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Anthem Insurance, based here in my home city of Indianapolis, has withdrawn from participation in several of the exchanges due to the lack of CSR certainty.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


  1. News this AM:

    A BLINK OF BIPARTISANSHIP — THE LATEST ON HEALTH CARE — “Centrist lawmakers plot bipartisan health care stabilization bill,” by Heather Caygle and Paul Demko: “A coalition of roughly 40 House Republicans and Democrats plan to unveil a slate of Obamacare fixes Monday they hope will gain traction after the Senate’s effort to repeal the law imploded. The Problem Solvers caucus, led by Tom Reed (R-N.Y.) and Josh Gottheimer (D-N.J.), is fronting the effort to stabilize the ACA markets, according to multiple sources. But other centrist members, including Rep. Kurt Schrader (D-Ore.), and several other lawmakers from the New Democrat Coalition and the GOP’s moderate Tuesday Group are also involved.
    “Their plan focuses on immediately stabilizing the insurance market and then pushing for Obamacare changes that have received bipartisan backing in the past. The most significant proposal is funding for Obamacare’s cost-sharing subsidies. Insurers rely on these payments – estimated to be $7 billion this year – to reduce out-of-pocket costs for their poorest Obamacare customers.” http://politi.co/2vdbyY7

  2. Trump proves once again that he’s not about governing, but only about “winning”. He would be a strong B. F. Skinner experimental subject.

  3. Why is the ACA being blamed for all problems within the health care coverage system across this country? Why has there not been specific reference made to problems and soaring costs in the Republican state health care systems (Indiana denies direct access to ACA unless and until applicants have been refused coverage by all companies in this state health care system). Soaring costs on anything connected to health care have been ongoing since long before the inception of the ACA and/or individual state health care systems and Big Pharma control of prices?

    Lack of regulations is the bugaboo in all big businesses; this is due to politicizing all businesses which were controlled by greed and that greed is now sanctioned by Citizens United. The Glass-Steagall Act was put in place to protect American citizens from ripoffs by the banking system after the stock market collapse. It was, piece-by-piece, eaten away with the party changeovers in Washington until the final dying breath was repealed by Bill Clinton. George W. took the ball and ran with it from there. President Obama’s biggest mistake during his entire administration was NOT to let the low tax rate on the wealthy end on the date George W. set; this is at the core of the health care system and Big Pharma costs. We must find a Constitutional and legal way to end, once and for all time, the constant Republican votes to repeal the ACA (has it reached a count of 70+ yet?); make the necessary changes and rename it – or require deletion of the misnomer of Obamacare. It is officially in government records as the Affordable Care Act. But; that name has become a misnomer due to the the soaring costs which are due to the lack of regulations and tax controls. It is fast becoming a game of Musical Toilet Seats as our health care coverage is circling the bowl with too many of our other rights.

  4. His Tweet was adorned with love from tens of thousands followers/voters. From what I’ve witnessed on other social media channels, right wing voters want the ACA killed.

    It was a signature piece of legislation created by a man of color. It’s 2017 and the new GOP primarily manipulated by Koch brothers’ vast network, including media which supports hate and conspiracies.

    If you voted on a piece of legislation supported by a black president, it’s grounds enough to run another GOP right-winger against them. This is the NEW GOP.

    The legislation may have helped you individually, but a black president is all you need to know to hate it.

    As despicable as Trump’s threats seem to be, remember he is catering to voters. What are his competitors on the left doing to appeal to voters?

    Moving to the right as well. Well, they’ve been doing this over 30+ years under Neoliberalism. In fact, the Establishment Democrats in 2017 are really moderate Republicans.

    I have to laugh when 75% of Democratic voters support single-payer insurance, yet #ABetterDeal recently proposed by the DNC Brat Pack failed to list Medicare expansion.

    Recent polls show 58% of Americans support Medicare expansion, yet the “Party of the People” is not allowed to offer it up as a viable option to voters. We have two corporate owned parties working for Oligarchs. Neither work for the people.

    When will academia join the chorus of supporting the people and hold the Democratic Party accountable for being a fraud?

    Or, was Albert Einstein correct in the 40’s when he said all American Institutions are controlled by Oligarchs. 🙂

  5. Most of what is being discussed appears to have little to do with health care at all. Debates focus on the redistribution of money, taking money that has heretofore been earmarked for health care and giving it, through tax relief, to the wealthy. We might very well do better to refer to the Tax Relief Bill rather than the Health Care Bill. For some people this reverse Robin Hood approach might be their way to allow the economic trickle down theory to work; for many, however, it’s simply a way of shifting money from who they consider the undeserving to the deserving.
    And for others, I am afraid, it is a cynical get-rich- quick scheme . Healy Care is. hardly an issue.

  6. This president’s thought process, if you can even call it that, is totally self-absorbed and focused on revenge, getting even and getting his way all the time. His verbal tantrums remind me of a two-year-old who attempts to get his way all the time by screaming two words; – NO and MINE. when a two-year-old has a tantrum in public, responsible parents remove him from public places so he does not annoy or bother other people. Apparently, our Congress has yet (and my never) become responsible.

