First day first show on Planet Trump went as per script: Rip Obamacare to shreds and promise the moon.
It’s easy to see this as Trump’s inherent dislike of America’s first black president’s legacy. There’s much more to it - Obamacare’s opponents were once its fans and they are the ones who gave Trump his final push into the White House. Repealing Obamacare’s worst features is Trump’s gift to a new voting bloc in the final bend of the 2016 election.
Who are these people? Those earning around just a shade less than $100,000 per year and spending close to 75% more than they did in 2010 on insurance alone.
As headlines scream about the millions who spilled out onto US streets cities in a stunning rebuke against Donald Trump, the new US president is swiftly investing time in a high yield matter - shredding the 955 page Obamacare and promising healthcare coverage for all.
Despite news cycles awash with Trump tapes and the FBI email dump on Clinton,Trump enjoyed a bump in the two weeks before the November 8 election from US citizens reeling under rising healthcare premiums that were set to go up sharply in 2017 - on average by about 25 %.
Republicans argue that higher prices will stop young Americans from signing up which means a spiral of losses for insurers and higher prices until the insurance market fails.
For the moment, many customers are protecting themselves from premium increases by switching to plans with lower costs and therefore, fewer benefits.
"We're going to have insurance for everybody," Trump told Washington Post over the weekend.
Republicans are opposed to the fundamental redistributive economics of Obamacare from the start - Americans who can afford it buy insurance directly from a provider and charged higher premiums that go to subsidise people who buy insurance from the government.
This is a rough outline of America’s healthcare system: It relies almost entirely on the private sector, one in three Americans is covered by government-led insurance which is Medicare for those over 65 or Medicaid for the poorest. Half of all Americans are insured through their employers and seven percent via the individual market which serves the self-employed or employees whose offices don’t offer coverage.
Obamacare has been the most overarching overhaul of the US healthcare system since the 1960s and remained controversial since it was born in 2010.
In its short history from 2010 to now, Obamacare has been debated in the Supreme Court four times; it was also the reason for the two week government shutdown in 2013.
Republican-controlled Congress is now likely to follow through by keeping Obamacare’s best features, dumping its controversial ones and hoping that ownership of its bright side becomes a Republican asset in public memory.
These are likely to be jettisoned:
-- The requirement that every American have health coverage.
-- Government subsidies for covering low-income workers.
For now, these provisions won’t come under the knife:
-- Parents can carry children on their policies until they're 26.
-- Insurers are forbidden from from denying coverage to those with pre-existing medical conditions.
-- Companies cannot charge women more than men
There’s zero clarity on how Trump plans to give every American insurance but if he does pull it off, it could silence critics and win him new supporters in the homeland.
Trump insists that none of the 22 million Americans who gained coverage during Obama's tenure will lose it. Health and Human Services (HHS) Secretary Tom Price has clarified that only those currently covered by Obamacare will continue to enjoy "access" to health services.
Insurance companies are turning away from Obamacare because fewer Americans are signing up. For middle class Americans, the subsidies for buying Obamacare policies are not lush enough and the fines for not having coverage too small to get them to enroll.
Trump takes office and turns the knife into Obamacare with an approval rating of just 37 percent - freshly minted US presidents usually begin with ratings above 50 percent. Trump wrapped up the presidential debates with low ratings too, that did not stop him from taking the White House. Obama leaves the White House with fantastic approval ratings and millions angry about rising healthcare costs.
A lot does not add up.
The Trump ascendancy has certainly returned protestors to the streets but don’t forget the small detail that it's the Obama years and many of those who voted Obama in who made up the ingredients for Trump’s shock win.
As comparisons between a Trump-led world and other hyper-nationalist politicians abound, look east to Poland. The first year of Jarosław Kaczyński’s rule had all the parallels of Trumpian dystopia but it’s been far from what was expected.
Liberal Poles thought Kaczyński would be erratic, reward the rich, hurt the poor and rile the working class. Instead, he has rebooted crucial social contracts to the amazement of critics.
Obama promised to close down Guantanamo - he had eight years to do it and did not. That’s why, when Trump asked Hillary “You had 30 years, why couldn’t you change anything?”, his core base cheered lustily and swarmed to the voting booth.
Despite all that looks impossible about transforming Obamacare, it’s still just the first week on Planet Trump.
A far less abrasive President with a silver tongue had a lot more time.
(Nikhila Natarajan is a Visiting Fellow at Observer Research Foundation | @byniknat)
Updated Date: Jan 23, 2017 15:38:51 IST