Andrew Sprung calls Obamacare “London after the Blitz.” It’s still standing, but the damage done by the Trump administration is already severe:
Uncertainty over CSR reimbursement and enforcement of the individual mandate have themselves driven premiums up by over 20% in 2018 (Gaba’s estimate) and driven many insurers out of the individual market.
Those premium hikes will probably knock several million unsubsidized buyers out of the individual market. Weakened mandate enforcement, real or perceived, will probably reduce the numbers of people enrolled not only in the individual market but also in employer-sponsored insurance and Medicaid. An increased percentage of unsubsidized enrollees in the individual market who do stay in will probably be underinsured, pushed into bronze plans and/or overburdened by the combination of rising premiums and out-of-pocket costs. Poor-to-nonexistent outreach from HHS may result in many current marketplace enrollees failing to shop anew and so re-enrolling in a suboptimal plan. Trump’s threat to issue an executive order that reportedly would empower association health plans to evade state regulation via ERISA could bleed health enrollees out of the individual market.
Red states, meanwhile, are lining up to accept HHS’s invitation to propose work requirements, time limits and more frequent enrollment redeterminations on Medicaid enrollees, which will likely inhibit reduce Medicaid takeup.
It’s easy to blame the media for everything, but this act of petty revenge is pure Trump. That said, it’s a little shocking that this hasn’t gotten more press attention. A president of the United States, acting out of pique, has undertaken a deliberate and calculated plan to undermine a program that provides health care to 20 million Americans at a very reasonable price. There is no feasible replacement in the works, and Republican efforts over the past year have demonstrated that even if there were, it would still take a toll of 20 million or more people:
And it just keeps coming. CSR games were just the start. They’ve been followed by a nearly weekly parade of sabotage: cutting the enrollment period, slashing the outreach budget, shutting down the website once a week, and now by a transparent invitation to cut back on Medicaid.
I know that not everything I think is important is big news. But this is astonishing stuff: a president deliberately undermining a successful program that provides access to health care for millions. And there are new announcements every few days, so it’s not like you’re stuck for ideas after you’ve written the story once.
I suppose a big part of the blame here is with Democrats. They should be screaming blue murder and forcing this to become news. For some reason, they aren’t. What are they waiting for?
