Slate - "The Big Con" - how Trump is betraying so many
In every respect, Trump's proposals betray the people he promised to help the most
Broken Pledge
Trump’s promises to “take care” of inner city, rural, and Rust Belt voters have officially proved to be a con.
By Jamelle Bouie
http://www.slate.com/articles/news_and_politics/politics/2017/03/trumpcare_proves_that_trump_s_promise_to_take_care_of_rural_voters_was_always.html
During the presidential campaign, Donald Trump issued regular promises to “take care” of ordinary Americans. He mentioned two groups in particular: the inner-city poor (who, for Trump, were a synecdoche for black Americans) and the rural and Rust Belt victims of the opioid crisis. “First, we have to support locally based and locally run clinics, and we gotta close up the border,” he said during a November 2015 stop in New Hampshire. “In the meantime, people are getting hooked, and we’re going to take care of those people.” Just before the election, he detailed his plans for dealing with addiction in America’s rural and post-industrial communities. “I want to dramatically expand access to treatment slots and end Medicaid policies that obstruct inpatient treatment,” he said, in a speech that called for more federal resources to reduce and treat opioid addiction.
Trump was less specific when speaking about inner cities—which he routinely described as lawless “war zones” of poverty and crime—but there, too, he said he wanted to help. “The African-American community has been taken for granted for decades by the Democratic Party. It’s time to break with the failures of the past—I want to offer Americans a new future,” he said last year in remarks to supporters in Wisconsin.
Those were Trump’s promises, building blocks of his image during the campaign, that of a caring, competent businessman. Enough voters—or at least, enough white voters—bought that image to give him an Electoral College victory, and thus the White House. Now, less than two months into his presidency, Trump is betraying both promises (and both groups of voters) in dramatic form. That this isn’t a surprise—as a businessman, Trump was notorious for cheating partners and shortchanging customers—doesn’t make it any less shocking.
On opioid addiction, Trump has committed his administration to the exact opposite of what he’s promised. Medicaid, the joint state-federal health program for poor and low-income Americans, is an integral part of the fight against the still-rising opioid painkiller and heroin epidemic, which contributed to tens of thousands of overdose deaths in 2015. It covers more than 70 million people and is the largest source of funding for behavioral health treatment, like addiction recovery and substance abuse prevention. Indeed, the Affordable Care Act required Medicaid to start paying for all available addiction treatments, beginning in 2014. And in the 31 states that expanded the program under Obamacare, 1.2 million people have gained coverage for substance abuse treatment. (Overall, according to one analysis, the ACA expanded access to drug abuse treatment for 2.8 million Americans.) Medicaid is far from perfect—varying rules for covering opioid addiction medication, as well as tough eligibility requirements in some states, make it less effective in combating substance abuse than it might be—but it’s still a valuable tool. If Trump were serious about fighting opioid addiction, he would at least commit to strengthening the program.
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