In the middle of a pandemic with a novel virus that has infected at least 2.5 million Americans and killed roughly 127,000, and with 20 million people jobless, what is a prime Republican response? They are advancing yet again a court case to strip tens of millions of poor, working poor, and middle-class Americans of  health insurance.

By the way, when doing so — by seeking a total repeal of the Affordable Care Act — the Trump Administration and a collection of states led by Republican attorneys general also would put at huge risk key health insurance safeguards that Americans embrace, including:

• They no longer would be guaranteed the protection of insurers denying them coverage based on pre-existing conditions.
• It would be unclear whether they could keep their children on their policies, at lower cost, until they turned age 26.
• Insurers would see a bar lifted, so they could impose lifetime limits on coverage, notably for costly and chronic conditions like cancer and heart disease.

The fall political campaign, the experts say, will showcase a battle royal over health care in this country.

Really? How much more will American voters need to decide on how well they think current elected officials, notably Republicans and the Trump Administration, have responded to the unchecked and raging Covid-19 pandemic?

Have prescription drug prices gone down, as promised? (No.) Have costly and surprise medical bills, notably for emergency services, disappeared? (No) Have Americans in the last four years seen improvements in the affordability, access, safety, or quality of their medical services? (No.) If there’s disagreement about the naysaying, where’s the evidence?

Health insurance is not the alpha and omega of health care. But it is a crucial way for patients to share the risks of unforeseen, costly, and bankrupting illness or injury. It can allow and has given, as Obamacare has shown for tens of millions of people, patients a better chance to seek covered care, potentially reducing their risk of their conditions going undetected or worsening.

Republicans have had more than a decade to fulfill an important role in a functioning democracy — they have had ample opportunity to put forward an ACA alternative, giving voters a real choice to see better options and to pursue them.

This has not happened.

Instead, at best, political partisans and sketchy operators have tried to gull consumers by offering skimpy plans — health insurance that carries low premiums and the pretense of coverage. But when consumers need medical services, they find they are not part of this bargain. This is proving true with Covid-19 cases, as it has been with past, sad consumer discoveries about catastrophic coverage shortfalls.

Before the coronavirus altered so many ways that Americans live, the Democrats had ground through a wearying presidential candidate selection process that obsessed about health care, notably fixing Obamacare or seeking even bigger alternatives with government efforts to cover yet more people in more ways. Polls showed voter wariness about the expansive Democratic plans.

At the same time, though, public opinion has shifted, and the GOP has accomplished something it never desired: The ACA is more popular and supported than ever before, especially with the protections it incorporates as mentioned above. It technically is true that the safeguards, such as for pre-existing conditions, are part of ACA coverage but not always for coverage that workers get through their employers (the bulk of the way Americans get health insurance). But how many employers would keep the items in their policies if they were gone from the ACA? Obamacare also is playing a big, important, and unprecedented role for the record-setting numbers of the unemployed.

In my practice, I see not only the harms that patients suffer while seeking medical care, but also their struggles to access and afford safe, efficient, and excellent medical care. This has become an ordeal due to the skyrocketing cost, uncertainty, and complexity of therapies and prescription drugs, too many of which turn out to be dangerous drugs.

The Covid-19 pandemic has driven home for Americans how we all are way too vulnerable to sudden, major, and costly sickness or injury that not only can debilitate but bankrupt us. The U.S. health care system — on which this nation spends $3.7 trillion annually, while seeing some of the worst outcomes among western industrialized nations — needs many fixes, not the least of which is ensuring health insurance coverage for as many of us as is possible.

So, maybe November can’t get here fast enough. Let’s  see if Republicans have won Americans’ hearts and minds about the job they have done in the critical area of health care. Let’s stick with facts, evidence, and the record that officials have built — and not be swayed by their flashy words or pledges. The midterm elections provided a preview. The president prides himself on being a showman. Bring on this performance and let’s hope it is not a tragedy.