October 13, 2017 8:53 am -

UPDATED, Oct 13, 2017, 8:50amEDT —When your own party knows better, there is an alternative: sabotage.

The cornerstone of real estate flim-flammer Donald Trump’s presidential campaign was a promise to “repeal and replace Obamacare” – in other words, destroy the Affordable Care Act, a major step forward in seeing to it that millions of uninsured Americans could actually afford insurance.

Trump has lied incessantly about Affordable Care Act premiums, exaggerated “diasaster” scenarios that are unrepresentative if not entirely bogus, and even claimed he would replace it with “something great.”

In the nine months he has held office, his own party’s Capitol Hill stooges failed miserably in every attempt to repeal the Affordable Care Act, a legislative farce that instead exposed and exacerbated divisions within an already fracturing Republican party.

Yesterday, Trump, having failed completely to “repeal and replace” the Affordable Care Act to placate his shrinking base, resorted to outright sabotage.

His first move was the mid-afternoon signing of an executive order that circumvents the ACA

… by making it easier for individuals and small businesses to buy alternative types of health insurance with lower prices, fewer benefits and weaker government protections.

The White House and allies portrayed the president’s move as wielding administrative powers to accomplish what congressional Republicans have failed to achieve: fostering more coverage choices while tearing down the law’s insurance marketplaces. The order represents Trump’s biggest step to date to reverse the health-care policies of the Obama administration, a central promise since last year’s presidential campaign.

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. Part of Trump’s action, they say, will spark court challenges over its legality.

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.

Amanda Michelle Gomez at Think Progress adds:

The move could break Trump and the GOP’s promise to protect sicker people’s access to affordable insurance. (Talking Points Memo has a good timeline of all the moments the GOP promised to cover people with pre-existing conditions.) Trump vowed to safeguard these consumers as a candidate, and later as the president. Now, with a stroke of a pen, he has gone back on his word, again.

… The order also calls for expanded access to short-term health plans, which are bare-bones plans that are exempt from the health law’s regulations. Short-term health plans use “medical underwriting” that allow insurers to use health information to evaluate applicants; this practice commonly excludes people with pre-existing conditions from coverage. Under current health law, people can only have these plans for three months, but Trump’s executive order would extend their lifespan to a year, per the request of some Senate Republicans.

… [T]he order not only encourages healthy people to leave the ACA marketplace, but steers sicker people to purchase plans there. Trump’s order would make it easier for employers to set aside money, tax-free, to help employees purchase health plans. A concern from insurers, first reported by Axios, is “employers might be able to offer coverage to their younger employees, while using these new funds to shift older workers, who tend to have higher health care costs, into the individual market.”

In other words, costs for the sick and vulnerable will skyrocket.

As if that weren’t bad enough, Trump made a move that was probably meant to be announced late Friday, to avoid rigorous scrutiny by the press. Politico broke this story late last night:

President Donald Trump plans to cut subsidy payments to insurers in his most aggressive move yet to undermine Obamacare after months of unsuccessful repeal efforts on Capitol Hill, according to two sources.

The subsidies, which are estimated at $7 billion this year and are paid out in monthly installments, may stop almost immediately since Congress hasn’t appropriated funding for the program.

Scrapping the funding is likely to provide another jolt to the already fragile Obamacare markets. The impact may be cushioned by the fact that many insurers had priced next year’s plans higher than they otherwise would have, fearing this decision. Others have already fled the Obamacare markets, which are set to begin open enrollment in Nov. 1 for the 2018 plan year.

Insurers rely on the subsidies to reduce out-of-pocket costs for low-income Obamacare customers. They’re still on the hook to provide the discounted rates to their members under the law, despite no longer receiving the federal funding.

Trump has threatened for months to cut off the payments, deriding them as a “bailout” for insurers. While Republican lawmakers complained the subsidies were never properly appropriated by Congress, many were wary of ending them suddenly.

A prominent Republican congresswoman is not pleased:

This morning, Trump tweeted:

Only his followers will be sufficiantly naive and uninformed to blame Democrats for Trump’s sabotage of health care.

By now, anyone who has been keeping track of the Trump trainwreck should have no question that Trump’s underlying priority is to undo everything President Obama and Democrats — often with help from centrist Republicans — have tried to do for citizens.

The fact that Trump puts his own avaricious goals and “promises” to his sycophantic, cultlike deplorables above the needs of the sick — heck, the fact that Trump is taking out his frustration on vulnerable people who are already struggling to make ends meet — is another sign that he considers the Constitution, whose preamble’s 26th through 29th words are “promote the general welfare”, no better than the toilet paper he hangs on his gilded dispenser.

It is time for him to be removed from office by the fastest legal means.

D.B. Hirsch
D.B. Hirsch is a political activist, news junkie, and retired ad copy writer and spin doctor. He lives in Brooklyn, New York.