On Pre-Existing Conditions, Trump’s Words Have Differed From His Actions

One of the main strategies—arguably the main strategy—taken by Senate Democrats during the Senate confirmation hearings for Amy Coney Barrett has been to portray her as an existential threat to the Affordable Care Act. The attack hinges on Texas v. California, a lawsuit filed by 18 Republican state attorneys general that seeks to overturn the ACA. Oral arguments are scheduled for November 10.

The suit is widely considered to be a dead end, but Democrats’ political instincts to focus on a threat to Obamacare are correct. For example, the legislation’s provision forbidding insurance companies to deny coverage to people with pre-existing conditions is immensely popular: 72 percent of the public believes keeping the provision is “very important,” including 62 percent of Republicans. 

President Donald Trump has consistently said that those with pre-existing conditions would be covered in any plan that replaces Obamacare, even signing a (largely toothless) executive order declaring that those with pre-existing conditions would retain coverage in the event of an ACA repeal. He tweeted in June that he would “ALWAYS PROTECT PEOPLE WITH PRE-EXISTING CONDITIONS, ALWAYS, ALWAYS,ALWAYS”—typical of his public rhetoric on the matter. 

Yet while a majority of Republicans think that Trump would do a better job than Democrats on protecting those with pre-existing conditions, only 38 percent of the broader public agree with that claim. That dynamic was a crucial factor in Democrats’ widespread success in the 2018 midterm elections, where the story of their victory was less about much-hyped progressive insurgents and more a tale of moderates who consistently warned voters that Trump and the GOP were planning to take away their health care.