Obamacare is more popular than ever — but Trump's still trying to kill it

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After four years in office, Donald Trump has yet to come up with his own health care plan.

During Tuesday's presidential debate, moderator Chris Wallace chided Donald Trump for failing to come up with his own health care plan to replace the Affordable Care Act.

"You have never in these four years come up with a plan," Wallace said.

"I got rid of the individual mandate," Trump retorted.

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"That is not a comprehensive plan," Wallace said.

The Trump administration is intent on killing the Affordable Care Act despite failing to come up with their own alternative in the last four years. They've taken the anti-Obamacare fight to the Supreme Court, which will hear arguments on November 10, a mere week after the presidential election. Democrats worry that if Amy Coney Barrett joins the Supreme Court, the health care law will be struck down by the court's 6-3 conservative majority.

The Supreme Court's ruling in the Texas v. California case will decide whether to uphold a lower court's ruling that the individual mandate can be severed from the rest of the Affordable Care Act, including its more popular features such as guaranteed coverage for preexisting conditions. Trump eliminated the individual mandate in 2017 when he signed the Tax Cuts and Jobs Act of 2017, reducing the penalty for not having health insurance to $0.

A plurality of Americans now hold a favorable view of the Affordable Care Act. The Kaiser Family Foundation found that 48% of voters "have a generally favorable opinion" of the health care law, while 46% of Americans with 82% of registered Democratic voters being in support.

Trump and other prominent Republicans have vowed to maintain guaranteed coverage for preexisting conditions even if the Affordable Care Act is overturned. In September, the White House announced Trump would sign a series of executive orders to protect people with preexisting conditions and prevent surprise medical billing. But legal experts say the orders do little to actually ensure those protections.

"The language itself guarantees nothing near the protections in the Affordable Care Act, and such sweeping protections are only possible by congressional action, not regulation," University of Pennsylvania law professor Allison Hoffman told Kaiser Health News.

The Kaiser Family Foundation estimates that nearly 54 million people under the age of 65 have preexisting health conditions, meaning that more than one-quarter of U.S. adults under 65 would become uninsurable if the Affordable Care Act were overturned. That number is likely to spike in the aftermath of the COVID-19 pandemic, which can cause long-term health effects such as chronic respiratory problems. Even people with mild health conditions stemming from COVID-19 could be excluded from future coverage, according to the health care think tank.

"Some insurers might accept people with mild cases of COVID-19 with few or no limitations," KFF writes. "However, before the ACA, insurers could and did take adverse underwriting actions against even relatively mild pre-existing conditions: They might deny an application. They might offer coverage with a surcharged premium (e.g., 150% of the standard rate for people in perfect health.) Or they might offer coverage with specific limitations."

On Sunday, Joe Biden emphasized the high stakes of the presidential election for Americans' health.

"This is about your health care," Biden said from Delaware. "This is about whether or not preexisting conditions will be continued to be covered."

He added: "This is about people's health care in the middle of a pandemic."

Published with permission of The American Independent Foundation.