The Daily 202: Throwing a bomb into the insurance markets, Trump now owns the broken health-care system
President Trump prepares to sign his executive order on health care in the Roosevelt Room at the White House on Thursday. (Jabin Botsford/The Washington Post)
With Breanne Deppisch and Joanie Greve
The administration announced late last night that he will immediately halt cost-sharing reductions. These $7 billion in annual subsidies to health insurers allow around 7 million low-income Americans to afford coverage.
Earlier in the day, the president signed a far-reaching executive order that makes it easier for individuals and small businesses to buy alternative types of health insurance with lower prices, fewer benefits and weaker government protections.
This is not “letting” Obamacare fail. Many nonpartisan experts believe that these active measures are likely to undermine the pillars of the 2010 law and hasten the collapse of the marketplaces.
The Pottery Barn rule comes to mind: You break it, you own it. Yes, the plate you just shattered had some cracks in it. But if you dropped it on the ground, the store is going to blame you.
As Barack Obama learned after the Great Recession, with heavy Democratic losses in the 2010 midterms, it’s hard to blame your predecessor for problems two years after you take office. Especially when your party has unified control of the federal government. No matter how much it might be the previous guy’s fault, many voters won’t buy it. People have very short attention spans.
President Trump's decision to halt payments for cost-sharing reductions and his health-care executive order will have ripple effects throughout the Affordable Care Act's marketplaces. Here's what you need to know. (Video: Jenny Starrs/Photo: Jabin Botsford/The Washington Post)
The White House says the executive order will give people more choices, but: “Critics, who include state insurance commissioners, most of the health-insurance industry and mainstream policy specialists, predict that a proliferation of these other kinds of coverage will have damaging ripple effects, driving up costs for consumers with serious medical conditions and prompting more insurers to flee the law’s marketplaces.”
“The most far-reaching element of the order instructs a trio of Cabinet departments to rewrite federal rules for ‘association health plans’ — a form of insurance in which small businesses of a similar type band together through an association to negotiate health benefits. These plans have had to meet coverage requirements and consumer protections under the 2010 health-care law, but the administration is likely to exempt them from those rules and let such plans be sold from state to state without insurance licenses in each one. Among policy experts, critics warned that young and healthy people who use relatively little insurance will gravitate to association health plans because of their lower price tags. That would concentrate older and sicker customers in ACA marketplaces with spiking rates.”
-- Beyond yesterday’s directives, Trump has been personally involved in undercutting the system. Juliet discovered a remarkable example last week about just how hands-on the president has been: “For months, officials in Republican-controlled Iowa had sought federal permission to revitalize their ailing health-insurance marketplace. Then President Trump read about the request in a newspaper story and called the federal director weighing the application. Trump’s message in late August was clear … Tell Iowa no.”
“HHS has slashed grants to groups that help consumers get insurance coverage,” Juliet adds. “It also has cut the enrollment period in half, reduced the advertising budget by 90 percent and announced an outage schedule that would make the HealthCare.gov website less available than last year. … HHS has told its regional administrators not to even meet with on-the-ground organizations about enrollment.”
After failing to repeal and replace the Affordable Care Act, Republican leaders said it will "implode." Health-care experts disagree, saying the ACA is stable under current law — but President Trump and congressional Republicans could change that. (Daron Taylor/The Washington Post)
