The explanation from the Biden campaign was also surprising, So let’s explore this claim in detail. It’s an interesting and complex story.
The Biden campaign explained that this line hinged on the fact that President Trump is backing a lawsuit that would nullify the Affordable Care Act, also known as Obamacare. The Trump administration filed a legal brief on June 25 asking the Supreme Court to strike down the entire law, joining with a group of GOP state attorneys general who argue that the ACA is unconstitutional. The court will hear arguments in the case, known as California v. Texas, on Nov. 10.
The case hinges on the fact that Trump’s 2017 tax law in effect eliminated the ACA’s individual mandate penalty by reducing it to zero. Without the mandate, the whole law should fall, rather than just individual portions, the plaintiffs argue. Trump decided to embrace that argument, rather than say that if one part of the law was unconstitutional, the other parts of the law could survive.
In an effort to reduce the number of people in the United States without health insurance, the ACA set up an insurance-market exchange and provided subsidies to help people buy individual insurance. The law also greatly expanded Medicaid, the health-care program for the poor. To help pay for this, the law also made adjustments to Medicare, mostly big cuts in payments to Medicare providers and a hike in the payroll tax for wealthy taxpayers.
Separately, the law added a handful of additional benefits for people on Medicare, primarily a gradual closing of the coverage gap — “the doughnut hole” — in the Medicare Part D program when coverage ceased for prescription drugs once a limit was reached.
The law also provided some free or reduced cost-sharing for some preventive services, such as mammograms and colonoscopies, as well as a free annual wellness visit. Private insurance plans known as Medicare Advantage also could no longer charge higher cost-sharing amounts than traditional fee-for-service Medicare for certain services, including skilled-nursing facility care, chemotherapy and kidney dialysis.
A Supreme Court amicus brief by AARP, the interest group for the elderly, cited an estimate that 40.1 million people took advantage of at least one Medicare preventive service with no co-pays or deductibles in 2016, while more than 10.3 million Medicare beneficiaries took advantage of an annual wellness visit.
The Biden campaign argues that it’s fair to say that Medicare benefits would be slashed because if the whole law fell, these benefits would disappear, as would every other part of the law.
First of all, the Bipartisan Budget Act of 2018, signed by Trump, sped up closure of the doughnut hole and, as of 2020, there is no longer a coverage gap. Four experts, both inside and outside Congress, told us that even if the ACA was repealed, the doughnut-hole closure is done and cannot be reversed.
(A discordant note was offered by Juliette Cubanski, deputy director of the Program on Medicare Policy at