The lies Trump tells on health care

From campaign trail to Rose Garden, Trump‘s promises are at odds with his policies

We’re little more than 100 days into the Trump presidency, and we’re becoming all-too familiar with a alternative fact, fake news world. Yet in light of the House of Representative’s passage of the American Health Care Act (AHCA), perhaps no area highlights Trump’s lies and broken promises like the attempt to repeal and replace the Affordable Care Act (ACA).

“Insurance for everybody”

This is the lie Trump is the most fond of telling, and the most blatantly false. Trump often promised universal coverage on the campaign trail and reiterated the promise shortly before taking office in January. It was an unlikely event even before the House bill was released, as Republicans had targeted the repeal of the ACA as an opportunity to shrink budgets and lower taxes for the wealthy.

After the AHCA was introduced, any chance at universal coverage was lost. The Congressional Budget Office (CBO) score of the AHCA hammered this point home: instead of expanding coverage, the AHCA would take coverage away from 24 million Americans. Prior to the ACA, the uninsured rate hovered around 15%. The ACA dropped the uninsured rate to historic lows.

That drop in the uninsured rate represents nearly 20 million people gaining coverage. The 24 million people who would lose coverage under the AHCA would move the United States even further away from insurance for everybody than the country had been before Obamacare.

2. No cuts to Medicaid

Trump promised he wouldn’t make any cuts to Medicaid. In fact, in the tweet above, he used it to differentiate himself from the rest of the GOP candidates in 2016. Unsurprisingly, Paul Ryan and reality have proven him wrong.

Once again, the CBO score tells the tale. One of the primary drivers of Americans losing their insurance under the Republican plan is a drastic cut to Medicaid funding. The AHCA changes Medicaid’s federal match rate for states into per capita caps. It’s also the primary source of the “savings” that Republicans tout as part of their plan. While GOP legislators try to spin the change from a federal match rate to per capita caps as an increase in “freedom,” it boils down to an $880 billion cut to Medicaid. That’s nearly a trillion dollars slashed from the program that provides health coverage to those who need it most: children, people with low incomes, seniors in long-term care, and the disabled.

3. “Every bit as good on pre-existing conditions as Obamacare”

In a Kaiser Family Foundation poll, 53% of households report having at least one person with a pre-existing medical condition. In the weeks prior to the House vote on the AHCA, these pre-existing conditions became the latest flashpoint in health care. That’s thanks to the MacArthur Amendment: the late-breaking amendment that gave states the ability to opt-out of coverage for pre-existing conditions.

Republicans are already running away from the promise, but no one’s told the president.

Obamacare granted brand-new protections for people with pre-existing conditions. No longer could insurers deny them coverage just for being sick or having a medical history. Trump’s health care plan walks back these protections. Now any state can choose to submit a waiver to opt-out of the requirement that people can’t be charged for more having a pre-existing condition. GOP Representatives stipulated that these waivers would be automatically granted. As a result, AARP estimates that premiums for people with pre-existing conditions could reach over $25,000 a year. Nearly 30% (some 52 million people) of the United States has some sort of pre-existing condition, and the list of illnesses or experience that applies is exhaustive.

If you’re wondering who would want to subject their state to such a program, Scott Walker is already raising his hand.

4. Getting rid of “the lines” for insurers

Quick note: there’s no phase 2 & 3

For whatever reason, this seems to be Trump’s favorite idea in health care: getting rid of the regulations that prevent insurers from selling plans across state lines. It’s an idea that would seem appealing to a businessman outside his area of interest: regulate the industry and increase competition and choice, driving down price. If only it were that simple.

In fact, neither states nor insurers want this. It infringes on what states see as their right to establish what care their citizens receives. In select states, insurers have actually had the chance to give this a try, and found it incredibly difficult to turn a profit.

Notably, this idea made it nowhere near the Republican repeal and replace plan. Yet Trump insists on promoting it as a fix.

5. “We will give people struggling with addiction access to the help they need”

Last year, more than 50,000 Americans died as a result of an opioid overdose. The response to the opioid epidemic was the last refuge of bipartisan action in health care. The supposed champion of small-town Americans, Trump joined everyone else in promising relief to communities across the country waging battles against opiate abuse. In practice, Trump is turning his back on this promise.

Immediately following the House AHCA vote, news spread that Trump proposed a 95% budget cut to the Office of National Drug Control Policy. This announcement comes on the heels of the quiet firing of Surgeon General Vivek Murthy, who released a wide-ranging report on the state of the epidemic last year.

Trump’s proposal reduces the staff of the Office of National Drug Control Policy by half, as well as shuttering the office’s drug-free communities initiative and high-intensity drug trafficking programs. The remaining staff will supposedly support Governor Chris Christie, who was appointed by the White House to lead a temporary commission on the issue.