In a special @abc2020, @GStephanopoulos presses Pres. Trump on claim he is preserving pre-existing conditions, even as his administration argues in court against Obamacare, which protects them: "You've been trying to strike down pre-existing conditions." https://t.co/ztM30WXxPT pic.twitter.com/u0mClQXlXg— ABC News (@ABC) September 16, 2020
Transcription below with my comments italicized in parentheses:
Trump responds to a questioner:
But what we're doing is we're going to be doing a health care plan, preexisting, protecting people with preexisting conditions. As an example, yourself, it sounds like that's exactly perfect. That's exactly what we're talking about. We're going to be doing a health care plan very strongly and protect people with preexisting conditions. I will say this: They will not do that (Obamacare/ACA has covered preexisting conditions since its inception and still does) because they have socialized medicine (we have a mostly private medical system. The VA and military have government hospitals and some municipalities have public health services, but the system is otherwise largely privately operated, mostly for profit. Obamacare is about health coverage, not publicly operated medical services, Biden has not proposed government owned or run healthcare delivery).
I have to stop you there just on a couple of points. Number one, Joe Biden has run against Medicare for all in the primaries (To clarify, Medicare is socialized insurance, not socialized medicine, and we've had it since the 1960s for seniors). More importantly, Obamacare guaranteed people with preexisting conditions could buy insurance (questioner nods in agreement) and guaranteed they could buy it at the same price as everyone else (True), guaranteed a package of essential benefits, guaranteed insurance companies couldn't put a lifetime limit on those benefits (All True). You fought to repeal Obamacare. You're arguing in the Supreme Court right now to strike it down (the administration along with 18 states). That would do away with preexisting conditions,
No (Yes) So we can do new health care (You can do new health care without striking Obamacare down in court. If you have the votes to pass a new coverage plan, it would replace Obamacare. The GOP tried that and it didn't work. Striking down ACA does not put a new health coverage plan in it's place. It leave nothing in it's place. You'd stilll have to propose and pass a new plan.)
You've been promising a new health care plan, I interviewed you in June, you said the health care plan would come in two weeks. You told Chris Wallace this summer it would come in three weeks (In 2015, Trump promised he had a plan that would be better and cheaper than Obamacare, and the plan would have coverage for everyone. Four years later, still nothing). You promised an executive order for preexiting conditions...
I have it already. I have it already.
You've been trying to strike down preexisting conditions...
It doesn't matter. I have it already (Trump said that in in 2015, but I repeat myself, and so does he.). It's a much better plan for you and it's a much better plan (Trump said that in 2015). When you say Obamacare, I got rid of the individual mandate, which is the worst part of Obamacare (To minimize the cost of insurance coverage on a per capita basis, a plan must be representative of the entire population. A plan that allows self-selected opting in or out incentivizes the sickest to buy in while the healthy are more likely to opt out. This jacks up per capita costs of coverage, in turn locking out the sickest. Any workable insurance pool must include healthier, lower-risk elements of the population just as it is the case with employer-based health insurance. Insurance is not otherwise viable. The mandate is one leg of a three-legged stool: 1.) Americans must buy in to have the broadest risk pool. 2, A minimum package of benefits must be available to all. 3. Government must provide some sort of income-based subsidy so that buy-in is affordable to all.)
I'm not saying that Obamacare is the best way to provide better coverage to more people or that ACA, in all its details, is the best way to go. It could be improved with a stronger mandate and reconsideration of incentives (e.g., more outcome-based reimbursement as opposed to reimbursement based entirely on a per-service basis). That's if we want to keep a privately-based delivery system. There are as many other ways to move toward more affordable, universal coverage as there are other countries that are providing guaranteed health care that doesn't bankrupt the sick.
Nothing Trump has ever said indicates that he has any plan to move us closer to better, more affordable coverage for all. Moreover, nothing he's ever said indicates that he has any idea how this might be done, other than his drug plan, which is a plan with bipartisan support. That plan should have been part of ACA, but Obama didn't push it because he needed the pharamaceutical industry's support for ACA. He got that support, but at the expense of kicking the drug-cost can down the road.