- The Donald Trump administration has been strongly rebuked for its handling of the coronavirus pandemic.
- But Trump's failures on healthcare stretch back much further: During his first days as president, he tried to repeal the Affordable Care Act (ACA).
- Trump is backing a lawsuit that could ACA coverage from 20 million Americans this autumn and strip preexisting condition protections from tens of millions more.
- Margarida Jorge is the Executive Director of Health Care for American Now (HCAN).
- This is an opinion column. The thoughts expressed are those of the author.
- Visit Business Insider's homepage for more stories.
In the past week, the number of coronavirus cases here in the United States has surpassed more than 2 million cases with nearly 115,000 reported deaths. Medical professionals and state health officials are still sounding the alarm on supply shortages, and while the curve is flattening in certain parts of the country, the pandemic continues to overwhelm the nation's healthcare system.
On the heels of a decline in approval linked to handling of the crisis, the Trump administration is finally taking the pandemic a little more seriously. Trump's attempts to downplay the severity of the virus at the start of the outbreak cost us invaluable time – and jeopardized the lives of countless Americans. Even now that the threat is undeniable, the president has been slow to mobilize the nation's emergency response resources, leaving mayors and governors scrambling to fill in the gaps. It's a failure of historic proportions.
But let's be clear — this isn't the first time Trump has failed on healthcare. Long before the current crisis, the Trump administration's relentless attacks on the Affordable Care Act (ACA), Medicaid, and Medicare undermined our capacity to fight even chronic disease, much less a worldwide pandemic.
Trump has fallen short on healthcare before and the pandemic could be no different
Trump's history on healthcare is littered with broken promises and feeble cover-ups. His first actions as president were to try and repeal the ACA and end Medicaid expansion, all the while claiming he had a fantastic new replacement that never materialized.
Trump declared the opioid epidemic a national public health emergency, but then rather than expand Medicaid funding or use executive authority to negotiate lower prices for naloxone, a drug that quickly counteracts the effects of opioid overdoses, he proposed a "just-say-no" style advertising campaign.
His pledge to eradicate HIV/AIDS reprises the same story. Rather than use executive power to make TRUVADA or PrEP more accessible by taking away the drug companies' monopoly power, he did nothing to stop Big Pharma's price gouging or expand health coverage for millions who still lack it.
In March, the President signed a coronavirus relief bill into law, which guarantees free testing. But it's not clear whether the coronavirus vaccine, once it is developed, will be affordable for everyone, even though taxpayers have invested over $1 billion in its research and development. Despite efforts from members of Congress to get a commitment from the Trump administration that no drug company will have monopoly power to set the price of this vaccine, Trump's Health and Human Services secretary — a former pharma executive -— refused to commit to affordability during congressional hearings and Trump has only promised to "look at" making a potential vaccine free.
We know what happens when drug corporations have the power to set prices: massive price-gouging that makes everything from insulin to EpiPens too expensive for some of the Americans that need the drugs. Can we really afford the same business as usual during a worldwide pandemic that is expected to infect at least a third of Americans?
Affordable access is at risk even for ACA enrollees. That's because President Trump is backing a lawsuit that could take coverage from 20 million Americans this fall and strip preexisting condition protections from tens of millions more.
The ACA requires insurers to provide important preventative vaccines without copays or deductibles, meaning that the eventual vaccine for COVID-19 would likely be covered. But if the president finally gets his way, the landmark ACA will end, leaving millions more vulnerable to the epidemic.
More than 20 million people could lose their health coverage if Republicans get a victory in the Texas v. United States Supreme Court case and the ACA is overturned. And if you are one of the 150 million Americans with a preexisting condition, you could lose coverage or face outrageous premiums – the last thing anyone needs at a time of deep economic uncertainty. Not to mention that while 38.6 million Americans are unemployed, the Trump administration refuses to open up a special enrollment period for the ACA that could make it easier for the millions of newly-uninsured Americans to seek out coverage.
An example of the vital importance of the ACA
As communities across the country face a mounting public health crisis, we've seen first-hand just how important the ACA is to the nation's ability to mobilize a response to coronavirus.
The Trump administration, finally facing reality, has given states more flexibility in extending Medicaid and Medicare to ensure that more of their residents are able to access care. This move underscores just how important Medicaid expansion under the ACA has been in providing access to affordable care and improving outcomes. Elected officials who previously railed against Medicaid expansion and now scrambling to get more of their constituents covered.
It shouldn't take a public health crisis of this magnitude to force our leaders to recognize the importance of the ACA, but it would be even more foolish for them to ignore this lesson once this emergency subsides. Every one of us needs access to affordable healthcare whether we are in the midst of a crisis or not.
We also need a president who fights to ensure access to quality, affordable healthcare for all of us, instead of working overtime to undo the painstaking progress we've made. We need a president who will work to expand coverage because it's the right thing to do, not just because his re-election chances are on the line.