Doctor sounds alarm that Trump could gut health care — even if he's not elected

Former President Donald Trump may publicly be backing off past attempts to destroy the Affordable Care Act, at least until he has more than the "concept of a plan" to do so — but he doesn't actually need Congress to gut America's health insurance coverage system, warned New York-based Dr. Danielle Ofri for The New York Times.

In fact, she warned, he doesn't even need to be elected president at all — his allies in industry can enlist the courts to do it for him.

"This summer, a pair of Supreme Court decisions radically reshaped the health care landscape by overturning the so-called Chevron doctrine. For the past 40 years, this doctrine acknowledged the technical knowledge of scientists and policy experts within federal agencies, giving deference to 'reasonable' regulations these agencies issued to interpret ambiguities always present in the complex laws," wrote Ofri.

"In overturning Chevron, the Supreme Court ruled that the courts — not government agencies — should take the lead in clarifying the ambiguities, with Chief Justice John Roberts writing that 'agencies have no special competence' in this regard. This significantly weakens the federal agencies’ ability to define the rules that cover health, safety, the environment and other sectors."

To some extent, far-right judges have been ignoring Chevron for decades anyway, injecting their personal politics to second-guess agencies on health care, as in the case that sought to remove FDA approval for abortion drugs. But now the Supreme Court has made it much easier to do so, and a wave of litigation could put all sorts of consumer protections on the chopping block.

Industry groups can now use lawsuits to attack "regulations intended to protect patients medically (such as requiring a minimum number of staff members on the floor at nursing homes) and financially (such as the No Surprises Act, which prevents excessive bills from out-of-network providers incurred during emergency care)," Ofri wrote.

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Moreover, rules may cease to be uniform across the country: "Inconsistencies in how lawsuits play out in different parts of the country could lead to a hodgepodge of unequal rulings that might make certain vaccines and birth control, for example, routine medical care for some Americans, and hard to come by for others."

There is a way to fight back in some cases, she noted, and it's at the ballot box — in many red states, voters used ballot initiatives to force lawmakers to expand Medicaid or protect abortion rights. But the damage as all this plays out will be real — and doctors will have to do what they can to protect people in their care.

"Medical professionals and patients — along with caregivers and families — carry firsthand knowledge of how political policies and judicial decisions play out in blood, bruise and breath," she concluded. "Our job will be to keep these human experiences front and center during this tumultuous election season."