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Trump uses Obamacare as a distraction. Biden sees an opportunity

Presidents from both parties know one rule about health care policy: don’t mess with what people already have. Democrats hope they can win on Trump’s health care talk

Eric Garcia
Monday 04 December 2023 17:58 GMT
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(Getty Images)

There’s an old saying when it comes to health care policy: don’t mess with what people already have. Much in the way that Americans think Congress is irrevocably broken but then re-elect their members by at least 90 percent most years, most Americans complain regularly about the status quo of the health care system, but the moment politicians try and change what Americans have, they revolt.

President Joe Biden’s campaign is going all-in on betting that his predecessor’s recent comments on health care will help him stay in office. Last week, former president Donald Trump began regularly posting on Truth Social about how he planned to get “much better Healthcare than Obamacare for the American people” were he to be re-elected. Later, the former president said his plan was not to “terminate” health Obamacare but “REPLACE IT with MUCH BETTER HEALTHCARE.”

My colleague Andrew Feinberg rightly pointed out last week that Mr Trump’s words are a distraction from his plans for creeping authoritarianism and roadmap to exact vengeance on his political enemies.

All of that is true, and indeed, Mr Trump never seemed to care much about the intricacies of health care policy. He famously said as president that “nobody knew health care could be so complicated,” which his direct predecessor Barack Obama could have told him. But many Americans see threats to their health care as more immediate to their wellbeing than still-hypothetical plans for Mr Trump to turn the government into his own personal bludgeoning tool. And Democrats seem to recognize this and have responded accordingly.

Almost immediately, team Biden pounced on the words of Mr Trump. The Biden team coordinated a press call with former House speaker Nancy Pelosi and North Carolina Gov Roy Cooper, which was no accident.

Ms Pelosi largely earned her reputation as a master vote counter by virtue of her ability to wrangle an unruly Democratic caucus to pass the Affordable Care Act in 2010. But Ms Pelosi saw how Republicans made hay out of her comments that Congress needed to “pass the bill so you can find out what's in it,” which led to a historic wipeout of Democrats in the House that year--which in turn paved the way for Mr Trump’s presidency.

Eight years later, after Obamacare had become more established and people benefited from the law’s protections against discrimination against people with pre-existing conditions and ban on lifetime caps, the law had become the status quo. In turn, Democrats hammered Republicans’ ill-fated attempts to overturn the health care law, which propelled them back into the majority in the House of Representatives.

Conversely, Mr Cooper is a Democratic governor of a state that usually votes for Republicans on the presidential level. Indeed, he won his first term in 2016 despite Mr Trump winning the Tar Heel state and again in 2020 partially on the promise of expanding Medicaid under Obamacare, which Republicans have blocked for a decade.

Earlier this year, though, he and Republicans finally came to an agreement and the expansion of Medicaid went into effect last week.

Similarly, the Biden campaign released an ad last week featuring a nurse from Nevada touting the president’s Inflation Reduction Act for allowing Medicare to negotiate the price of prescription drugs while also saying “I don’t want to go back” to the days of the Trump administration’s health care policies. In addition, Rep Maxwell Frost (D-Florida), the first Generation Z congressman, went on MSNBC last week to talk about how a Trump White House would mean people under 26 would not be able to stay on their parents’ health insurance since Obamacare allowed them to do so.

The selection of Nevada is intentional, of course, given that longtime followers of Inside Washington know that it’s the swing state to watch given its large Hispanic population that is trending rightward. The late Senate Majority Leader Harry Reid hailed from the Silver State and worked like the devil to pass Obamacare but nearly lost his Senate seat in 2010 in the aftermath. But in 2018, Democrats flipped the governorship and Senate seat largely because of even the state’s then-Republican governor opposed Republican efforts to repeal the 2010 law.

But repealing Obamacare is not only something that could hurt Mr Trump. Florida Gov Ron DeSantis was a congressman in 2017 and voted for the Republican plan to repeal and replace Obamacare. This weekend, the governor whose campaign has been lagging told Meet the Press that he would “replace and supersede with a better plan.” Similarly, former South Carolina governor Nikki Haley won her first campaign for governor in 2010 and in turn refused to expand Medicaid.

Similarly, friend of the newsletter Kadia Goba at Semafor reported that Tim Sheehey, who is running in Montana against incumbent Democratic Sen Jon Tester, said at a meet-and-greet that “we need to return healthcare to pure privatization.” Mr Sheehey is considered a marquee recruit in a state Mr Trump won by double digits. Expect Democrats in the coming weeks to make this the centerpiece of their down-ballot races as well, especially in red states where they must protect their incumbents.

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