During the debate and rollout of the Affordable Care Act, President Obama frequently repeated a snappy but inaccurate soundbite: If Americans liked their plans, he said, they could keep them. This was a foolish promise, since one of the ACA’s key goals was to craft minimal standards so that consumers wouldn’t discover at the worst possible moment—say, after a serious injury or life-changing diagnosis—that their insurance policy was threadbare and would prove worthless. The President should, therefore, have said that while some older plans would be grandfathered into the new system, many would not, including, obviously, those that had since been changed. A more careful formulation might have gone something like this: We’re crafting higher insurance standards for consumers, and if your plan’s not worth the paper it’s printed on, we’ll make sure you can afford a better one.
Needless to say, conservatives were apoplectic at this broken promise. In the National Review, it was called “one of the most misleading parts of Obamacare” by a writer who ominously intoned that “Americans are left to deal with the consequences” of Obama’s “breathtaking mendacity.” Opponents of the ACA suggested that, were it not for this massive deception, the law would never have been passed: As an article from the American Enterprise Institute put it, the ACA was “sold to the American people with lies,” and it was these “lies and false promises that allowed Obamacare to become reality.” A piece on Paul Ryan’s website expressed sympathy for Americans experiencing “the harsh reality of losing their health care,” solemnly observing that “the stress and financial uncertainty associated with losing health insurance is no laughing matter for families across the country.” Mainstream sources joined in as well: The Washington Post awarded the Administration’s claim Four Pinnochios, and PolitiFact named it the “Lie of the Year” for 2013.
Of course, as the Post noted, “it’s certainly incorrect to claim, as some Republicans have, that people are losing insurance coverage. Instead, in virtually all cases, it’s being replaced with probably better (and possibly more expensive) insurance.” This was undoubtedly an important qualification, but even so, it wasn’t unreasonable for Americans to expect a more straightforward message from the President and his Administration. Slightly complicated policy details aside, the President should not have suggested that a bill raising insurance standards would leave everyone’s policies untouched.
With the memory of this kerfuffle in hand, let us revisit the expansive promises of Donald Trump in light of the rollout of Trumpcare. Among other things, this newly-released plan would slash billions from Medicaid, drastically shift tax credit assistance from lower-income to higher-income people, and result (on average) in annual cost increases of over $1,500 for the average Obamacare enrollee. There’s no score from the Congressional Budget Office yet, but the plan would result in millions—perhaps tens of millions—of Americans losing their coverage.
Aside from all the obvious reasons why this matters, it’s worth recalling that less than two months ago, President Trump promised “insurance for everybody” to The Washington Post. Under his plan, the President declared, people “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.” In fact, he said, deploying one of the half-dozen or so modifiers in his arsenal, they’d be “beautifully covered.” Not a single word of this is true, and there is no additional context that mitigates the dishonesty of Trump’s assertions in the slightest. Nor can we take comfort in the notion that, however misleading the promise, the intent was good: Trump is not trying to improve anybody’s health care by crafting higher industry standards.
This is worth mentioning because, only a few years ago, it was considered outrageous for a President to make a misleading promise to Americans about something as important as their health care, even if that promise concerned a change that would benefit them. Here, we have a President who is lying through his teeth about every aspect of a plan that will devastate millions of Americans, especially the poor and sick. Silence from certain formerly outraged quarters is to be predicted, but the resignation from the same elites and media outlets that castigated Obama will be a far better indicator of the singularly bizarre politics of the Trump era. After all, it’s important to recall that when Trump first promised beautiful insurance for everybody, not only did his own party not believe him; they didn’t even think he knew what he was talking about. As Yuval Levin reported at the time, “the conservative health-care universe, including some people on Trump’s own team, quickly concluded that the separate administration plan [the President] described was entirely a figment of Trump’s imagination.” Think about that. This President’s lies receive far less outrage because—in the judgment of his own party—he’s so delusional, or such a fabulist, that there was never any reason to take his words seriously in the first place.