The 2020 Debate Over Health Care Is Getting ‘a Lot More Real’

In addition to those questions, the virus is a providing an unmistakable reminder that Mr. Trump and Mr. Biden have starkly different views about the future of American health care — and starkly different records on the issue.

Four years ago, Mr. Trump ran for president promising to repeal the Affordable Care Act, popularly known as Obamacare. But his campaign pledge quickly turned into a debacle in the first year of his presidency when Republicans struggled and ultimately failed to repeal and replace the health law. In the midterm elections the next year, Democrats emphasized health care, highlighting issues like preserving protections for people with pre-existing conditions, and they won control of the House.

That line of argument has already surfaced in the 2020 election cycle. “Too many Montana families go to sleep at night worried about health care — coverage, costs, now the fear of coronavirus,” the narrator said in a recent ad targeting Senator Steve Daines, Republican of Montana, who is up for re-election. The ad was run by Protect Our Care, a liberal advocacy group that supports the Affordable Care Act and has set up a coronavirus “war room” aimed at holding Mr. Trump accountable over his handling of the crisis.

Mr. Trump is particularly vulnerable on the issue of health care. Over the course of his presidency, his administration has repeatedly taken steps to undermine the Affordable Care Act, including by arguing in court that the entire law should be invalidated. The Supreme Court agreed this month to hear an appeal in that case, which is the latest major challenge to the law. The court is not expected to rule until next year, but Democrats point to the Trump administration’s legal position as yet another example of the president’s desire to shred the Affordable Care Act.

All together, those steps by Mr. Trump and his administration amounted to something of a policy piñata for Mr. Biden and other Democrats to swing at in the general election, even before the coronavirus threat emerged.

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