As the nation has learned in 2½ months of Donald Trump’s presidency, little is as it appears. Worse, little is as he says.
The problem is that his comments, pro and con, rotate around an important issue as quickly as the International Space Station orbits Earth.
When the House of Representative’s health care bill failed March 24, following mighty pushing and schmoozing by Trump and House Speaker Paul Ryan, the two were glum.
“This is a setback, no two ways about it,” Ryan said. “Obamacare is the law of the land,” he said, and it will be “for the foreseeable future.”
“I’m disappointed,” Trump said. Before the day was through, Trump circled around the other side of the health care globe to say, “I want to have a great health care bill and plan — and we will.”
Ryan said Tuesday that he would allow House Republicans to try again on health care. “We are all going to work together and listen together until we get this right.” Ryan did not provide a plan or schedule.
While Trump and Ryan entertain wishful thinking, the executive branch is obligated to carry out every aspect of the Affordable Care Act, as Obamacare is titled.
Tom Price, secretary of health and human services, has that duty. Obamacare is healthy. The nonpartisan Congressional Budget Office predicted March 13 that insurance markets will remain stable.
As such, Price has no excuse for anything other than vigorous support for Obamacare as its executive leader and through his Department of Health and Human Services.
Neither may Price fall back on the ultraconservative, anti-Obamacare positions he held as a Republican member of the U.S. House. In the House, Price was a member of the Tea Party, much of whose outlook is shared by the House Freedom Caucus. Caucus members opposed the conservative House health bill as too liberal.
Concern about Price’s willingness to meet the requirements of his position has proved valid in the short time since his Feb. 10 confirmation by the Senate.
Price’s agency delayed a health rule March 21. The HHS notice pushed back reform of Medicare payment for follow-up treatment after a heart attack, or heart-bypass or joint-replacement surgery. For months, Trump has promised no Medicare reductions.
This mischief shows just a sliver of the worrisome possibilities. Price must keep at full strength a wide range of Obamacare protections, particularly its essential health benefits. Among them:
- The individual mandate, which requires nearly all to have health insurance or pay a tax penalty. This makes possible the coverage of people with pre-existing conditions.
- Preventive coverage. Examinations and tests find problems about which patients are unaware. Early detection makes treatment easier and reduces cost. The benefits of laboratory-test coverage and chronic-disease management are similar.
- Emergency coverage ensures that one can receive comprehensive hospital care immediately. Before Obamacare, too many could not get beyond emergency rooms and too many died.
- Maternity care for mother and child is important for them and future society. Often, it was an exception before Obamacare. Mental health was covered at a reduced rate. Equal mental health coverage helps both patient and populace.
Between insurance exchanges and Medicaid expansion, some 20 million Americans have health insurance because of Obamacare. The CBO projects the percentage of uninsured people to stay between 9.5 percent and 10 percent for a decade. Before, it reached 16.3 percent.
The Affordable Care Act needs an advocate at the top level of government. Because he accepted nomination, was confirmed and swore to uphold his duty, Tom Price is that advocate.
Price must perform. President Trump, Congress and the people must hold him accountable.