The GOP’s pandemic health plan: Everything is fine

The pandemic is all but vanquished.

That’s the overarching health care message that has come out of the Republican convention, a narrative so dominant that it has squeezed out all other traditional GOP health policies, with the exception of their opposition to abortion versus Joe Biden’s embrace of abortion rights. Republicans aren’t even talking about repealing Obamacare, although that helped define what it meant to be a Republican for more than a decade.

With President Donald Trump down in the polls, Republicans are betting their political survival on convincing Americans that the country has turned the corner on the coronavirus, and that Trump is the one leader who can deliver a vaccine in record-smashing time.

Banking on the beleaguered public’s Covid-19 fatigue requires a narrative of healing and recovery, of controlling the virus and ending the economic distress. Republican strategists think the images they presented at their convention, including people gathering without masks, is a winning contrast with the Democratic convention last week, with its Zoom shots of solitary people in their living rooms and diligent mask wearing, from Joe and Jill Biden on down.

Biden’s admission in a television interview soon after the convention that he’d impose a national lockdown if scientists recommended it also drew a contrast between the two parties.

Democrats could have tested people who were attending their convention to convey the same image of normalcy but “they chose not to,” said veteran GOP operative Kevin Sheridan. “What you’re seeing from Biden and [Kamala] Harris is — I don’t know if they want the shutdown to continue, but they’re not offering any kind of way out or way back to normal.”

The pandemic isn’t over. Covid-19 has killed more than 180,000 people and could kill 300,000 by December, according to top disease modelers. The U.S. per capita death and infection rates are among the highest in the world.

But at the Republican National Convention, speaker after speaker praised Trump’s handling of the pandemic and several, notably White House economics adviser Larry Kudlow, spoke of the virus in the past tense.

“Thanks to the courage and compassion of the American people, we are slowing the spread,” Vice President Mike Pence said Wednesday night. “We are protecting the vulnerable. And we are saving lives. And we are opening up America again.”

The guests gathered to hear Pence at Fort McHenry — including his 87-year-old- mother — were not wearing masks and weren’t tested for Covid-19. Like the convention’s other live audiences, it created an illusion that the danger has diminished, and a return to normal life is in sight.

But whether Republicans convince voters that Trump has led them through the worst of Covid-19 and on to better days depends in part on how the unpredictable virus behaves between now and the election — especially since numerous public health experts say the Trump administration’s failure to offer a coherent national response has helped the disease spread widely and led to whack-a-mole state and city shutdowns that have crippled small businesses and knee-capped local economies.

It’s true that rates of hospitalizations and infections have improved. Since late July, Covid-19 daily cases have significantly declined, according to the COVID Tracking Project. But without vigilance and consistent public health measures, epidemiologists warn, they can bounce right back up again as they did in several states earlier this summer.

Just 31 percent of Americans, including only 28 percent of Independents, approve of Trump’s handling of the pandemic, according to an AP-NORC Center for Public Affairs Research poll released this week. But support remains strong among Republicans, a recent CBS poll found. Three-quarters of Republican voters surveyed said Trump’s pandemic response is “going well” and nearly 60 percent said the number of deaths has been “acceptable.”

Still, Democrats see the pandemic as a huge vulnerability for Trump. In a new $20 million ad campaign, former Trump staffers endorse Biden — including an ex-official at the Department of Homeland Security who said the president undermined the pandemic response because of the virus’ threat to the economy.

Throughout Democrats’ convention last week, speakers frequently referred to Trump’s infamous “It is what it is” quip about more than 1,000 American deaths per day. They contrasted that with stories of Joe Biden’s empathy and personal experience with illness and tragedy — including the death of his son Beau from brain cancer.

The pandemic crowded out discussion of almost all other health policy at both conventions.

In an atypical move, Republicans did not adopt a party platform in favor of “enthusiastically support[ing] the President’s America-first agenda.” They touted some smaller actions they’ve taken over the past four years and laid out vague agenda items for a second term — such as “develop a vaccine by the end of 2020,” and “return to normal in 2021.”

On health policy, the Trump campaign pledged to “cut prescription drug prices” and “end surprise billing,” echoing goals from the last two years that the administration wasn’t able to broker with Congress or pharmaceutical companies.

During the convention, the Republicans didn’t spend much time on lowering drug costs, a mostly unfulfilled promise from the 2016 campaign. Instead, they highlighted a more obscure law known as Right to Try that Trump championed, which lets terminally ill patients try to get access to experimental drugs. That fit into larger campaign messages about cutting red tape and eliminating regulations.

Largely missing, both from the policy list and the convention stage, was a return to the GOP’s decadelong litany of grievances against Obamacare.

Repealing Obamacare didn’t turn out the way Trump and his allies expected. After winning rare, unified control of the government in 2016 with Trump’s victory and a sweep of the House and Senate, they promised to swiftly do away with the health law. Instead, the more they tried to kill the law, the more Americans decided they liked it after all, particularly its protection for preexisting conditions. That’s a big reason the House went Democratic in 2018.

Trump’s constant promise of a new and better health law hasn’t materialized — instead, more red states have expanded Medicaid through Obamacare. His administration is backing conservative states trying to kill the law at the Supreme Court this fall, although that wasn’t played up at the convention either. The Supreme Court will hear oral arguments one week after the election.

Democrats have made this threat to Obamacare a core part of campaigns up and down the ballot, especially in battleground states and districts. For instance, the House Democratic campaign arm has unleashed ads across the country blasting Republicans for their failed 2017 repeal attempt and their president’s legal assault on Obamacare.

Democrats’ convention also hammered Trump’s court battle against the ACA at their convention, warning that it would strip coverage from millions of vulnerable Americans. But they were light on their own policy details — hardly mentioning Biden’s plan for a public insurance option that competes with private plans, or his proposal to lower the eligibility age of Medicare from 65 to 60.

The GOP convention, in turn, sidestepped health policy specifics but sought to portray Trump as fighting for religious conservative values, with speakers repeatedly touting Trump’s anti-abortion achievements and painting Biden as an abortion extremist. While Biden has shifted left on reproductive health, he does not promote unfettered access to abortion all through pregnancy, as the GOP depicted.

And when Republicans did tout other health policies, they characterized the president as fighting for the patient.

What would the country look like “without Donald Trump as our patient advocate for the past four years?” Natalie Harp, an advisory board member for the Trump campaign, asked during her convention speech.

“Well, the opioid epidemic would’ve stolen even more lives. Kidney patients would have no future except dying on [transplant] wait lists, for there’d have been no initiative to increase donations. … Insulin and other drug prices would’ve continued to rise while many generic drugs would still be stuck in the pipeline.”

One of Trump’s popular initiatives is an effort to overhaul dialysis payments and improve the organ donation process. He’s also gotten some bipartisan support for drawing attention to addiction and trying to get money to states. Drug overdose deaths had begun trending downward in 2018, but had already begun reversing course before the pandemic unleashed a spate of drug deaths.

The FDA has set record levels of approving generic drugs — a trend that began with the Obama administration. Drug makers have raised the price of hundreds of medicines during the pandemic — even as Trump himself has taunted them with executive orders the industry hates.

But those policies have been largely overshadowed by the pandemic-focused campaign. Just hours before Trump was set to take the stage, Democratic vice presidential nominee’s Kamala Harris hammered Trump on his coronavirus response.

“Donald Trump stood idly by and, folks, it was a deadly decision,” Harris said. “Instead of rising to meet the most difficult moment of his presidency, Donald Trump froze.”