  7. Let us not forget Seema Verma’s conflicts of interest that gained her many millions of dollars while Daniels and Pence saw no problem at all with her working for both IN government and the company they contracted with for health care data management.

  8. I would like to note that Anthem doesn’t need a 22% increase to stay in the black. It needs a 22% increase to continue to make billions of dollars more each year. It is considered a sin to make less profit this year than last. Kind of makes me long for the good old days when BC/BS was a mutual.

  9. It would appear that Mr. Trump is learning how to govern from the Russian mafia. They must be thrilled with their protege’s performance thus far.

  10. Trump and some Republicans are engaged in a scorched earth campaign. The Trumpet forces are in retreat but are determined to destroy ACA in the process.

    When Napoleon invaded Russia in 1812, the Russians retreated but in the process destroyed anything of value the French Army could use. Per Wiki > As the Russian army fell back, Cossacks were given the task of burning villages, towns and crops. This was intended to deny the invaders the option of living off the land. These scorched-earth tactics greatly surprised and disturbed the French, as the willingness of the Russians to destroy their own territory and harm their own people was difficult for the French to comprehend.<<

    The problem with ACA is is laid out very well in this article: Health care rationing: 28 million Americans without insurance, and millions more insured, but avoiding treatment because of sky-high deductibles and co-pays. Compared to ten other wealthy countries, the U.S. ranks dead last for life expectancy, and access to care. We even have the lowest number of hospital beds per capita, a way that health experts measure the capacity of a nation’s health system. It’s as if our system was designed to deny care. https://www.commondreams.org/views/2017/07/28/its-time-adults-nation-talk-seriously-about-medicare-all

    ACA cannot exist without subsidies to the Insurance Companies. ACA is nothing less than Privatized Health Care. This Privatized Health Care socializes the costs, and privatizes the profits. The solution is Enhanced Medicare for All (HR 676 sponsored by John Conyers with 116 Co-Sponsors).

    The Democrats need to stand with John Conyers and HR 676 and stop fooling around with trying to "repair" ACA. I was inspired as as young man when JFK made his commitment to put a man on the moon and return him safely within 10 years. The Democrats need to have that JFK spirit on Health Care.

  11. I think that the first thing that Democrats have to do is to repeal and replace Congressional Republicans.

  12. Let’s end all this foolishness with single payer, like most civilized countries have done. There is proof positive from their experience with this system that it is cheaper, better and whose structure (like social security) is largely beyond the reach of politicians. What’s not to like unless, of course, you are a politician who needs fodder for discussion based on your definition of worthiness rather than who is sick and in need? It’s as though we refuse to give up our horse and buggy transportation system in a world of motor cars and trucks, as is demonstrated by our poor standing in mortality statistics. When are we, for the sake of profit, going to give up killing and/or shortening the lives of Americans? When?

  13. There are a few obstacles to single payer.

    The fact of our out of cost control health care delivery non-system.

    A Republican majority Congress.

    A Cabinet totally without qualifications for their jobs.

    An oligarchical President.

  14. Let’s have a revolution, a military coup in the manner of the Third World, and let’s send the oligarchs to the guillotine.
    Our citizens are well armed thanks to the NRA, no need for pitchforks and clubs.
    Where is Madame Defarge when we need her?
    Someone will Tweet “we are not hungry enough; too much cake.”

  15. Pete makes a good point. Single payer is about as likely to pass this right wing Congress as a born again Hitler is to be elected mayor of Tel Aviv. We have to reverse each and every one of Pete’s observations – and as soon as possible so as to lay the groundwork for single payer (and a few other things I have in mind, such as wage inequality, my chief beef).

  16. A question: When is anyone going to get a brain and realize the insurance industry makes BILLIONS each year and in about 2008 I remember a study explaining the expenditures of the industry across the board – they took in 11.8 billion dollars and paid out approximately 2% to awards and premium cash ins. I am not so naive as to believe that this is just greed, I realize the US government uses such as a resource to reinforce the Fed, the banking industry the same… where do you think they get all the funding for those wonderful cruise missiles…? it isn’t just ‘tax’ dollars. The whole thing is rather incestuous. But the game has to be stopped. I don’t care if people criticize my thoughts but to tell you the truth – there is a better way and it involves expanding and working our a proper formula for Social Security. And that is just fact. the People PAY for the Social Security fund – not the government – and it is damn time they stopped robbing IT to fund their little sideline BS wars and assassinations… (and YES they are still using the Jackals! And CIA hit men!) No, it isn’t a matter of the programs failing – it is a matter of getting the programs ordered properly and cutting a lot of unnecessary waste in bureaucracy. Look Healthcare and the problem it is in – is NOT going away you can sweep it under the rug, you can not listen to the people (for only so long I might add!) but it is not going to go away. So let’s deal with the mess we have an call a spade a spade – the finger should be pointed squarely at the administration – the banks, the military and the insurance industry! We know how to fix it – we just have to keep the meddling capitalist hands from mucking up the pond!!! IMHO.

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