Nobody ever accused Trump ofbeing a policy wonk, but it goes beyond misunderstanding tocharge that “Under the Democrats' plan, today's Medicare would beforced to die.” (Photo: AP)

President Donald Trump once pledged to replace Obamacare with a system that wouldprovide good health insurance for all Americans. His failure todevise such a plan became obvious during his first year in office,as he and the Republican Congress tried in vain to repeal the Affordable CareAct. Various alternatives were floated that would have onlyincreased the number of Americans without health insurance.

Consequently, Americans turned against the idea of “repeal andreplace,” and became wary of efforts to undermine Obamacare, especially its guaranteeof access to insurance for people with pre-existing conditions.This has now turned into a big problem for Republican senators andrepresentatives running for re-election.

The dismantling of
the ACA: A timeline
A look at the key
developments and changes to
the landmark health
care law over the past year.

In an apparent effort to help them out, Trump published an op-edin USA Today. This was not an attempt to explain or even addressthe Republicans' health-care misfires, let alone to finallyreveal his once-promised health-care plan. Rather, Trump chose toattack Democrats by spinning a string of misrepresentations andfalsehoods.

Democrats, Trump asserts in the piece without evidence, want to“eviscerate Medicare” and “outlaw” private health insurance in theU.S. “The new Democrats are radical socialists who want to modelAmerica's economy after Venezuela,” he claims.

Setting aside the Venezuela whimsy, Trump seems to be under theimpression that all Democrats want to enact Bernie Sanders's planto have “Medicare for All.” In truth, Democrats have all sorts ofideas for shoring up or strengthening the U.S. health-care system —including at least six that involve expanding Medicare eligibilityor creating a public insurance option that's based on the Medicareor Medicaid model.

Nobody ever accused Trump of being a policy wonk, and he may notunderstand the other party's proposals. But it goes beyondmisunderstanding to charge, as he does, that “Under the Democrats'plan, today's Medicare would be forced to die.”

Among the other falsehoods in the article, perhaps the mostegregious is Trump's claim that he has kept his own promise to“protect coverage for patients with pre-existing conditions.” Theexact opposite is true: His administration has asked a federaljudge to declare that Obamacare's protections for pre-existingconditions are invalid, now that Congress has done away with theindividual mandate (the tax penalty for going without healthinsurance).

Congressional Republicans are doing little better speaking forthemselves. Some have introduced legislation meant to keepprotections for people with pre-existing conditions in the eventthe Trump administration wins its argument in court. But this wouldnot stop insurers from excluding some kinds of health-care coveragethat people who are ill might need.

In any case, insurers would have difficulty accepting customerswith pre-existing conditions in a system that did not also expandinsurance enough to cover the cost.

The best way to avoid any further weakening of the U.S.health-care system is to embrace and improve upon Obamacare,including by reinstating the individual mandate. Voters shouldremain wary of any political candidate who claims that Trump orcongressional Republicans have a better idea.

Brush up on the latest developments in theACA:

• GOP candidates sprinting away from ACArepeal
• 9 ACA employer mandateFAQs
• Azar credits Trump with ACA lower premiums,disses Medicare forAll

To contact the senior editor responsible for BloombergView's editorials: David Shipley [email protected].

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