Sabotaging the ACA

Trump halts payments to insurers, making Obamacare’s demise disastrously inevitable.

The smug look on Donald Trump’s face on Thursday brought to mind a fast-talking flim-flam man on late-night TV. Brandishing for the cameras his executive order that will destabilize and ultimately destroy his predecessor’s signature health-care accomplishment, he just as easily could have been touting the latest never-curl garden hose or a handy kitchen melon slicer between faded segments of “Full House” or “Three’s Company.”

But wait! There’s more! By abruptly halting payments to insurance companies, payments that are designed to lower the out-of-pocket costs for low-income and middle-class Americans who depend on Obamacare, Trump is likely to kick the health-insurance market into chaos. He also risks harming millions of people, including those working-class Americans who proudly consider themselves his red cap-wearing base.

The $9 billion or so that Trump blocked will force insurers to raise premiums by as much as 15 to 20 percent. They’ll likely stop selling policies in some parts of the country.

As numerous critics of the president’s ill-considered action have pointed out, his order actually ends up costing the government money, since people who buy coverage on the Obamacare exchanges also receive subsidies to keep their premiums affordable. The cost to the government will be about $2.3 billion next year, according to the Kaiser Family Foundation. Of course, it’s a small price to pay for a president intent on smashing any and all accomplishments of the Obama era.

While Trump preened for the cameras, U.S. Sen. Lamar Alexander, the Tennessee Republican who chairs the Senate Health Committee, and U.S. Sen. Patti Murray of Washington, the senior Democrat on the committee, were still trying to craft a bipartisan arrangement that would continue the subsidy payments to insurance companies while allowing states to obtain waivers from some of the requirements of the Affordable Care Act. Their tentative plan is still viable, despite the White House sabotage effort. If Murray and Alexander can agree on how much flexibility to allow the states, it will be up to Republican leaders in Congress to allow a vote on the plan.

The two senators offer the sensible approach, but for Trump, of course, it would be an acknowledgement that Obamacare lives and that he and most of his fellow Republicans have no idea how to replace it. They can kill it, and in the process hurt millions of Americans, but they have neither the will nor the wherewithal to construct a better system.

But wait! There’s still more! Trump also directed his administration on Thursday to create what would be, in effect, an alternative health-insurance system without the safeguards built into Obamacare. He’s insisting that people use association health-care plans with a history of inadequate coverage and shortterm policies that leave out a range of coverage areas. They’re basically “junk” insurance policies. The president insists his plan will help Americans obtain cheaper insurance; what it will likely do is force insurance companies to abandon Obamacare’s insurance exchanges. It’s yet another way to hollow out the Affordable Care Act.

Amy Davidson Sorkin of the New Yorker noticed on Thursday that it looked like the president almost forgot to sign his executive order — just as he has conveniently forgotten to protect millions of working-class Americans who need affordable, reliable health care. Vice President Mike Pence had to scurry after the president and lead him back to his desk. Neither Pence nor anyone else in this benighted White House is leading this nation toward any kind of health care system worth a presidential signature — or even an ad on late-night TV.