Trump and Johnson Vow to Repeal Obamacare

Johnson denies it publicly because it's unpopular, but let's break down what he said and what it means.

Oh, my! Only four days and a wakeup before election day, and Republican Speaker of the House Mike Johnson is caught on tape telling supporters at a private campaign even that he intends to kill the Affordable Care Act, otherwise known as “Obamacare.”

Before I started reading the news, I was an expert in public health, specifically health insurance. My Doctorate is in Health Administration, so I know a little bit about the language that Mike Johnson used when he didn’t think we were listening. So I’d like to break it down for you.

Here’s what he said:

“Health care reform’s going to be a big part of the agenda. When I say we’re going to have a very aggressive first 100 days agenda, we got a lot of things still on the table. We have a ‘docs caucus’ - a group of physicians who serve in the house - and they have a menu of options about this thick, and I think this is part of it. Because if you take government bureaucrats out of the health care equation, and you just have the doctor/patient relationship, it’s better for everybody. It’s more efficient, it’s more effective; that’s the free market. Trump’s going to be for the free market. You heard a little sample of that last night. We wanna take a blow torch to the regulatory state, okay? I mean these agencies are weaponized against the people. They’re crushing the free market. It’s a boot on the neck of job creators and entrepreneurs and risk-takers. Health care is just one of the sectors and Trump is gonna go big. He only has one more term, so he’s gonna be thinking about legacy.”

Then an audience member asked “No Obamacare?” And Johnson chuckled, shook his head and said “No Obamacare. The ACA is so deeply ingrained, we’re gonna need a massive reform to make this work, and we got a lot of ideas on how to do that.”

There’s a lot to unpack there, but it’s chock-full of loaded language I’ve heard from privatizers in the health care industry for more than a decade - so let’s break it down.

Let’s start with the “docs caucus.”

This reminds me of the three private physicians - members of Trump’s private Mar-a-Lago Country Club - who ran a “shadow VA.” As ProPublica reported in August of 2018 - just 8 months before the Trump Administration investigated me and decided to move my VA job across the country to force me to quit - these three Trump pals were basically running the agency:

But hundreds of documents obtained through the Freedom of Information Act and interviews with former administration officials tell a different story — of a previously unknown triumvirate that hovered over public servants without any transparency, accountability or oversight. The Mar-a-Lago Crowd spoke with VA officials daily, the documents show, reviewing all manner of policy and personnel decisions. They prodded the VA to start new programs, and officials travelled to Mar-a-Lago at taxpayer expense to hear their views. “Everyone has to go down and kiss the ring,” a former administration official said.

Former administration officials say that VA leaders who were at odds with the Mar-A-Lago Crowd were pushed out or passed over. Included, those officials say, were the secretary (whose ethical lapses also played a role), deputy secretary, chief of staff, acting under secretary for health, deputy under secretary for health, chief information officer, and the director of electronic health records modernization.

(I was working on health records modernization at the time, FYI.)

These guys were in it for themselves. Perlmutter was using Trump to get the VA to promote Marvel Comics. The three of them used their access to get favors done for rich friends. Perlmutter even got the VA to give a lucrative contract to his rich buddies at Johnson & Johnson. Then Moskowitz wanted to enrich his son at the expense of Veterans and taxpayers:

As it turned out, Moskowitz wanted Apple and the VA to develop an app for veterans to find nearby medical services. Who did he bring in to advise them on the project? His son, Aaron, who had built a similar app. The proposal made Apple and VA officials uncomfortable, according to two people familiar with the matter, but Moskowitz’s clout kept it alive for months. The VA finally killed the project because Moskowitz was the only one who supported it.

But the motherlode was to privatize VA healthcare. Something republicans have been champing at the bit to do for years. Why spend the taxpayer money on direct health care when we could enrich our friends in the private health care industry by sending Veterans to private doctors - effectively moving taxpayer money appropriated for Veterans into the pockets of their rich friends? Plus, we could get our friends’ third party vendors multi-million dollar contracts to adjudicate the claims! Everyone gets rich - while VA health care falls by the wayside.

In other words, they proposed inviting private health care executives to tell the VA which services they should outsource to private providers like themselves. It was precisely the kind of fox-in-the-henhouse scenario that the VA’s defenders had warned against for years. Shulkin delicately tried to hold off Perlmutter’s proposal, saying the VA was already developing an in-house method of comparing its services to the private sector.

THIS is why Trump continues to lie about creating the “Veterans Choice” program. It was signed by Obama and co-sponsored by John McCain, and it was intended to temporarily allow Veterans to go to private providers at the expense of taxpayers until the money appropriated in the bill could kick in and improve the VA. What Trump did was make that permanent, and then cancelled the money set aside for the VA. What a dick.

So when Mike Johnson says they have a “docs caucus” - it’s rich private health care providers drooling at the chance to take the money appropriated for our health care. A repeal of the ACA and full privatization. That’s why Johnson said if you take government bureaucrats out of the health care equation, and you just have the doctor/patient relationship, it’s better for everybody. It’s more efficient, it’s more effective; that’s the free market. Trump’s going to be for the free market. You heard a little sample of that last night. We wanna take a blow torch to the regulatory state, okay? I mean these agencies are weaponized against the people. They’re crushing the free market.

Republicans ALWAYS cloak their plans to steal taxpayer money as “free market.” That’s why they want to “torch the regulatory state.” They want to REMOVE government protections that prevent insurance companies from throwing you off your plan for a preexisting condition, so the “free market” rich fucks can do what they want to increase their bottom line.

And it takes a LOT of chutzpah to talk about taking the government out of health care when you’re FOR the government making choices for women, tracking our periods, asking for our medical records, barring us from interstate travel, and jailing doctors for providing care.

Then Johnson says “It’s a boot on the neck of job creators and entrepreneurs and risk-takers.” That’s old rhetoric which translates to “Government protections for consumers is a road block to rich white men taking advantage of communities and the environment.” I’m sure you’ve heard a common refrain when talking about drug manufacturers, too.

Then he just comes right out and says it: “No Obamacare?” And Johnson chuckled, shook his head and said “No Obamacare. The ACA is so deeply ingrained, we’re gonna need a massive reform to make this work.”

When he says “The ACA is so deeply ingrained,” he means “People really like it, but fuck them, we’re gonna kill it.”

So when you hear Mike Johnson and Donald Trump say “We’re not going to get rid of Obamacare,” remember that they’re lying. Republicans tried 58 times and were only thwarted by the vote of the late Senator John McCain - and Trump hasn’t stopped hating him for it.

~AG