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Huffington Post: The Trump Administration Doesn’t Care If You’re Uninsured And Have COVID-19

April 1, 2020

President Donald Trump(link is external) and his administration have a message for uninsured Americans who fear the cost of treatment for COVID-19(link is external), the illness caused by the coronavirus: We don't care.

On Tuesday, Politico reported(link is external) that the federal government will not reopen health insurance enrollment on the federal HealthCare.gov(link is external) exchange that serves the residents of 38 states(link is external). Peculiarly, those places are mostly GOP(link is external)-leaning states that declined to create their own health insurance exchanges and that Trump won in the 2016 presidential election.

By contrast, the health insurance exchanges operated by California(link is external), Colorado(link is external), Connecticut(link is external), Maryland(link is external), Massachusetts(link is external), Minnesota(link is external), Nevada(link is external), New York(link is external), Rhode Island(link is external), Vermont(link is external), Washington state(link is external) and the District of Columbia(link is external) are allowing uninsured people to sign up for coverage(link is external) and apply for financial assistance.

The negative consequences of this active refusal to offer help to vulnerable Americans are obvious.

The people living in the 38 states that use HealthCare.gov ― and those in Idaho, which hasn't reactivated its state-run exchange ― will likely remain uninsured, leaving them potentially exposed to tens of thousands of dollars(link is external) in costs if they get sick from the novel coronavirus(link is external) and need medical treatment.

Moreover, the high cost of health care frequently discourages(link is external) Americans from seeking care, especially those who are among the 28 million uninsured(link is external). And sick people not being isolated and treated means they are at risk of spreading the coronavirus to more people.

No one benefits from not allowing these millions of Americans to get health coverage in the midst of a pandemic that has practically shut down the nation. There is no upside to the Trump administration's decision.

It is plain, as it has been during Trump's entire presidency, that he is utterly unconcerned(link is external) about people in need. It is just as plain that this cruel(link is external) and spiteful move is rooted at least in part in Trump's obsession with tearing down anything his predecessor Barack Obama did.

The Affordable Care Act(link is external), which created the exchanges, anticipated a moment like this. Even in the states where people can't enroll because of the Trump administration(link is external) and the Idaho government, they still can qualify(link is external) for health insurance and income-based subsidies under certain circumstances, such as losing a job. The law allows for "special enrollment periods" for emergencies, which is why 11 states and the District of Columbia have taken advantage of the option.

Newly jobless people also may be eligible for Medicaid coverage, which is cost-free in most cases.

More than 100 House Democrats pleaded with Health and Human Services Secretary Alex Azar for a special enrollment period for the coronavirus outbreak in a letter, as did nine Senate Democrats in a letter(link is external) to Majority Leader Mitch McConnell (R-Ky.) and Minority Leader Chuck Schumer (D-N.Y.).

So did more than 200 patient advocacy organizations, labor unions and nonprofits in a letter(link is external) to Vice President Mike Pence, Centers for Medicare and Medicaid Services Administrator Seema Verma and Azar. Rep. Lloyd Doggett (D-Texas) and Sen. Bob Casey (D-Penn.) authored legislation to force a special enrollment period, but it has not advanced.

But for Trump and other Republicans, using the Affordable Care Act to offer assistance during an emergency would be an admission that the law and its benefits help people. An admission of that sort would blow up the decade-long Republican(link is external) mantra that "Obamacare" is nothing but a train wreck destroying the American health care system.

It was only days ago that Trump affirmed that he continues to support a lawsuit pending(link is external) at the Supreme Court that would eliminate the Affordable Care Act. "What we want to do is terminate it," he said(link is external) on March 22. (The Republican state attorneys general who originated the lawsuit also aren't backing down(link is external).)

Perhaps it's not surprising that Trump's hostility toward the Affordable Care Act ― arguably Obama's most impactful domestic policy initiative ― wouldn't abate, even during a global public health emergency.

Prior to running for president, Trump railed against Obamacare(link is external). He promised to repeal it on the campaign trail four years ago. He spent much of his first year and a half in office on a failed effort to repeal the law in Congress. He joined the lawsuit awaiting a hearing at the Supreme Court.

But the harms that would befall the estimated 20 million people(link is external) who would become uninsured if that lawsuit succeeds remain abstract. What's very real is that a growing number of Americans are getting sick from a disease with no cure and are staring down life-destroying medical bills, and Trump has decided the right thing to do about that is nothing.