increase insurance premium tax credits for all income brackets, and remove the Affordable Care Act's limit on eligibility for subsidies. 

The bill would also create a national reinsurance program, which helps protect companies providing insurance through Affordable Care Act marketplaces from high-cost enrollees, mitigating the need for premium hikes.

In addition, the legislation would redirect federal dollars to enrollment outreach efforts to make up for cuts the Trump administration made to that budget.

According to the nonprofit Families USA, increasing premium tax credits alone would cut premiums by 47 percent for those purchasing coverage with the credits, which would reach nearly 9 million people.

Democratic chairs of the House Education and Labor, Energy and Commerce, and Ways and Means Committees introduced the bill the day after the Justice Department reversed course and asked a federal appeals court to strike the entire Affordable Care Act down as unconstitutional.

In December, a federal judge in Texas ruled that the Affordable Care Act does not pass constitutional muster without the individual mandate. Congress had reduced the penalty for taxpayers without insurance coverage to zero as part of its tax overhaul in 2017. 

Led by Texas, the states that brought the underlying lawsuit had argued that without a mandate requiring health coverage, insurance companies can't be required to provide essential health benefits.  

The New Orleans-based Fifth Circuit is now considering the district court's ruling, which will likely be appealed to the U.S. Supreme Court regardless of the outcome.

According to the think tank the Urban Institute, the number of uninsured people in the country could increase by 65 percent, or nearly 20 million people, if the courts invalidate the Affordable Care Act.

Doing so would eliminate the Medicaid expansion, which the Urban Institute says could result in more than 15 million fewer enrollees, thereby increasing the uninsured rate among lower-income Americans.

States that expanded Medicaid would see the biggest increase in their uninsured rates compared with states that did not expand the program. 

And because insurance companies would no longer be required to cover pre-existing conditions, those with such conditions could face higher prices or be priced out of the market all together.  

It remains to be seen how voters will respond if the courts strike down the law but Trump declared Tuesday on Twitter that "The Republican Party will become 'The Party of Healthcare!"

Polling suggests, however, that might not be a winning strategy for Republicans. A recent Fox News poll shows that 52 percent of voters disapprove of President Trump's handling of health care while only 37 percent approve.

And according to a January Pew Research Center poll, 69 percent cited reducing health care costs as a top priority. 

Meanwhile, health care was a top priority for voters in last year’s midterm elections, topping a list of most important issues in an October Kaiser Family Foundation poll.

While the issue was more important to Democratic and Independent voters than to Republicans, the midterm elections allowed Democrats to take control of the House.

With the administration’s move Monday to invalidate the entire federal health care law, Democrats seized on the opportunity to contrast their position on health care.

During a press conference to unveil their new bill Tuesday, Representative Steny Hoyer of Maryland made sure to note that Democrats tackled health care first thing after the election.

“The first action the Democratic majority took was to protect those with pre-existing conditions,” Hoyer said. “And we are going to continue to fight until those protections are real.”

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