At a Senate hearing today, Health and Human Services Secretary Alex Azar said the Trump administration won't offer a plan to replace Obamacare until after it's struck down by the Supreme Court. In other words, if the Court does exactly what the administration has been asking for and overturns the Affordable Care Act while Trump's still in office, Americans won't find out until then what Trump has in mind to replace it (not like Trump or Republicans have ever had a real plan, ever). Heck, healthcare is only a sixth of the economy. It's not like it's complicated or anything.


Testifying before the Senate Finance Committee, Azar said the administration wouldn't release a plan "until final judgment" by the Supreme Court. In December, a federal appeals court upheld a lower court's decision that the ACA is unconstitutional, but the administration decided it's in no hurry to have the Supremes take the case this year, what with an election coming up. In January, the Supremes decided not to expedite the case, and then earlier this month the Justice Department said it agreed there'd be plenty of time to get to that after the 2020 elections, and asked the Court to please let the cockamamie lawsuit brought by red states work its way through the lower courts, to, uh, make sure they get it right, yeah, that's the ticket.

Azar's testimony today echoed what he said in January after the Court decided it would hold off on the issue for now. On a wingnut radio show, Azar said there will be time, there will be time:

"There's really not a need for a replacement of the Affordable Care Act unless and until there's a final Supreme Court decision," Azar said, adding that would be "some time away" [...]

"I can assure you that's not on Nancy Pelosi's agenda," Azar said, adding that "it's not a material thing right now."

He did say that maybe, if Republicans win back the House when Trump is re-coronated later this year, that might be a good time to actually write up a replacement, but until then, why bother? In that January interview, Azar added "We're spending way too much time talking about it," because the whole thing is dumb and not even worth going into.

After all, he claimed then, Obamacare is actually a really tiny part of the overall healthcare system, which is just plain a lie. Sure, the individual insurance market covered by the exchanges is smallish — just 11 million on the exchanges, and another 13 or so million covered by Medicaid expansion, so really, an expendable number of people. But while far more Americans are covered by employer-paid insurance, the ACA regulates almost all health insurance, which is why Republicans have called it Hitler tyranny for a decade. Those are also the things people like, like protections for people with preexisting conditions, the ability to keep kids on your plan up to age 26, and the ban on lifetime or annual coverage caps, all of which would vanish if the ACA is overturned. It's a big fucking deal, and why Republicans like to pretend they'll protect people with preexisting conditions (they're lying, remember.)

And of course Trump's recent budget proposal only included a note saying "Obamacare Replacement Goes Here."

In today's hearing, Sen. Bob Menendez (D-New Jersey), gave Azar holy hell for the administration's non-plan:

Why would you wait with the healthcare of millions of Americans and their fate to see what the Court decides? It seems to me we've been hearing about killing Obamacare since it was passed. There have been years to have your own version [of healthcare]. Why would you wait until there's a disaster to then deal with the millions of Americans who have health care insurance? [...]

I have yet to see one plan the administration has put forward over the healthcare of millions of Americans. What are you waiting for?

The administration clearly hopes the Supreme Court won't address the case this year, so it won't become an election issue, but the Court may not cooperate. The Court will be discussing two Democratic appeals of the December ACA ruling at its next private conference, scheduled for February 21, and it may decide to expedite the appeals, which could mean a final ruling in June.

But if that happens, we bet Donald Trump can just dust off that plan from the 2016 campaign that would replace Obamacare with "something terrific" that would cover "everybody," and for less money than Obamacare. Oddly, he misplaced it in 2017 and asked congressional Republicans to come up with something instead. Or maybe he'll finally unveil the "phenomenal" plan he teased last June, which he promised he'd introduce "in a month," and we all remember that beautiful July 2019 healthcare plan, which was way way better than all the other GOP healthcare plans that somehow never got announced either.

Look, just reelect Trump and give the GOP control of Congress again. You just know they're going to come up with something extra terrifically phenomenal, at least in terms of adjectives.

[Shira Stein on Twitter / The Hill / Bloomberg]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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