Donald Trump has homed in on a target issue for the final days of the presidential campaign: Obamacare.
On Monday, the Department of Health and Human Services announced that the average increase for a monthly premium on the Affordable Care Act, better known as Obamacare, exchanges would be 25% in 2017. It was the largest jump for average premiums on the Obamacare exchanges in their three-year history.
And the Republican nominee has been hammering away at it ever since — mostly during the first few minutes of his raucous rallies.
“Real change begins with immediately repealing and replacing Obamacare,” Trump said during a Thursday rally in Toledo, Ohio. “What a mess. It never worked from day one. It was never destined to work. There was no way it was going to work. And I said before, before they voted, that’s never going to work.”
“And it’s just been announced that Americans are going to experience a massive double-digit hike in Obamacare premiums, including a 116% premium hike in the great state of Arizona,” he continued. “Think of that. Don’t worry, you’re not going to be so far behind. Don’t worry. It’s a mess. It’s a mess. It’s going up at numbers you won’t believe.”
Trump went on to say Democratic nominee Hillary Clinton wants to “double-down and double-up” on Obamacare, which he said will destroy healthcare and businesses “forever.”
Additionally, Trump has emphasised the connection between the healthcare law and Clinton. In the Toledo speech, Trump seized on former president Bill Clinton’s recent remarks that the design of the ACA “makes no sense.”
“Even Bill Clinton admitted Obamacare is the craziest thing in the world,” Trump said. “‘The craziest thing in the world.’ People wind up with their premiums doubled and their premiums cut in half. Job-killing Obamacare is just one more way the system is rigged.”
Bill Clinton has since clarified those comments and said that he fully supports the law.
The controversy that Trump has focused on the marketplaces, or exchanges, on which people without insurance through the government — such as Medicaid or Medicare — or their employer can get coverage. However, this represents only one part of the law with only around 5% of Americans receive their insurance through the exchanges and thus subject to the increases.
Much of the attention around the ACA has focused on the exchanges and their troubles such as increasing premiums and large insurance companies such as Aetna and UnitedHealthcare shuttering a majority of their exchange business.
This issue is also divisive politically. According to the Kaiser Family Foundation, a nonpartisan health policy researcher, 45% of American adults have an unfavorable view of the ACA, while 45% have a favourable view. Looking politically, this line of attack from Trump appeals to his base: 83% of Republicans view the law unfavorably.
But it could also could make a difference among independents or swing voters. Among those identifying as independents in the Kaiser survey, 52% view the ACA unfavorably while just 38% view it favourably. Democrats are split 76% to 14% in favour.
Many of the most important states in the election are facing down the biggest Obamacare increases. Arizona, a key state for Trump to hold onto, saw the highest average premium increase of any state in the country, which Trump made sure to note in the Toledo speech as well as in others.
North Carolina, another pivotal state, also saw the average premium increase by 40%, well over the national average.
The recent bad news for Obamacare is headline grabbing, it’s palatable for independents that Trump needs to swing, and hits key swings states hard.
And he seems to know it.
Said Trump: “Repealing Obamacare is one of the single biggest reasons we must win on November 8.”
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