On Obamacare repeal, Trump gives Biden a 2024 political shiv for fresh attacks

Richard Nixon, several years after resigning from the presidency amid the Watergate scandal, recalled about his Democratic congressional enemies, “I gave them a sword, and they stuck it in, and they twisted it with relish.”

Now another former Republican president who is also a longtime Nixon admirer, Donald Trump, has created his own potentially self-inflicted wounds by tackling an issue that’s already hurt him badly once before — abolishing the Affordable Care Act. President Joe Biden’s White House and political teams are practically salivating over Trump’s call to junk a major component of the nation’s healthcare system. It’s a seeming political gift that comes as the Democratic incumbent faces consistently laggard poll numbers 11 months out from his likely rematch against Trump.

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“The cost of Obamacare is out of control, plus, it’s not good Healthcare,” Trump wrote in a Nov. 25 Truth Social post. “I’m seriously looking at alternatives. We had a couple of Republican Senators who campaigned for 6 years against it, and then raised their hands not to terminate it. It was a low point for the Republican Party, but we should never give up!”

Trump has since made similar comments a few times on the campaign trail in Iowa, where, ahead of the Jan. 15 Republican caucuses, he leads GOP rivals by 20 points or more, according to polls. It’s a theme Biden and supporters are happy to have Trump emphasize.

Biden is now bringing up the topic at every turn, including at a Dec. 1 speech in Pueblo, Colorado, in an event that was supposed to focus on his administration’s Inflation Reduction Act.

“My predecessor has once again, God love him, called for cuts that could rip away health insurance for tens of millions of Americans,” Biden said.

The issue is a microcosm of the political conversation Team Biden wants to have on healthcare and other issues to draw contrasts with Trump and amplify the former president’s words to motivate Democrats and persuade independent and moderate Republican voters.

Shortly before the president’s Western jaunt, his campaign released a video featuring several years’ worth of promises by Trump to repeal Obamacare and replace it with an alternative healthcare plan.

After more than 13 years since it became law, most congressional Republicans have reconciled themselves to Obamacare’s enduring existence, even if many consider it bald government overreach into the private healthcare sphere, dampening medical innovation and ultimately doing more harm than good. Like so many government programs created since the New Deal era nearly a century ago, trying to pull it back is politically poisonous.

A record 16.3 million people flocked to the Affordable Care Act exchanges for 2023 coverage, the Centers for Medicare and Medicaid Services said in January. More than 40 million people now get their health coverage under the ACA. And as many as 1 out of every 2 people too young for Medicare have a preexisting health condition that, without the protection of the ACA, could make healthcare insurers discriminate against them.

Trump says he will replace the ACA with something better, but his advisers acknowledge that they have no plans to do more than chip away at the existing law.

The Affordable Care Act has deeper resonance for both Biden and Trump, in starkly different ways. Biden was vice president under President Barack Obama from 2009-17 and played a key role in negotiating the health law in the early part of that administration. At the law’s signing ceremony, Biden was caught on mic telling Obama it was a “big f***ing deal.”

Trump, after running on a repeal-and-replace platform in his 2016 shock win, came up short in 2017 when an archfoe, the late Sen. John McCain, cast the deciding vote against Senate efforts to repeal Obamacare. That 2017-19 session of Congress was the last time Republicans had full control of the federal government and the ability, at least in theory, to undo the Obama administration’s signature domestic achievement.

2018 Redux?
Obamacare repeal is an “oldie-but-goodie” attack issue for Democrats. The issue had its most political potency in the 2018 midterm elections when Democrats nabbed their first House majority in eight years and lost fewer Senate seats than expected amid a tough political map.

Exit polls and other survey results released immediately after the 2018 elections showed voters were highly concerned about healthcare. More cited it as their top concern than the economy or any other issue — the first time in at least a decade that had happened.

Some Trump foes at the time found that frustrating. Not that they didn’t care about healthcare. But they wanted to see Trump rebuked nearly halfway through his presidency on what they called Russian interference on his behalf in the 2016 campaign, his uncouth behavior, and general unfitness for office.

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Of course, a win’s a win. And in this view, if healthcare is the best issue on which to defeat Trump in 2024, so be it. Biden focusing on keeping the Affordable Care Act is kind of like a quarterback calling the same play for his teammates because it keeps working, even if they had expected to have to shake up their strategy in a game’s second half.

Neither Republican members of Congress nor GOP candidates seem to want much to do with Trump’s repeal efforts. And with the contours of the presidential race now just starting to take shape, it’s hardly a self-inflicted wound of Nixonian proportions. At least not yet.