Trump is screwing not just the rest of America, but tens of millions of people who voted for him.

Until lately, Democrats have been comforting themselves over Trump’s nearly unbroken string of legislative losses. Despite a Republican majority in both houses of Congress, Trump and different factions of the GOP kept tripping over each other, denying him key legislative victories. His penchant for insulting leading Republican senators only adds to the dysfunction.

Now, however, Trump may actually win a few. Consider the Affordable Care Act.

Trump has found a way to cripple it via executive power, first by withholding insurance subsidies that are key to making the program affordable.

By doing so, he destabilizes insurance markets, and courts the indignant opposition of every major medical and hospital group, as well as the insurance industry and many Republican politicians whose constituents have gained coverage under the ACA. But Trump’s sick obsession is to expunge anything that Barack Obama created, and hang the consequences.

He can further cripple the ACA by altering the rules to allow cheap insurance products with immense deductibles and co-pays to be offered by small businesses, thus technically meeting the test that they offer their employees insurance, even though these junk products are not legitimate insurance at all. And he can do additional harm by changing the rules and federal subsidy terms for Medicaid, reducing coverage there as well. The result of all of this is to do devastating damage to poor, working-class, and some middle-class Americans—many of whom voted for Trump.

The gutting of subsidized and regulated health coverage is another of Trump’s uses of racism. Beneficiaries of these programs are disproportionally black. Yet a majority are actually white. Thanks to the ACA, white non-coverage has declined at a steeper rate than for blacks and Latinos.

Trump is spinning his gutting of health coverage as the result of fatal flaws of Obamacare. But this is nonsense. A year from now, millions of Americans will be paying more money for less coverage, and many will lose coverage entirely. This will be entirely Trump’s doing. The challenge of setting the record straight is difficult, since insurance is such a complex mess.

There is still a chance that pushback from medical and hospital groups, as well as from Republican politicians fearing constituent backlash, will temper some of the worst aspects of Trump’s grand design to gut health insurance for Americans. As his Iran policy shows, Trump sometimes does settle for symbolic wins — but this will take massive organizing and public education.

Consider also the tax cut. Here again, despite all manner of schisms and mutual insults, Trump and the Republicans may yet prevail.

Keep in mind that cutting taxes on rich people and corporations has been the prime Republican objective going back to Ronald Reagan. Taxes were cut under every Republican president ever since, and three times just under Bush II. No matter how much Trump and key Republican senators loathe each other, the goal of further tax cutting trumps even their distaste for Trump.

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