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Their view: A disservice to four honorable men

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Accused Walmart shooter takes stand in own defense

<p>President Donald Trump still doesn&#8217;t get it: He owns Obamacare now. </p><p>He&#8217;s been hard at work undermining the government-regulated health insurance program &#8212; eliminating subsidies to insurance companies, slashing programs to enroll new customers, authorizing bare-bones plans to lure healthy patients out of the insurance pool. But if the system collapses, he insists it won&#8217;t be his responsibility. &#8220;I think the Democrats will be blamed for the mess,&#8221; he said on Monday.</p><p>Trump&#8217;s argument is twofold: Obamacare wasn&#8217;t his doing, and the program is already &#8220;finished. It&#8217;s dead. It&#8217;s gone,&#8221; as the president put it on Monday. &#8220;There is no such thing as Obamacare anymore.&#8221;</p><p>So if customers see their premiums rise or their plans disappear, how can that be his problem?</p><p>&#8220;When the premiums go up, that has nothing to do with anything other than the fact that we had poor health care &#8212; delivered poorly, written poorly, approved by the Democrats,&#8221; he said.</p><p>It&#8217;s absurd to say Obamacare is &#8220;dead.&#8221; Insurance under the Affordable Care Act exchanges still covers about 11 million Americans, and thousands more are expected to sign up this fall. <ins>(That&#8217;s not counting Medicaid expansion.) </ins></p><p>It&#8217;s also absurd for Trump to believe he won&#8217;t be blamed. Most Americans want their president to manage government programs, reform them or shrink them &#8212; not blow them up. Indeed, a Kaiser Family Foundation poll this month found that 71 percent of Americans think the government should try to make the law work; only 21 percent thought the government should try to make the law fail. Among Republicans, 48 percent favored supporting the law; only 43 percent favored undermining it.</p><p>Those lopsided numbers may help explain why, last week, Trump abruptly canceled subsidies that help insurance companies cover millions of low-income people &#8212; only to then claim he wants Congress to restore the payments.</p><p>If Trump had framed the cancellation as a constitutional issue, that apparent 180-degree turn would make sense: Republicans have long argued that the subsidies aren&#8217;t legal without a formal congressional appropriation.</p><p>But that&#8217;s not what Trump did. He objected to the payments as a matter of what sounded like high principle. <ins>&#8220;That was a subsidy to the insurance companies. That was a gift,&#8221; he said. &#8220;You could almost call it a payoff. And it&#8217;s a disgrace.&#8221; </ins></p><p>Now, the White House says Trump will go along with a bipartisan Senate deal that would restore the subsidies for two years, as long as he gets something in return. His move was a bargaining ploy, in other words. Even so, there&#8217;s no guarantee that the deal can get through the conservative-dominated House of Representatives.</p><p>An impasse would put the president in a precarious position. Canceling the subsidies means Obamacare premiums will go up all over the country by an average of 19 percent, according to one Kaiser Foundation expert. Trump won&#8217;t be able to pin that one on the Democrats.</p><p>Trump wants to have it both ways. He wants Obamacare to die, but he doesn&#8217;t want his fingerprints on the corpse.</p><p>Too late. He&#8217;s already bragged too loudly, and too often, that he plans to stand by and watch the program collapse. Worse, he&#8217;s still promising voters that he&#8217;s about to deliver much better health insurance at a much lower cost. That&#8217;s a promise he has no strategy to fulfill.</p><p><ins>&#8220;Since Congress can&#8217;t get its act together on health care, I will be using the power of the pen to give great health care to many people &#8212; FAST,&#8221; the president tweeted last week. </ins></p><p><ins>&#8220;People will have great, great health care,&#8221; he added. &#8220;And when I say people, I mean by the millions and millions.&#8221; </ins></p><p>The executive orders he signed last week won&#8217;t do all that. If they stand, they will loosen regulations to allow stripped-down insurance plans that don&#8217;t offer all the benefits guaranteed by Obamacare. They&#8217;ll be cheaper. They won&#8217;t all be better. For anyone with an existing medical condition, they&#8217;ll be worse. And they&#8217;re unlikely to cover millions of people fast.</p><p>Whether Trump understands it or not, he&#8217;s rhetorically embraced the principal that the federal government is responsible for ensuring good, affordable health care for every American. In fact, not just good health care; &#8220;great&#8221; health care. That&#8217;s something no previous Republican president has done.</p><p>As Barack Obama discovered to his chagrin, when a president takes responsibility for health insurance, he often gets blamed for anything that goes wrong<ins> &#8212; including, in Obama&#8217;s case, cost increases for people who get insurance through their </ins><ins>employers</ins>.</p><p>Sooner or later, voters are going to take the president at his word and hold him to his promise of better health care at lower cost.</p><p>Sometime, say, around next year&#8217;s enrollment season for insurance plans &#8212; which happens to come at the same time as the 2018 congressional election.</p><style>
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<div class="metaInfo"><bylineMeta><p>Doyle McManus</p><p>Guest Columnist</p></bylineMeta></div><div class="metaInfo"><shirttailMeta><p>Doyle McManus is a columnist for the Los Angeles Times. Readers may send him email at <a href="mailto:doyle.mcmanus@latimes.com">doyle.mcmanus@latimes.com</a></p></shirttailMeta></div>

Their view: Who’s to blame if the ACA blows up?