Tag Archives: deliberate sabotage

If You Can’t Defeat It, Sabotage It

During the ongoing saga of the Senate’s inability to formally eviscerate the Affordable Care Act, “President” Trump has tweeted out several threats: to fund primary opponents of Republicans who refused to support repeal,  to punish Alaskans for the votes of their Senator, and implicitly, after the measure failed, to sabotage the Affordable Care Act to ensure that it will fail.

Nice guy–as no one ever has said.

The Washington Post, among many others, has reported on the methodology behind the madness. (Madness used here in both senses of that term…)

Blue Cross Blue Shield of North Carolina has announced that it intends to try to raise premiums by 22.9 percent next year. The company says it would have tried to raise them by only 8.8 percent, but it is going for the larger increase because the Trump administration has not said whether it will continue paying the law’s so-called “cost-sharing reductions” (CSRs) to insurance companies, which subsidize out-of-pocket costs for lower-income people who get insurance on the individual markets. Democrats in Congress want to appropriate money to cover these subsidies, but Republicans have not done so….

Trump has repeatedly threatened to cut off the CSRs. Doing so could cause many insurers to exit the market, potentially costing millions their insurance, while causing others to dramatically hike premiums. The administration paid them for May, but officials continue to refuse to saywhether the payments will continue after that. The CSRs are tied up in court: House Republicans sued to stop them under Barack Obama, whose administration appealed the decision, and the payments continued pending the appeal, but the Trump administration has not said whether it will continue the appeal (dropping it would cause the payments to halt) and recently asked for a 90-day delay from the court while it mulls their fate. But this has only injected further uncertainty, and while some congressional Republicans have said they think the funds must be appropriated to stabilize the situation, there’s no sign whether they actually will.

Anthem Insurance, based here in my home city of Indianapolis, has withdrawn from participation in several of the exchanges due to the lack of CSR certainty.

The Center on Budget and Policy Priorities has actually added “Sabotage Watch” to its webpage; it tracks administration actions taken to undermine the Act, month by month, since Trump’s inauguration. Here’s the entry for July:

July 20

The Trump Administration ends contracts with two private firms to provide in-person assistance in states using HealthCare.gov for marketplace enrollment.  Since the first open enrollment period in 2013, Cognosante LLC and CSRA Inc. have provided one-on-one assistance for people enrolling in marketplace plans and applying for subsidies.  The loss of this assistance is especially likely to affect enrollment for 2018 coverage because the Administration has already shortened the open enrollment period to six weeks.

July 20

The Department of Health and Human Services (HHS) continues its public relations campaign attacking the ACA. HHS has released 23 videos featuring individuals explaining how the ACA has harmed them.  HHS has also used its twitter account to amplify anti-ACA messages and removed website content promoting the ACA, including the popular ACA provision enabling young people to stay on their parents’ plans until they turn 26.

A number of publications have reported on the Administration’s efforts to undermine “Obamacare.” The following explanation from New York Magazine is typical.

By threatening to stop paying out those so-called cost-sharing reductions — while also threatening not to enforce penalties on those go without insurance — the White House sowed uncertainty that chased insurers out of Obamacare.

In mid-April, several of America’s largest insurance companies descended on Washington to seek the White House’s assurance that Trump’s rhetoric about withholding the subsidies was just a bluff. Seema Verma, Trump’s head of Medicare and Medicaid Services, informed the insurers that it couldbe a bluff — if they agreed to publicly support the president’s health-care bill.

The insurers found little comfort in this exchange. Nor did Trumpcare’s sudden revival calm their nerves. To protect themselves from a diverse array of very-bad-case scenarios, many jacked up their premiums and wound down their participation in the Affordable Care Act.

It’s hard to find words to describe this behavior. Unconscionable, despicable and disgusting come to mind….