Since Barack Obama signed Obamacare into law in 2010, more than 20 million Americans have received access to health care coverage. The law has improved health outcomes, reduced economic stress, and health care inflation has slowed. In short, the law, while not without problems, has largely been a success.
Yet, Republicans seemingly will not stop until they destroy Obamacare.
We’re all familiar with the eight-month effort in Congress to repeal the law, which thankfully crashed and burned last week.
But what Congress couldn’t accomplish, the Trump administration is still intent in doing on its own.
Over the past few weeks, the evidence has been mounting that the administration is engaged in a concerted effort to undermine Obamacare and in the process deny Americans health insurance coverage.
The Department of Health and Human Services has reduced the open enrollment period for people to sign up for coverage. It slashed the advertising budget to alert people that they need to sign up by 90 percent and has made the Healthcare.gov website unavailable for 12 hours nearly every Sunday during open enrollment. It reduced funding for outside groups tasked with signing up people and even forbid the department’s regional directors from meeting with these organizations.
Americans who don’t sign up for coverage could face a tax penalty for failing to do so, which of course has been one of the GOP’s loudest complaints about the law.
What is perhaps most remarkable about this sabotage of Obamacare is that HHS isn’t even trying to hide its efforts.
A statement sent to CNBC by a spokeswoman for HHS last week basically admitted it. “The American people know a bad deal when they see one and many won’t be convinced to sign up for ‘Washington-knows-best’ health coverage that they can’t afford. For the upcoming enrollment period, Americans are being hit with another round of double-digit premium hikes and nearly half of our nation’s counties are facing Obamacare monopolies.”
The irony of all this is that ncreased Obamacare enrollment would actually address the concerns raised by the department. It would help to lower premiums and encourage more insurers to offer coverage.
Even worse the Trump Administration’s actions are specifically making the premium increases worse.
According to a recent CBO report, premiums will likely rise in 2018 by “roughly 15 percent higher” than in 2017 and “largely because of short-term market uncertainty,” particularly over “whether federal funding for certain subsidies that are currently available will continue to be provided.”
This is a reference to federal subsidies provided to insurers who cover poorer customers and which the Trump administration has still refused to say whether it will continue. The CBO also highlights the general uncertainty about the law that is a direct result of Congress’s repeated attempts to kill it and HHS’s efforts to undermine it. HHS’s complaints about Obamacare are akin to a child who murders his parents and then asks for mercy because he is an orphan.
As if all this wasn’t bad enough, this week it was revealed that Trump personally intervened in trying to shut down an effort by officials in Iowa to get a federal waiver for revamping their health insurance marketplace. According to the state’s Insurance Commissioner, failing to receive the waiver sought by Iowa would mean that more than “20,000 middle class farmers, early retirees and self-employed Iowans will likely either go uninsured or leave Iowa,” and that those who do sign up could see a 57 percent increase in premiums.
This follows on the heels of another red state, Oklahoma, pulling its waiver request because the of failure to get HHS to provide it with a timely answer, a move that the state says “will prevent thousands of Oklahomans from realizing the benefits of significantly lower insurance premiums in 2018.”
When you put all this together what we have is an administration clearly committed to undermining and weakening a law that it is duty-bound to uphold. Far worse than that, by making it harder for Americans to get health care coverage, it could literally make the difference between life and death for those who are not enrolled.
I understand that Republicans don’t like Obamacare, albeit for reasons that have everything to do with their dislike of the former president rather than the law itself. But after eight years of trying to kill Obamacare, Republicans have failed. Americans have made clear that they want the law to remain on the books, warts and all. It’s time for Republicans to recognize reality. In the meantime, those Americans who do not have health care coverage should be encouraged to visit healthcare.gov or the Massachusetts health care exchange and do what the Trump administration doesn’t want them to do.Michael A. Cohen’s column appears regularly in the Globe. Follow him on Twitter @speechboy71.