Like many people, I’d like to know what the Mueller report actually says. In case you haven’t noticed, we don’t; all we know is what a couple of Trump appointees claim the report says. But meanwhile, a lot of other things are happening. And on the issue that actually dominated Democratic campaigning in the 2018 midterms — health care — the big news is that the parties are farther apart than ever.
I’m not talking about the debate within the Democratic party about what its grand vision should be for the long-term future of health reform — Medicare for All, Medicare for America, whatever. Instead, I’m talking about the health reform we have: the Affordable Care Act, which Democrats enacted in 2010, Republicans tried but failed to repeal in 2017, but which has a fate that’s still very much up in the air.
As the figure shows, the A.C.A. led to a dramatic reduction in the number of Americans without health insurance; around 20 million people who wouldn’t have had coverage without the act now do. Obamacare comes in for a lot of criticism, but it’s hard to think of a piece of legislation since the enactment of Medicare, more than half a century ago, that has done so much to improve the lives of so many.
But gains in health coverage have stalled out under Trump, partly because of administration sabotage, but also because subsidies designed to make insurance affordable turn out to be unavailable or inadequate for many middle-class families.
So House Democrats are introducing legislation with a goal of resuming stalled progress on health care, both by blocking the Trump administration’s sabotage efforts and by closing some of the gaps in subsidy coverage. The thing to realize here is that while this legislation obviously won’t be enacted as long as Republicans control the Senate and White House, it could very well become law very quickly if Democrats win control next year. And given past experience, it would probably mean health insurance for millions more Americans.
Meanwhile, for its part, the Trump administration has just filed suit in federal court calling for the abolition of the entire Affordable Care Act. If that suit prevails, around 20 million people would lose coverage right away.
So as I said, there are other things going on beyond the question of how far Trump scandals reach and who, exactly, did what to and for whom. I don’t know whether the 2020 election, like the 2018 midterms, will be largely about health care — but if the election is about what will directly affect people’s lives for better or worse, it should be.