Trump has waged war against the decade-old Affordable Care Act aka Obamacare. Part of it is because he wants to overturn every aspect of Obama’s legacy. But another is that Republicans have long fought bitterly against the law because it helps poor people and is thus, by definition, ‘socialism’. Trump promised to overturn the law but failed repeatedly so naturally, since he can never see himself as a loser, he claimed that he actually won because he got rid of that part of the law known as the individual mandate.
Insurance works by spreading the risks and the larger the pool of insured people, the better the system works. The mandate was the fine that was imposed on people who did not sign up for insurance. Trump did not actually get rid of the individual mandate. What happened was that an earlier Supreme Court decision said that while such a mandate exceeded congress’s power and was unconstitutional, in a narrow 5-4 ruling by chief justice John Roberts, they also said that it could be considered a tax and thus was within congressional taxing powers.
The Republican led congress then passed a measure that made the fine zero. Today, the Supreme Court heard oral arguments in a lawsuit brought forward by various attorneys general in Republican states and joined (of course) by the Trump justice department that making the fine zero essentially eliminated the idea that it was a tax and, if so, this made it a mandate and thus unconstitutional and that this meant that the entire law was unconstitutional and must be struck down.
The Supreme Court is weighing three issues. The first is whether the state attorneys general have standing to bring this lawsuit. If the answer is yes, the second is whether making the fine zero meant that it was not a tax but a mandate and thus unconstitutional. If the answer is yes, the third is whether that part of the law can be eliminated by itself or whether it should make the entire law unconstitutional
If the entire Obamacare law is struck down, then over 20 million people will lose their current insurance. Furthermore the aspect of the law that everyone enjoys and supports that protects them from being denied coverage because of pre-existing conditions will disappear. Insurance companies were notorious for using that provision in the past to deny coverage to sick people. Another much-loved benefit is that children can be on their parents’ polices until the age of 26.
The protection of people with pre-existing conditions is one of the most popular provisions of Obamacare. You can see this by the way that Trump and the Republicans claim that even if Obamacare is overturned, that protection will remain. When asked how that can be, Trump says that his plan will have the same protections even though he has said this for years and has never produced such a plan. It is obvious that they do not have a plan at all. But the Trump cult seems to feel that Obamacare must be overturned because it is socialism and that when it happens, the protections it provides that they like will magically reappear.
The level of delusion necessary to believe such a thing is immense. This is not some abstract policy issue but one that affects pretty much everyone directly. I sometimes wonder if when Republican leaders get together privately, they marvel among themselves as to how they could have persuaded so many people to believe in something so preposterous on an issue that could literally mean the difference between life and death for them.