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With the Senate abnegating its constitutional duties and making it clear it will give Donald Trump a free hand to commit any malfeasance, American democracy is one step closer to crumbling. In a normal week, that would be the overwhelming Signal. So, too, would be the clearly racially motivated expansion of the travel and immigration ban to include Eritrea, Sudan, Nigeria, Tanzania, Kyrgyzstan, and Myanmar.
But this isn’t a normal week. The real Signal, as the coronavirus verges on becoming a pandemic, is the insanity of the administration’s approach to public health. Here’s what we know about the virus: It has a higher lethality rate than regular flu, is more communicable than the flu, has an incubation period of up to two weeks, and asymptomatic carriers may be able to transmit the illness to others. There’s currently no vaccine, which means the only hope of stopping coronavirus from sweeping the globe, overwhelming health care systems, and paralyzing trade and travel routes is robust public-health intervention, bulked-up health spending, and ease of access to medical care.
Instead, this administration is rampaging in the opposite direction. A summary of recent decisions: Following the Supreme Court’s decision to allow the “public charge” restrictions to go into effect—intended to block immigrant access to public services—the Department of Homeland Security announced that they would kick in later this month. Hundreds of thousands of immigrants in the process of applying for green cards will lose access to care; perhaps millions more, scared off by rumor and fear of deportation, will voluntarily cut themselves off from it.
In addition, the administration is still siding with Texas and other conservative states in their legal efforts to have the Affordable Care Act declared unconstitutional. Earlier this year, the Justice Department asked the courts to strike down the law. More recently, it has asked the courts to invalidate the law in the 18 states that have filed suit against it. If it succeeds, tens of millions could see their health care pulled out from under them. The Supreme Court has announced that it won’t address the issue before the election. That means more than a year of uncertainty before we know whether the tens of millions who were able to get health care following its passage, or the additional millions with preexisting conditions whose coverage is guaranteed by the law, will be able to get treatment down the road.
And just this past week the administration announced that it would allow states to request that their Medicaid funding plans for able-bodied adults be moved to block grants, thus capping benefits. At a moment when the nation’s public-health systems must be able to treat sick people as quickly as possible, this change would allow some states to kick huge numbers of poor people off their health care programs.
Denying medical coverage to immigrants, poor Americans, and Americans with pre-existing conditions is a recipe for disaster during a pandemic. Fewer people will seek prompt treatment; more immigrants will turn to cash-only doctors who don’t report their illnesses to the Centers for Disease Control; and people with viral pneumonia will go to overcrowded emergency rooms, further spreading their infections, rather than seeing primary-care doctors and getting put into isolation earlier.
The Trump administration seems to think it can control epidemics by canceling flights and temporarily locking people out of the country. Yes, quarantines and travel restrictions are sometimes necessary, but they are never sufficient. There have to be robust health care systems underpinning any response to a medical emergency. In its zeal to punish the poor and marginalize immigrants, this administration has put public health care on the cutting block at a time when it’s most critically needed.