Trump scrambles to defend pre-existing conditions record amid ObamaCare lawsuit

President Trump, who is backing a court challenge to the Affordable Care Act that would overturn the law and eliminate its protections for people with pre-existing conditions, is now tweeting about how he saved those protections.

In an election year where Democrats are vowing to focus on health care, Trump’s tweets suggest he is recognizing the political danger posed by his support for the GOP-led lawsuit.

Trump’s efforts have been undercut not only by the court challenge but also his repeated vows to repeal the 2010 law, including support for a House Republican bill in 2017 that would have allowed for weakening protections for pre-existing conditions.

“I was the person who saved Pre-Existing Conditions in your Healthcare, you have it now, while at the same time winning the fight to rid you of the expensive, unfair and very unpopular Individual  Mandate,” Trump tweeted last week.

“And, if Republicans win in court and take back the House of Represenatives, your healthcare, that I have now brought to the best place in many years, will become the best ever, by far,” he added. “I will always protect your Pre-Existing Conditions, the Dems will not!”

Pre-existing conditions protections were included in the Affordable Care Act, which was passed by Democrats in Congress on a party-line vote. Republicans have attempted to weaken or repeal the law dozens of times over the years.

Trump’s tweets appear to have been sparked in part by ads from Democratic presidential candidate Michael Bloomberg, who foreshadowed a likely line of attack from Democrats as November draws closer.

“A broken promise. Trump repeatedly tried to undermine coverage for 134 million Americans with pre-existing conditions,” states one ad from Bloomberg.

“If he is reelected he’ll keep trying to do that, and I think we can’t let that happen,” the former New York City mayor says in the ad.

Democratic attacks on Republican efforts to repeal ObamaCare and weaken pre-existing condition protections proved successful in the 2018 midterms, when Democrats won back control of the House. They’re now looking to use the same playbook against Trump in 2020.

“I think [Trump] is feeling the heat on the issue,” said Brad Bannon, a Democratic strategist. “He knows he’s been on the wrong side of it. He’s trying to cover his tracks.”

Voters trust Democrats more than Republicans on handling health care, by a margin of 44 percent to 29 percent, according to an October poll from the Kaiser Family Foundation. A Gallup poll this month found more U.S. adults ranked health care as “extremely important” to their votes than any other issue, at 35 percent.

With pre-existing conditions shaping up to be a key issue in November, Trump has recently been defending his record on the issue, while drawing little to no attention to earlier attacks on the Affordable Care Act (ACA).

Larry Levitt, a health policy expert at the Kaiser Family Foundation, said the Trump administration has “affirmatively argued to overturn” the ACA’s pre-existing condition protections in the lawsuit that’s making its way through the courts.

That suit, brought by a group of GOP-led states seeking to overturn the entire health law, is supported by the Trump administration.

Levitt also noted that in 2017 Trump “celebrated the House repeal and replace bill in a Rose Garden ceremony, and that bill would have weakened pre-existing condition protections.”

The legislation, which Trump later distanced himself from, would have allowed states to get waivers to allow insurers to charge much higher premiums to people with pre-existing conditions.

The Trump campaign has hit back against Democrats on health care by focusing more on “Medicare for All” plans backed by progressive candidates like Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) that would eliminate private health insurance coverage and replace it with a government-run plan.

“President Trump has been clear that he wants Americans with pre-existing conditions to be protected from losing their health insurance,” Trump campaign spokeswoman Sarah Matthews said when asked about the Democratic attacks and how Trump’s tweets square with his support for the ACA lawsuit. “Compare that to Democrats who want to go far beyond Obamacare and are embracing a government takeover of health care that would eliminate private insurance for 180 million Americans.”

The Trump campaign also points to non-ObamaCare related health care actions, such as the president’s efforts to lower drug prices and increase price transparency.

The administration has put forward some significant proposals on those fronts, though there is uncertainty about when and whether they will go into effect, given the legal challenges and other obstacles.

Joe Antos, a health policy expert at the right-leaning American Enterprise Institute, argued Trump has largely been ineffectual on health care.

“Truly nothing has actually happened,” Antos said, adding that the ObamaCare lawsuit is not expected to ultimately succeed.

He said that if Trump were really trying to “sabotage” the ACA as Democrats claim, “it has been remarkably unsuccessful,” given that the health law continues to function even after the repeal of the mandate requiring people to have coverage or pay a penalty, a step touted by Trump.

Levitt, of the Kaiser Family Foundation, pointed to one action that has gone into effect under Trump’s presidency: expanding short-term health insurance plans that are less expensive than ObamaCare plans but do not have to cover pre-existing conditions.

But as voters start weighing their options at the ballot box, Antos said, Trump and all politicians have to at least argue they are on the side of protecting people with pre-existing conditions.

“I don’t think anybody can be a credible politician running for office without supporting those kind of protections,” he said. “The public didn’t used to know this term, and now the public is very knowledgeable about what this term means.”