‘Sabotage” is the prevailing cry from liberals after a series of executive actions by President Trump on Obamacare. To the contrary, the steps he has taken are sensible and, in one case, obligatory. But they also point to the continuing need for legislative action to replace Obamacare.
The most controversial step Trump has taken is also the most defensible. Trump decided that the government would stop making “cost-sharing reduction” payments to health insurers. Obamacare was written to include these payments, but it did not actually put up the money — doubtless to keep the price tag low enough to get it passed.
Another executive action liberates “association health plans.” The importance of this step has been exaggerated, both as a boon and a menace, because the same term was used in the past to describe an older, more expansive idea. All it seems to be doing is instructing regulators to allow small employers to band together to offer their employees insurance. If they do they will receive the same freedom from state governments’ regulatory mandates that large employers do. It is a modest step that should boost coverage numbers, although it is possible that it will cause premiums on Obamacare’s exchanges to rise a bit.
A third action begins to loosen the rules on short-term health insurance and makes it possible for it to be renewable. Depending on how the market for this kind of insurance develops, new rules really could destabilize Obamacare’s exchanges by pulling young and healthy people out of them.
Even before these actions, liberals were crying that Trump was undermining Obamacare by limiting open-enrollment periods and cutting back on outreach to get people to sign up. Perhaps a law that requires its opponents to nurture it was not especially well-designed?