The Mueller Investigation is complete, and President Trump opted for battle over governance and leadership.  Foregoing a near perfect opportunity to forge ahead on critical bipartisan issues including infrastructure and prescription drugs, topics Trump has repeatedly asserted as priorities, he instead focused on dangerous trends towards authoritarianism such as with a new enemies list and renewed attacks on the media as the enemy of the people.  Surprising most Republicans, the White House announced a new divisive effort to completely end the Affordable Care Act (ACA) in its entirety.  The majority of voters in the 2018 midterm election stated that healthcare was the most issue, thus we have a likely preview of a major aspect of the 2020 campaign.      

    Throughout the 2016 election, candidate Trump continually campaigned on repealing the ACA, vowing he would replace it with a stronger, better system that would cover preexisting conditions, expand coverage, lower prices, etc.  During more than 2 years of his Presidency, Trump has proven this to be a complete lie and the American people cannot trust him and Congressional Republicans to improve their health care.  Despite many years of repeated attempts to repeal the ACA, Republicans have never offered a new plan to address the complex challenges of health care.  It is easy to oppose something, but they failed in their responsibility to generate a new plan.  The same goes for Trump.  Promise after promise he tried to convince us that he was going to deliver a new and improved health care system.  He has yet to offer a single specific component of any such plan.  The reality is that he lacks any understanding of health care and has no intent or ability to fulfill his ongoing hollow promises to the American people. 

    The ACA is not perfect.  There were legitimate issues surrounding individuals maintaining their existing plans and doctors as well as the legally controversial requirement to purchase private insurance.  However, the ACA significantly expanded coverage including preexisting conditions with millions more Americans having health care coverage.  Democrats have consistently maintained that the ACA needs some improvements and support those efforts rather than repeal or replace.  It is time for Democrats to offer their plans to accomplish this.  In 2018, voters demonstrated their trust in Democrats to address health care over Republicans.  Their ability to do so will be directly proportional to their 2020 results. 

     President Trump has continued his incredibly disgusting attacks on the late John McCain, often citing McCain’s pivotal vote blocking the last Republican effort to kill the ACA.  Lindsay Graham, who has morphed into a complete Trump sycophant, nonetheless concedes that Republicans have spent too much effort on the “repeal” effort with no effort on the “replace” part.  McCain voted no because Republicans failed to have a plan ready to replace the ACA and he was not willing to throw millions of people off their coverage.  Trump and Congressional Republicans persist in their efforts to end the ACA, terminate coverage for millions of people, and offer no replacement.  If they ever succeeded in this endeavor, it would be disastrous for the country. 

    Both Republicans and Democrats need to commit to improving the existing system, by any name, and challenge each other to offer superior plans that cover more people, mandate preexisting conditions, address rising costs, etc.  They should openly debate various options including single payer, Medicare for all, private insurance, and anything they deem viable to improve the system.  We cannot maintain a health care system that significantly challenges families’ ability to receive necessary treatment and leads to bankruptcy.  Leaders must address the ever-rising costs and offer solutions.  No more hollow promises and empty rhetoric.  This is the gauntlet for 2020.