Impeached president Donald Trump's third and, God help us, final state of the union speech was the most hateful diatribe of venom and self-aggrandizement that the nation has ever been subjected to, a white supremacist pep rally. All that loathsomeness was intertwined in the usual web of lies from Trump, the never-ending whoppers that his addled brain clings to and that his fervent worshippers and enablers will lap up even if they know better. Take the most enduring one: "I have also made an ironclad pledge to American families: We will always protect patients with pre-existing conditions."
He actually said that last night. He said that while his administration is suing in a federal court in Texas to have the entire Affordable Care Act—including those protections—thrown out. That is, of course, not all. From day one he's been attacking Americans’ health care. He issued an executive order literally on day one directing government agencies to undermine the law by enforcing it as loosely as possible.
When Republicans in Congress failed to repeal the law, he issued new rules to make sure that short-term, limited-duration insurance policies were no longer short-term and wouldn't have to comply with Obamacare's requirements for coverage—including having to cover people with pre-existing conditions, or covering care for those conditions. He's issued rules to allow states to make big changes in their ACA markets by allowing those junks plans to be sold on them, and to structure the market to try to force out older, sicker people, those most often the ones with pre-existing conditions. That's not even going into all the ways in which he's attacked Medicaid, with block grants and work requirements and attempted budget cuts.
And then he has the gall to attack Democrats who want to expand health care to more people as socialists, saying 132 Democrats "want to take away your healthcare, take away your doctor, and abolish private insurance entirely," a "socialist takeover of our healthcare system." More bullshit, of course. Health care is never static—you can never be assured that you will keep your health insurance policy, because policies change. You can't be sure your doctor will keep accepting your insurance. You can't control your employer's decision to change your insurance options. In fact, Medicare for All could add a lot more certainty there. If there's one big game in town, you can bet your doctor is going to take it.
And then he said this: "Over 130 legislators in this chamber have endorsed legislation that would bankrupt our Nation by providing free taxpayer-funded healthcare to millions of illegal aliens, forcing taxpayers to subsidize free care for anyone in the world who unlawfully crosses our borders." That, by the way, The New York Times calls "mostly true." What it is is racist and white supremacist and mostly false. Medicare for All legislation would extend health care coverage to residents of the U.S. and would by no means bankrupt the nation, certainly no more than Trump's massive tax cuts to rich people and corporations have. The rationale behind making sure everyone in the country has health care is that it's smart public health. Everyone getting vaccinations for measles or flu means fewer people getting measles or flu and fewer people infecting those who can't get vaccinations. Making sure everyone can get primary and preventive health care makes sure that catastrophic costs are reduced overall. That's why you cover entire populations: to keep the entire population healthy, something that in Trump's world should only be a benefit of being white and wealthy and preferably male.
He wasn't done with that one, though, going onto say, "These proposals would raid the Medicare benefits of our seniors and that our seniors depend on, while acting as a powerful lure for illegal immigration." No. It has nothing to do with Medicare, which, by the way, Trump has tried to cut in his own budgets, one of the things he's pondering again as a second-term project, if the nation is deranged enough to give him that opportunity.
The good news is that health care remains one of the top issues for voters going into the 2020 election, and Trump has dismal ratings on every aspect of health policy, but especially on protecting people with pre-existing conditions. Nothing Trump says in a speech as offensive and deplorable as the one he gave this week is going to change that.