This week, given the failure of Congress on multiple occasions to pass new healthcare legislation, President Trump resorted to signing two executive orders which effectively gut the Affordable Care Act. John Oliver addressed Trump's healthcare executive orders on Last Week Tonight and laid out what we can expect from the decisions, which, spoiler alert: have adverse consequences for both citizens and the government.
The first executive order intended, as Oliver put it, "to make it easier for people to buy cheaper, sh*ttier healthcare plans." In other words, it allows people who aren't sick and don't need comprehensive healthcare services to choose insurance plans at a very low premium which covers very little. Of course, the point of insurance is that no one knows when they're going to get sick or when an emergency will happen. If swarms of younger, healthier people opt for this low-cost, low-coverage option, it has the potential to wreak havoc later, when some of those people inevitably get sick or experience unexpected healthcare costs.
His second executive order is even more nonsensical. It cuts the government subsidies that go to insurers to help offset the cost of deductibles, premiums, and other out-of-pocket expenses for around 7 million Americans by $7 billion. Paradoxically, Trump managed to sign an executive order which the nonpartisan Congressional Budget Office estimates will 1.) increase premiums for those on Obamacare next year by 20 percent, while simultaneously 2.) costing the government by adding $200 billion to the national deficit over the next 10 years.
Yes, Trump's plan is going to make insurance more expensive and lose the federal government more money. It's a strategy that you can read about in his book The Art of Being Bad at Stuff (Including Book Titling, no end parenthesis.
The big consequence to cutting off subsidies to insurers? It will destabilize the insurance marketplace. Insurers have the right to pull out of the Affordable Care Act if there are changes to subsidy policy. If they do, that means fewer options in the healthcare marketplace for Americans to choose from, potentially boxing people into weak plans. Insurers can also sue the federal government to recoup their losses from the subsidy cut-off if they don't make them up in the marketplace. And, in fact, 18 states are already in the process of suing as of Friday.
"As far as the subsidies are concerned, I don’t want to make the insurance companies rich," Trump told reporters, according to Huffington Post. "They’re making a fortune by getting that kind of money." But this past April, he threatened to cut subsidies just to force Democrats into negotiating on behalf of repeal-and-replace, which makes it pretty clear that it was never really about curbing insurance company greed.
Oliver pointed out that Trump wasn't successful during that April bid, thanks to the Republicans who talked him out of it:
Even members of his own party note this is bad politics. When he's raised the prospect of cutting off these subsidies in the past, some have managed to talk him out of it. The problem is Republicans are playing checkers and Trump is playing Chex. That's right, Chex, the game of stress-eating Chex Mix because you do not understand your job.
The executive order halts payouts of government subsidies to insurers beginning next month, and it's already turned the stock market upside down. Disturbingly, although unsurprisingly, Trump tweeted Saturday morning bragging about sabotaging the stock market:
This also comes on the eve of the enrollment period for Obamacare opening again on Nov. 1. If the lawsuit doesn't force the administration into paying its subsidy for next month, low-middle income Americans who don't qualify for Medicaid are looking at significantly steeper premiums.
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