Why Trump still needs Obamacare
To bring down drug prices and fight opioids, the White House uses provisions of the health law it constantly attacks.
A Texas judge’s stunning declaration that Obamacare is unconstitutional not only kneecaps the health care law, it would also cripple President Donald Trump’s entire health care agenda.
Trump wants lower drug prices, drastic action on the opioid crisis and protection for people with pre-existing conditions. Those are the parts of the law many Republicans do want to keep, but with the entire law invalidated — pending appeal — Trump and Republicans are trying to figure out how to live with a judicial ruling they kind of wanted, but didn’t want in such a big way.
The blunt force of the Texas ruling, without consideration for the dozens of popular provisions sprinkled throughout the law, shows just how intertwined the Affordable Care Act has become as part of the American health care system.
And nobody on the Republican side has a clear plan on what to do now.
Nothing is changing yet. But if the ruling does stand following appeals, or if the Trump administration reverses course and refuses to enforce more parts of the law, because of the Texas case, seniors would immediately be on the hook for thousands of dollars in additional drug spending. Millions of Americans would lose Medicaid coverage — the largest payer of addiction treatment in the country.
Meanwhile, the administration would also lose access to a powerful weapon for reforming the U.S. health system — the CMS Innovation Center. Created by the health law, it gives the government broad powers to test new health policies, whether it be doctor payment models or new cancer drug pricing ideas, and scale them up nationally without congressional approval.