But give the Democratic leadership credit, for once, with keen political sense. They have chosen their message wisely. They will avoid discussion of abortion, which is divisive, and focus on Obamacare, which is not.
That may be surprising, given how divisive Obamacare has been in the past, but currently the Supreme Court is facing a lawsuit seeking to strike down the entire law. Consider the implications.
Obamacare expanded Medicaid. Pre-pandemic, about 10 million people had health insurance under the Medicaid expansion. It also set up health insurance exchanges. Pre-pandemic, about 10 million people bought health insurance on the exchanges. Mass layoffs during the pandemic have presumably raised both figures, but let us assume them for the time being. Repeal the entire law, and both provisions immediately vanish. That means the Supreme Court could strip 20 million people of their health insurance overnight!
But that is not what Democrats are focusing on. Repeal will also remove all Obamacare's requirements that health insurance companies cannot deny coverage for pre-existing conditions. Given the number of people with pre-existing conditions, or who know someone with a pre-existing condition, this is what Joe Biden called a BFD.
The practical upshot of all of this is that basically no one favors the wholesale repeal of Obamacare. And yet their is a lawsuit to do just that schedules for hearing in front of the Supreme Court shortly after the election. And Donald Trump has ordered the Department of Justice to argue in favor of repeal, an action that one Republican spokesman described as making as much political sense as diving headfirst into a wood chipper. The Supreme Court did its best to keep Donald Trump away from the wood chipper by postponing argument until after the election. But sometimes the unpredictable happens, and suddenly the question of whether a Trump appointee would strike down the protections of Obamacare has become a major election issue.
That raises two other questions.
One is what the Supreme Court would do. There is more or less unanimous agreement, even among people who pressed for repeal in the past, that the argument lacks legal merit. But when has that ever stopped a determined Supreme Court? I am reasonably confident that if Trump is reelected, a Republican majority on the Supreme Court will save him from himself and uphold the law. The country will be exposed to a bunch of outraged tweets, but no other harm will be done.
If a Democrat is in the White House, I can see a Republican Supreme Court striking down Obamacare. Underlying whatever fancy justifications the Supreme Court can come up with, the real reasons will be simple. First, they will consider the disastrous fallout to be suitable punishment to Democrats for passing such a monstrosity. Second, they will trust that Democrats will be unable to come up with a replacement fast enough to prevent disaster and will count on the public to blame the party in the White House for the disaster and vote accordingly. This may be a miscalculation. If the Supreme Court is obviously, immediately at fault for the mess, and if the Democrats make skilled use of the bully pulpit (a dubious bet, I realize), the Supreme Court just might be blamed, and suddenly court packing will not seem so radical after all.
The second question is why Donald Trump is doing something that makes as much sense as diving head first into a wood chipper. So far as I can tell, the answer is simple ignorance. Republicans attempted to find a replacement for Obamacare, failed, and realized they are not able to do health care policy. They decided that they were better off leaving well enough (or bad enough) alone. Donald Trump seems to be the only person in the country not to notice what happened. He keeps saying Republicans have a great plan that will deliver great care at a fraction of the cost. Maybe he actually believes it. Or maybe he believes that if he just says so loud enough, no one will notice the 20 million people who lose their health insurance and the countless people who lose coverage for pre-existing conditions.
After all, his base has managed not to notice a pandemic that has infected over 6 million Americans and killed some 200,000.
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