Trump Spends Seven Months Trying To Strip Health Coverage From More Than 20 Million Americans, Resolving Long-Standing Concern That The Country's Sick Were Still Receiving Treatment

The Filing

WASHINGTON. After seven months of sustained effort to remove health coverage from more than 20 million Americans, the Trump administration confirmed Friday that the campaign had regrettably failed by a single vote, leaving the nation's sick with continued access to treatment they had done nothing to earn.

The final attempt, a pared-down Senate measure that the Congressional Budget Office projected would increase the ranks of the uninsured by roughly 16 million, collapsed in the early morning hours when one Republican senator declined to supply the deciding vote. Administration officials described the result as a temporary setback in a broader initiative to ensure that fewer Americans could afford to see a doctor.

"Repeal and replace," President Trump had said repeatedly throughout the spring, in what aides confirmed was a complete description of the plan. When the Senate effort failed, the President recommended on social media that lawmakers simply allow the existing system to "implode," a strategy officials clarified would produce the same number of uninsured Americans on a slightly more relaxed timeline.

According to sources within the administration, the President remained confident that coverage could still be stripped from millions by other means. "The vote was disappointing, but there are many roads to the same destination," said one official, speaking on condition of anonymity because the destination is fewer insured people. "You can repeal the law, or you can stop advertising it, shorten the sign-up window, fund the junk plans, and let the rest take care of itself. We are pursuing all of them."

Within months the administration had cut enrollment outreach by 90 percent, expanded short-term plans that need not cover pre-existing conditions, and, in December, repealed the law's individual mandate as part of a tax cut weighted heavily toward the top. The budget office estimated the maneuver would leave 13 million additional Americans uninsured over the following decade. Officials noted with quiet satisfaction that the goal the Senate had blocked in July had been substantially achieved by Christmas.

At press time, the President was reviewing a list of Americans who still had health insurance and asking aides which of them had voted for him.

Who Benefits

§Donald J. Trump, who converted a failed repeal into a marketable narrative of a promise relentlessly pursued, and who secured through the tax bill the mandate repeal the Senate had denied him.
§The wealthiest American households, for whom the surviving half of the 2017 effort, repeal of the individual mandate, arrived bundled inside a tax cut delivering the large majority of its benefits to the top.
§Sellers of short-term and "junk" health plans, newly expanded to compete with comprehensive coverage by leaving out the parts that pay for care.
§Congressional Republicans, who could now campaign on having tried, an outcome requiring none of the governing that a successful replacement would have demanded.
§Insurance and pharmaceutical lobbies, relieved of various Affordable Care Act taxes and fees through the same year-end legislation.

Sourced to the public record · presented without editorial embellishment