Based on what side of the political aisle you're sitting, it's likely you think Wednesday's impeachment of President Trump was the worst thing ever to happen to any White House, or one of the most massive election liabilities for the Democrats in years.
As it turns out, it wasn't even the worst thing to happen to both sides that day.
Something far more politically dangerous that had been brewing all week reached a dramatic crescendo Wednesday when a federal appeals court struck down Obamacare's individual mandate provision. The ruling did send the question of whether the entire Affordable Care Act should be struck down to the lower courts. But the decision means the issue will likely be decided by the Supreme Court, and it also means that health coverage is much more likely to become a marquee campaign issue in 2020.
But the court's decision was just one part of what has to be characterized as a very bad week for Obamacare. On Tuesday, the House of Representatives passed a budget bill that included the Democrats giving in on a Republican push to repeal the so-called "Cadillac tax" on high-end health insurance plans and a tax on medical devices. Both of those taxes were pushed as key funding sources for the ACA.
That's not all.
In a tweet posted on Sunday, Rep. Alexandria Ocasio-Cortez actually complained about all the "complex choices" the Obamacare exchange has presented her for health insurance coverage. She called the many choices "absurd" and that "no person should go through this."
The cave in on the Obamacare taxes and the dig at the ACA from one of the Democrats' rising stars both show just how far the party has strayed from rallying behind Obamacare and characterizing it as a signature triumph for the Obama administration and the Democratic congressional supermajority of 2009-2011. We've come a long way from President Obama's signing of the Affordable Care Act with the famous, "this is a big f***ing deal" cheer from then-Vice President Joe Biden.
Today's House Democrats now have a big problem. Remember that concerns about health care costs were consistently rated as the number one issue for voters in the 2018 midterm elections. The fact that the court ruling on the ACA mandate came on the same day as the impeachment vote in the House served as a strong shot in the arm for the GOP argument that the Democrats have done little about healthcare because of an obsession over ousting President Trump.
To be fair, Speaker Nancy Pelosi did push through a prescription drug pricing bill last week, but the Senate won't pass it and it's not clear if enough voters noticed it anyway. The House Democrats had better get moving on something more substantial on their health coverage platform soon.
But these developments are just as harrowing for the Trump White House and the Republicans in Congress. Remember that the GOP couldn't even complete the "repeal" part of the "repeal and replace" Obamacare efforts back in 2017. Ever since the late Sen. John McCain famously defected and cast his deciding vote against repeal, the Republicans and the administration have basically been flat-footed on the issue. This failure to fix the ACA in a meaningful way has led to higher costs since President Trump got elected, and he can't blame that all on the Democrats.
Again, to be fair, the Trump administration has consistently worked to get prescription drug prices down and is currently pushing through a plan to import lower cost drugs from Canada that even has some bipartisan support. The White House has also enacted its rule to require hospitals to publish their standard charges for services, a move many believe will force more competition and lower prices.
But these moves by both sides don't seem like enough to win over the public on the health care issue right now. So that brings us back to political posturing.
Prediction: the first side to convince enough of the public that it has a plan ready to go, but the other side just won't let it happen, will "win" the health care issue at the polls. It will simply be about not taking the fiercest blame from the public for the rising costs.
Both sides have some major roadblocks ahead of them on that score. President Trump's longer time period in office than the 2018 midterm-winning Democrats gives him and the GOP a weaker excuse for not getting it done. But the clear impeachment focus from the House Democrats this year will make it harder for them to convince the public they put the voters' healthcare concerns first.
Too bad neither side is addressing the bigger challenges that would really make a difference in health care costs. They include lowering prices by increasing the number of doctors nationwide, pushing back against hospital consolidation, and focusing on ways to streamline care for the sickest 5% of Americans who account for half of our healthcare spending. As it is now, anyone promising to address health costs who doesn't quickly couch their solutions according to the law of supply and demand is simply not worth listening to.
But thanks to this court ruling on the Obamacare mandate and the new budget deal, Democrats and the White House had better come up with something credible to pitch to the public on healthcare costs soon. Otherwise, all they'll be hearing from the voters is "buh-bye."