This May Be the Farthest Trump Has Ever Gone in Attempting to Invert Reality

It's hard to know what to say anymore. It has been clear for years now that the lying is not just impulse, not just spin and not just an attempt to squirm out of something. It is an assault on the concept of observable reality, a demand that you reject the evidence supplied by your eyes and ears, an assertion of power over the truth itself. Any fact is fungible, and the truth is whatever you can get enough people to believe. This process of first bending the contours of reality, and now breaking with the whole concept entirely, has steadily escalated up to perhaps this very point.

Speaking at a rally in Pennsylvania on Thursday, Donald Trump, American president went further than he ever has before. (Except, perhaps, his reported habit of insisting in private that the Access Hollywood tape was fake, despite admitting it was him—and, for once, semi-apologizing—when it first came out. Except this is in public, and it actually affects people's lives beyond evoking base revulsion at this creature we have so elevated in this ongoing repudiation of the American experiment.) The president, you see, has completely inverted reality on the subject of mandating coverage for preexisting conditions.

(He actually snuck it in after another insane lie: that Joe Biden will destroy Social Security, when it's Trump who's promised to nix the payroll tax—which funds the program—as a spasm of electoral self-preservation amid the economic downturn of the pandemic.)

But the main event was the preexisting conditions discussion. The Affordable Care Act, rechristened as Obamacare by conservatives looking to recast a healthcare reform program with roots in their own ideological tradition as a totem for racial panic, has come up short in a number of ways. Some are tied to the vandalism of those very same conservatives. Others are probably unavoidable for a program that still, at base, treats healthcare as a commodity and subjects human health—and suffering—to the profit motive.

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Still, if there's one thing people like about Obamacare, it's protection for preexisting conditions—that insurance companies cannot deny you coverage because you have a chronic illness and will need care. That did not exist before the bill was passed by congressional Democrats and signed into law by Barack Obama, whose vice president was Joe Biden.

Meanwhile, Republicans have for a decade now attempted to cripple, maim, or outright destroy the law in total—including the protections for preexisting conditions—with some success. They attempted to repeal the law 70 times, including when they controlled both houses of Congress, with no serviceable replacement. They did succeed in sneaking a repeal of the individual mandate, which helps the law function (to the extent it does) by forcing healthy people into risk pools to lower the cost for less-healthy people, into their tax cut for rich people and corporations. And now, a raft of Republican attorneys general are suing to throw the law out entirely and the Trump administration has joined them.

That's right: Trump is right now suing to destroy protections for preexisting conditions. He has long lied about this, promising to maintain them, and he's not the first. Senator Josh Hawley was one of the attorneys general trying to get the law thrown out when he ran for the Senate and put out ads promising to protect preexisting conditions. It was a sign that this gross disregard for the truth will not depart the scene with Trump. But the current president truly is the grand master. He has gone beyond lying about his own position on preexisting conditions to accusing his opponent, who was part of the administration that instituted the protections, of trying to destroy them.

Again, it's honestly hard to grapple with this level of shamelessness. What is there to say, other than that if he will say something so at odds with reality on this issue, he will do it for any other. This is not just a grave threat to the entire concept of democratic accountability, as when public officials can simply lie about what they've done and are doing and get away with it, they can get away with anything. People's lives are also on the line. Premiums are too high under Obamacare, the plans aren't much good, but if you nix protection for preexisting conditions—that is, if you make it so sick people can't get coverage—people will go bankrupt and they will die.

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