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My favorite Lily Tomlin line is this one: “No matter how cynical you become, it’s never enough to keep up.”
I love it more today than ever, because it applies so perfectly to how we must respond to the campaign claims of Donald Trump and JD Vance. Especially Trump’s assertions about his role — heroic, in his vision — in “saving” the Affordable Care Act and fighting the COVID pandemic.
I’ve written before about the firehouse of fabrication and grift emanating from the Trump campaign like a political miasma. On these topics, he has moved beyond his habit of merely concocting a false reality about, say, immigration and crime to deliberately concocting a false reality about himself.
To start by summarizing: Trump did everything in his power to destroy the Affordable Care Act, starting on the very first day of his term in 2017. On COVID, he did everything in his power to make America defenseless against the spreading pandemic.
Let’s take them in order.
Here’s what Trump said about the Affordable Care Act during his Sept. 10 debate with Kamala Harris: “I had a choice to make when I was president, do I save it and make it as good as it can be? Never going to be great. Or do I let it rot? … And I saved it. I did the right thing.”
This was the prelude to his head-scratching assertion that he has “concepts of a plan” to reform healthcare in the U.S. I examined what that might mean in a recent column, in which I explained that it would turn the U.S. healthcare system to the deadly dark ages when people with preexisting medical conditions would be either denied coverage or charged monstrous markups.
During his own debate Tuesday with Tim Walz, Vance made himself an accomplice to Trump’s crime against truth .
Here’s Vance’s version of the Trumpian fantasy:
“Donald Trump has said that if we allow states to experiment a little bit on how to cover both the chronically ill, but the non-chronically ill … He actually implemented some of these regulations when he was president of the United States. And I think you can make a really good argument that it salvaged Obamacare. … Donald Trump could have destroyed the program. Instead, he worked in a bipartisan way to ensure that Americans had access to affordable care.”
Here’s what Trump actually did to the Affordable Care Act during his presidency. He had made repealing the ACA a core promise of his 2016 presidential campaign, stating on his website, “On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.” (Thanks are due to the indispensable Jonathan Cohn of Huffpost for excavating the quote.)
On Inauguration Day, Trump issued an executive order instructing the entire executive branch to find ways to “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement” of the ACA.
During his presidency, he never abandoned the Republican dream of repealing Obamacare, even after July 28, 2017, when the late Sen. John McCain (R-Ariz.) strode to the Senate well and delivered a thumbs-down coup de grace to a GOP repeal bill.
Trump never ceased slandering the ACA as a “disaster.” He returned to the theme during last month’s debate: “Obamacare was lousy healthcare,” he said. “Always was. It’s not very good today.” As president, he threatened to make it “implode,” and used every tool he could get his fingers on to do so.
In September 2017 he slashed the advertising budget for the upcoming open enrollment period for individual insurance policies by a stunning 90%, to $10 million from the previous year’s $100 million. He also cut funds for nonprofit groups that employ “navigators,” those who help people in the individual market understand their options and sign up, by roughly 40%, to $36.8 million from $62.5 million.
Just after taking office, he abruptly canceled the customary last-minute advertising blitz to encourage enrollments in Obamacare plans before open enrollment ended on Jan. 31. The last minute surge in enrollments, which had occurred every previous year, vanished. The drop-off was particularly devastating because it was concentrated among the healthiest potential enrollees — those who often wait until the last minute to sign up and whose premiums generally subsidize older, less healthy patients.
The impact these policies had on enrollment was inescapable. In the three years before Trump took office, ACA marketplace plans experienced annual enrollment increases, to 12.7 million enrollees in 2016 from 8 million in 2014. During every year of the Trump administration, enrollment declined, falling to 11.4 million in 2020.
Every year since Joseph Biden took office, enrollment has increased, reaching a record 21.3 million this year — an 86% increase over Trump’s last year.
As for Vance’s fatuous claim that Trump “worked in a bipartisan way to ensure that Americans had access to affordable care,” you have the right to ask what Vance has been smoking.
The only bipartisanship on the ACA during the Trump years, Cohn observes, were the actions of GOP senators such as McCain and Lisa Murkowski of Alaska to cooperate with Democrats to stave off their fellow Republicans’ anti-ACA vandalism.
