Trump targets Obamacare
Two U.S. senators unveiled a bipartisan proposal to fix parts of the Affordable Care Act this week, after President Trump announced executive actions that critics said would sabotage the beleaguered health-care law. The president’s most significant move was ceasing about $10 billion in federal funding for cost-sharing reductions—key payments to health insurers that offset the cost of covering about 7 million low-income Americans through Obamacare. Under the compromise offered by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), Congress would authorize funding for these payments for two years, in exchange for giving states greater flexibility to regulate health coverage. If passed, the legislation would ease the review process for states that want waivers from some of the law’s requirements, and expand eligibility for “catastrophic insurance,” which is cheaper but less comprehensive than other ACA plans. The proposal would also provide $106 million in enrollment outreach funding, largely offsetting the Trump administration’s recent efforts to cut programs that seek to enroll the uninsured.
Republican congressional leaders did not take a position on the Alexander-Murray bill, and several GOP lawmakers came out against it, describing it as a means to prop up Obamacare. Trump initially called the proposal a “very good” deal, but a day later said Congress should “find a solution to the Obamacare mess instead of providing bailouts to insurance companies.” The president vowed to dismantle the Affordable Care Act and eventually replace it. “Obamacare is finished,” Trump said. “It’s dead. It’s gone.”
What the editorials said
Trump’s executive orders were a “malicious” attack on our healthcare system, said the Los Angeles Times. Obamacare works by offsetting the higher health-care costs of older, sicker consumers with the premiums of younger, healthier people. Allowing too many of the young to leave the ACA’s insurance pools will force insurers to raise premiums for everyone else. And halting the cost-sharing payments will force insurers to either steeply raise premiums or abandon the exchanges altogether. If Republicans don’t pass the Alexander-Murray proposal, they’ll “add roughly 20 percent to the premiums faced by millions of their constituents.”
Trump had good reason to cut the cost-sharing reductions, said NationalReview.com—they were illegal. Obamacare “did not actually put up the money” for the payments, and when Congress refused to appropriate funding, the Obama administration sent the billions to insurers regardless. As for the introduction of cheaper health plans providing coverage only for hospitalizations, they could well raise premiums for older people. But that just underscores a key “weakness of Obamacare”: It’s almost impossible to fix the law’s flaws “without threatening other parts of it.”
What the columnists said
“It took almost a year, but we now have the ‘Trump Doctrine,’” said Thomas Friedman in The New York Times. On nearly every major issue—health care, the Iran nuclear deal, the Paris climate agreement, the domestic clean power initiative—the president’s position is the same: “Obama built it. I broke it. You fix it.” His guiding motivation is to smash his predecessor’s legacy—regardless of what happens “the morning after.” Trump’s policy sabotage, and his repeated insistence that Obamacare is “imploding,” has already badly damaged the program, said Greg Sargent in WashingtonPost.com. Polling shows that “only 31 percent of customers insured through the ACA exchanges and 12 percent of the uninsured” know that open enrollment starts on Nov. 1. Trump’s false claim that Obamacare is “finished” will no doubt “fuel [this] lack of awareness.”
I thought liberals wanted to “reduce the number of uninsured,” said Betsy McCaughey in the New York Post. Yet when Trump allows insurers to sell policies at half the price of “bronze” plans on the exchanges, they shout “Sabotage!” The ACA’s “one-size-fits-all package” is patently unfair for young, healthy people who rarely require medical treatment. Why should “the healthy pay the same for insurance as the chronically ill”?
Trump thinks if he inflicts “sufficient damage” on Obamacare, he can blackmail Democrats into cutting a health-care deal “on his terms,” said Ezra Klein in Vox.com. But Republicans control both Congress and the White House, and if the health-care system falls into chaos, the president and the GOP will “absorb the blame.” Trump is “sabotaging himself.”
AP, Elizabeth Robertson/The Philadelphia Inquirer/AP ■