By Ryan Zamarripa and Galen Hendricks, Center for American Progress
In 2015, Donald Trump promised: “Everybody’s going to be taken care of much better than they’re taken care of now.” Yet, long before news of the COVID-19 outbreak reached the United States, the Trump administration had been dismantling policies and proposing new ones that have vastly exacerbated the coronavirus pandemic.
As the United States braces to combat a public health crisis and a severe economic downturn, it is important to note that the Trump administration’s policies have contributed to this crisis. Three years of deregulation under the Trump presidency and a botched response to the COVID-19 pandemic have in part spurred what may be one of the costliest public health crises in American history—both financially and in terms of human life. This column breaks down four of the Trump administration’s deregulatory actions that have worsened the impacts of the coronavirus pandemic.
Dismantling the Affordable Care Act
More than 27 million Americans, about 9 percent of the U.S. population, have no health insurance coverage. Despite a yearslong decline in the number of uninsured Americans following the passage of the Affordable Care Act (ACA), the Trump administration’s effective elimination of the law’s individual mandate, as well as other efforts to undermine comprehensive coverage, led to an increase in the uninsured rate for the first time in 10 years. At the same time, the administration has pushed to allow insurance companies to offer short-term plans with limited coverage, also known as junk plans. While these plans offer cheaper premiums, they provide limited benefits and few consumer protections; enrollees could potentially have massive bills for COVID-19 treatment.
Even amid this crisis, Trump’s Department of Justice is actively backing a lawsuit to repeal the ACA in its entirety. If the administration is successful, 20 million Americans would lose coverage, and 135 million with preexisting conditions would lose protections against discrimination by insurance companies. People with conditions as common as asthma, which the Centers for Disease Control and Prevention (CDC) has listed as one of the medical conditions that increases the severity of COVID-19, could face premium hikes or outright denial of coverage if they need to purchase insurance in the individual market. Furthermore, the Trump administration is encouraging states to impose greater eligibility restrictions for Medicaid that could take away health care coverage from people who have lost their jobs.
Leaving key public health positions in the administration unfilled for years
The Trump administration is notoriously understaffed, with roughly one-third of the 745 key executive branch positions remaining unfilled over the three years of his presidency. Among the hundreds of empty roles is the National Security Council’s (NSC) global pandemic director. Timothy Ziemer, who was in charge of the President’s Malaria Initiative under both George W. Bush and Barack Obama before joining the NSC, was reported to have been “basically pushed out” of the agency. The position has now been vacant for nearly two years, and the pandemic office has remained closed. As it became clear that the coronavirus would become a pandemic, Trump made no effort to quickly fill the position; instead, he downplayed the effects of the virus and insisted that it would “go away.” Experts have suggested that these moves seriously hindered the administration’s response to the outbreak.
Slashing funding for the critical public health and infectious disease programs
Each of the Trump administration’s budget proposals has recommended slashing funding for the CDC. In 2018, the CDC cut its epidemic prevention activities, which help “train front-line workers in outbreak detection and work to strengthen laboratory and emergency response systems in countries where disease risks are greatest,” by 80 percent—with China being one of the countries where the CDC significantly scaled back its focus. Despite calls from the CDC, the U.S. Department of Health and Human Services (HHS), and the NSC to increase funding in its fiscal year 2020 budget, the Trump administration proposed a 12 percent cut to the HHS and a 10 percent cut to the CDC.
Even now, amid what may be one of the worst public health crises in recent American history, the acting director of the Office of Management and Budget has doubled down on the White House’s fiscal year 2021 proposed budget cuts of $1.2 billion to the CDC and $35 million to the Infectious Diseases Rapid Response Reserve Fund.
Dismantling safety net programs
As the coronavirus outbreak worsens, it is likely that businesses will begin to close, workers will lose jobs, and an unprecedented number of people will turn to federal programs and benefits, such as unemployment insurance and the Supplemental Nutrition Assistance Program (SNAP), to help make ends meet. Claims for unemployment insurance, for example, exploded last week and are likely to increase further as the economic fallout from COVID-19 worsens. But the Trump administration has spent much of the last three years attempting to gut safety net programs and make them more difficult for people to access.
In December 2019, the Trump administration issued a new ruling that limited states’ ability to account for local unemployment rates in determining whether and for how long someone can receive SNAP benefits. This means that even in the event of an economic downturn, people who lose their jobs due to the COVID-19 pandemic may end up losing their access to food assistance as well. Legislation recently signed into law temporarily suspends this rule until shortly after the public health emergency is lifted, but after this, localities would still be unable to provide benefits to all who need them as they continue to experience the effects of the recession. The administration has also proposed further stripping funding from the program: Its most recent budget proposal included $182 billion in cuts to SNAP over the next decade.
Programs such as SNAP are essential for helping families maintain financial stability, especially in the event of a recession. Denying families access to food at a time when jobs are scarce will only serve to exacerbate the impacts of a recession and further draw it out.
The Trump administration’s policies have worsened the impacts of the COVID-19 pandemic in the United States. As it becomes clear that the outbreak has created both public health and economic crises, policymakers must work to reverse the ripple effects of the administration’s harmful policies and provide a strong, well-targeted response to ease the burden on the hardest-hit communities.