Now onto Trump’s fantasy vision of his role in fighting the COVID pandemic. Speaking in a low-energy, exhausted monotone at a speech Tuesday in Milwaukee and reading at times from a binder, he praised himself for instituting Operation Warp Speed, which funded COVID vaccine development in record time and got them rolled out in January 2021.
“We did a great job with the pandemic. Never got the credit we deserved,” he said. He then veered into blaming China for the pandemic, a familiar topic. He said bluntly that the pandemic was “caused by the Wuhan lab. I said that from the beginning, came from Wuhan. And the Wuhan lab, it wasn’t from bats in a cave that was 2,000 miles away. … It’s really the China virus.”
As for the rest of his COVID performance, he said this: “We did a great job with the ventilators, the masks and the gowns and everything. … When we got here the cupboards, our cupboards, I used to say our cupboards were bare. … No president put anything in for a pandemic.” Then he segued into praising himself for a big tax cut, and COVID was forgotten.
A few points about this spiel:
Trump is correct that Operation Warp Speed was a significant achievement. But he didn’t follow up by advocating for its product, the COVID vaccine. Instead, he has thrown in his lot with fanatical anti-vaccine agitators such as Robert F. Kennedy. He has repeated an anti-vax mantra, promising, “I will not give one penny to any school that has a vaccine mandate or a mask mandate.” This is a formula for exposing children to vaccine-preventable diseases such as measles and even polio.
Trump’s reference to the Wuhan Institute of Virology as the source of SARS-CoV-2, the virus that causes COVID, underscores how closely the so-called lab-leak theory of COVID’s origins is tied to right-wing partisan politics. The theory originated with Trump acolytes at the State Department, who saw the accusation as a convenient weapon in Trump’s economic war with China.
To this day, not a speck of evidence has been produced to validate this claim; scientists versed in the relevant disciplines of virology and epidemiology say the evidence overwhelmingly supports the hypothesis that the virus reached humans via the wildlife trade, and that its journey may well have started with bats thousands of miles from Wuhan, China.
Trump is lying when he says his predecessors in the White House left him without resources. The truth is that Trump himself hobbled pandemic response from the start.
In 2016, in the wake of the Ebola epidemic in Africa, President Obama had established the the Directorate for Global Health Security and Biodefense at the National Security Council “to prepare for and, if possible, prevent the next outbreak from becoming an epidemic or pandemic,” in the words of its senior director, Beth Campbell. Trump dissolved it in 2018.
During the pandemic, Trump cut off funding for the World Health Organization. He eliminated a $200-million pandemic early-warning program training scientists in China and elsewhere to detect and respond to such threats. He sidelined the White House Office of Science and Technology Policy, which had been established under Franklin D. Roosevelt.
Due to these steps, the U.S. was fated to sleepwalk into the pandemic. The COVID death toll in the U.S. stands at more than 1.2 million, and its reported death rate from COVID of 341.1 per 100,000 population is the highest in the developed world.
Ventilators, masks and gowns? Trump placed the procurement of this essential personal protective equipment in the hands of his son-in-law, Jared Kushner, who handled the task incompetently. Kushner turned away urgent appeals from state and local officials for those supplies.
“The notion of the federal stockpile was it’s supposed to be our stockpile, it’s not supposed to be states’ stockpiles that they then use,” Kushner said at a briefing.
Following his remarks, the website of the government’s national strategic stockpile of medicines and supplies was changed from asserting that its purpose was to “support” the emergency efforts of state, local and tribal authorities by ensuring that “the right medicines and supplies get to those who need them most.” The new language redefined the stockpile’s role as “to supplement state and local supplies … as a short-term stopgap.”
Supplies of ventilators, masks and gowns remained scarce through the first months of the pandemic. A procurement official at a Massachusetts hospital system told me of having had to cut a deal with a shadowy broker offering 250,000 Chinese-made masks at an inflated price, completing the transaction for $1 million at a darkened warehouse five hours from home.
Trump made anti-science incompetence and disregard for the welfare of Americans part of our history. The same thing, or worse, looms on the horizon in a second Trump term.