The Washington PostDemocracy Dies in Darkness

Opinion Trump says his terrific health-care plan is finally here. That would be news to his health advisers.

Columnist|
September 17, 2020 at 5:51 p.m. EDT
President Trump at the White House on Wednesday. (Jabin Botsford/The Washington Post)

There’s secret, top-secret, code-word-secret — and then there’s whatever President Trump’s health-care plan is.

It’s apparently so deeply classified that the people overseeing the plan don’t even know they’re involved.

The Republican Party has promised (and failed) to repeal and replace Obamacare for more than a decade — that is, the entirety of the law’s existence. Trump began teasing his own replacement plan during his first presidential bid, five years ago. Back then, he pledged to swap out the Affordable Care Act for “something terrific,” details TBD.

Over subsequent months and years, Trump boasted about the benefits of his plan. It would be cheaper yet somehow also more generous than Obamacare. It would be “so easy,” even though “nobody knew health care could be so complicated.” It would “take care of everybody,” even as it took literal care away from many.

Trump proclaimed the GOP will become "the party of healthcare," but a conservative replacement to Obamacare would probably look something like...Obamacare. (Video: Joshua Carroll/The Washington Post)

This plan was always “two weeks” away — coincidentally the timeline promised for most every Trump announcement, including those about wiretapping, infrastructure and Melania Trump’s immigration history.

As the fortnights passed, suspense grew. Finally, an announcement came this week: This Godot-like plan, this girlfriend-who-lives-in-Canada of public policies — it exists!

“I have it all ready,” Trump said at a town hall Tuesday, “and it’s a much better plan for you, and it’s a much better plan.”

Alas, Trump remains unable to share this “much better plan” with the public. Or, it seems, anyone within his administration.

A day after Trump’s town-hall statement, several senior health officials testifying before the Senate were asked whether they were aware of any specific administration proposal to replace Obamacare.

“I’m not involved in the replacement plan,” said Adm. Brett Giroir, assistant secretary for health at the Department of Health and Human Services. “I don’t know what that is. I supply public health advice as much as I can for whatever that plan would be.”

His colleague Robert Kadlec, assistant secretary for preparedness and response, likewise said the mythical proposal is “not in my portfolio” and “I have no awareness of that.” The director of the Centers for Disease Control and Prevention, Robert Redfield, echoed that an Obamacare replacement plan is “really not in my main lane, but I’m not aware of one.”

Now, it might seem improbable that Trump wouldn’t clue in his most senior health officials about a health-care program they would oversee. But it’s less strange when considering other tasks explicitly in these officials’ portfolios that they also apparently know nothing about.

On Thursday, for instance, White House Chief of Staff Mark Meadows said that Redfield’s testimony about when the public would have access to a covid-19 vaccine — a timeline the president had criticized — was wrong. The CDC director, Meadows explained, hasn’t had “intimate discussions” with those involved in vaccine distribution. Never mind that just a day earlier, the CDC had published a playbook for vaccine distribution.

Asked who was working on the Obamacare replacement, White House press secretary Kayleigh McEnany explained that planning involved “a wide array of people.” Also: “I’m not going to give you a readout of what our health-care plan looks like and who’s working on it.”

Finally: “If you want to know, come work here at the White House.”

In other words, Trump’s brainchild is so sensitive, so secret, it must remain within the cone of silence. There it will stay, under lock and key, presumably alongside evidence from Area 51, the names of the real Kennedy assassins and the nuclear codes. (But not the country’s secret new weapons system; that Trump is happy to blab about to Bob Woodward, unprompted.)

Now, you might argue that the public has a vested interest in learning the details of a plan that would overhaul 18 percent of the economy. Particularly during a public health crisis. Especially one that has caused millions to lose not only their jobs but also their health insurance.

And perhaps especially when the incumbent system Trump’s plan would replace, Obamacare, is already being destroyed.

Trump has had loads of free airtime to boast, usually unchallenged, about the impossible feats his still-confidential health plan would achieve; much less coverage has gone to the damage he and fellow Republicans have wrought upon the existing health-care system — through impenetrable red tape for Medicaid enrollees, the expansion of junk insurance and other administrative sabotage. Under Trump’s watch, the uninsured rate was rising even before the pandemic recession, especially among children.

Meanwhile, Trump has asked the Supreme Court to strike down Obamacare, including its protections for those with preexisting conditions. The court is scheduled to hear arguments a week after the election.

Maybe by then we’ll have seen Trump’s replacement plan. Or maybe he’ll simply claim he’s already signed it into law and hope no one notices. Placebos sometimes work, you know.

Sign up to receive Catherine Rampell's columns by email as soon as they're published

Read more:

Catherine Rampell: Who would kick millions off health insurance in the middle of a pandemic? Yes, Trump.

Paul Waldman: Trump’s latest health-care lies reveal what a second term would look like

Catherine Rampell: We’ve finally learned Trump’s grand plan for fixing health care

Paul Waldman: How this crisis could help us get to health-care reform

Catherine Rampell: Repealing Obamacare didn’t work. So Republicans are trying sabotage.