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We’ve hit the ‘make-wild-health-care-promises’ part of Trump’s campaign

Donald Trump on Thursday told NBC News that, if reelected, his administration would ensure that in vitro fertilization (IVF) was free for all Americans. But before we dig into that claim, we should talk about breakfast meat.

At an event in Wisconsin on Thursday, the former president offered a seemingly incongruous argument in support of his return to the White House.

“You take a look at bacon and some of these products, and some people don’t eat bacon anymore,” he said. “And we are going to get the energy prices down. When we get energy down — you know, this was caused by their horrible energy. Wind — they want wind all over the place. But when it doesn’t blow, we have a little problem.”

To a layperson, this is incomprehensible. To someone who has heard Trump speak with any regularity over the past few years, though, what’s happening is clear. In short, Trump claims that the surge in inflation following the emergence of the coronavirus was a function of a spike in energy costs, in part because it lets him blame the Biden administration (and, by extension, Vice President Kamala Harris) for the increase and for higher gasoline costs. This spike in inflation meant an increase in the cost of food, including the one he mentions all the time: bacon. While he’s on the topic of the Biden administration’s approach to energy, why not ding wind power, which Trump has long hated (for golf-course related reasons) and which he likes to suggest doesn’t work if no wind is blowing.

These are all typical elements of his campaign patter. He’s been using them so long that he has little snippets of shorthand for them: no one eats bacon, what if there’s no wind, etc. In Wisconsin, he just sort of mashed all those shorthands together, resulting in something incomprehensible to anyone not well-versed in Trump’s political lore. It’s like presenting someone new to the franchise with the last ten minutes of a recent Marvel movie.

The point is that Trump has a familiar, comfortable and established way of running for president. As well he might; he went from being a political outsider in 2016 to being the American with the most experience at the top of his party’s ticket since Richard Nixon in 1972. So he drops strange riffs on wind power and bacon — and he makes sweeping promises about health care that he can’t or won’t effect once in office.

In 2016, the promise Trump made centered on the Affordable Care Act (ACA), more commonly known as Obamacare. The pledge was often vague: There would be “insurance for everybody” and “everybody’s going to be taken care of much better than they’re taken care of now.” But, as had been the case since the ACA passed, his party had no alternative plan in place and ultimately proved unable to find the votes to overhaul the legislation despite majorities in both chambers of Congress.

This wasn’t entirely a surprise, mind you. It was generally understood that there was no perfect alternative in the wings. Trump’s proclamations that he’d find a perfect alternative yielded widespread skepticism, particularly given his antipathy toward reinforcing his promises with plans.

In 2020, the effort was more egregious. Trump contracted covid-19 that October and credited the drug Regeneron with his recovery. So, speaking to Fox News host Sean Hannity, he made a promise.

“I viewed it as a cure,” he said. “It’s incredible. And we’re going to get it to everybody, free of charge. It’s going to hospitals. It’s starting very soon.”

Regeneron was not a cure and proved to be less effective against later variants of the virus. More importantly, it was not provided to everyone free of charge “very soon.” Coronavirus deaths spiked that winter as Trump was otherwise distracted.

This was even predictable then. He’d done something similar in 2018, promising just before the midterm elections that his party would deliver huge tax cuts by the beginning of November. Not only did that not happen, there was no indication it was ever in process to any significant degree. It was just Trump saying that he would do a thing he thought people would like and keeping his fingers crossed.

It’s important context for the IVF promise.

“We are going to be, under the Trump administration, we are going to be paying for that treatment,” Trump told NBC. “We’re going to be mandating that the insurance company pay.”

You will notice that those are two different things: the administration/we paying, which implies federal funding, or making insurers cover the cost, which would be the insurance companies paying. Or, more precisely, it would likely be insurance companies’ customers paying, since the insurers couldn’t simply absorb the hefty costs of IVF without increasing the money paid by everyone else. The point of the ACA, incidentally, was to increase coverage by mandating that people carry insurance, meaning more healthy people paying for low-cost insurance and increasing the income for the insurers mandated to provide the coverage. Then Trump pushed for that mandate to be removed.

Beyond there being no reason to assume that Trump would actually try to implement free IVF coverage as president, the idea would certainly alienate some of his more fervent supporters. The reason IVF is a subject of discussion in the 2024 campaign is there’s an effort on the right to block the procedure. Between that constituency and those who aren’t thrilled about a promise to spend billions of dollars on personal health care (or to make private companies spend those billions), there will be (and has already been) pressure on Trump and other Republicans to drop this idea.

But, again, we should assume it’s just Trump saying things. We should assume it’s Trump having a sense of what people want to hear and saying those things, even if the context is incomplete, or even if he doesn’t really mean it. Bacon is expensive because of the wind is Trump’s familiar, clumsy effort to bash Harris on prices; IVF will be free for everyone is his familiar, clumsy effort to promise that no one will have to worry about health care if he is elected — just as everyone got free Regeneron, curing the coronavirus in December 2020.

This post appeared first on washingtonpost.com

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