Keep government out of my Obamacare!
5 reasons why Obamacare may live and thrive
In the Battle of Obamacare Gulch, House Republicans and their commander-in-chief, President Trump, bugled “Retreat!” loud and clear last month.
Trump immediately tweeted to his troops that the enemy would soon destroy itself anyway. “ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE,” he declared.
The important question then became whether the Trump administration would actively try to sabotage the Affordable Care Act through unilateral, executive actions. A caper like that poses big risks for Trump and the Republicans if consumers suffer; they might actually have to take responsibility for their words and actions, something they haven’t had to do since at least 2008.
The administration has now quietly made one key decision that will help stabilize the insurance marketplace and that insurance companies like. Though Trump, as president, has not so far shown he values consistency or transparency in government, this could be a sign that the Trump and his sappers will not try to blow up Obamacare to clear the battlefield for Trumpcare.
This raises the very realistic prospect that even this early in Trump’s term, Obamacare might be sneaking into safety and possibly, improvement. Here are five reasons that may happen.
First: In response to probing by Robert Pear of The New York Times, one of the top reporters on health care, the Department of Health and Human services announced it would continue to reimburse insurance companies for reductions in deductibles and other out-of –pocket costs they give to low income consumers, as the ACA requires. These are called “cost-sharing” subsidies and they are anathema to many conservatives who see them as corporate welfare and social welfare — the worst of both worlds. In fact, House Republicans filed a lawsuit arguing the “cost-sharing” payments were illegal because they were expenditures not approved by the proper congressional appropriations process.
But insurance companies needed to know immediately if Trump and HHS Secretary Price were going to pull the plug on the “cost-sharing” payments. If they did, some companies were likely to pull out of some markets. That possibly could have started the kind of implosion Trump seems to wish for. Now the insurance companies don’t have to worry.
In fact, influential House Republicans actually are pushing colleagues to pass a legislative fix that would create a legit appropriations for the “cost-sharing” payments, rendering the lawsuit moot.
The bottom line is, Trump had an opportunity to send a Tomahawk missile into the financial gullet of the current health insurance system and he blinked.
Second: The idea that Obamacare is in a death spiral and about to implode or explode (Trump’s says both) has been countered by a new, authoritative source outside the government, Standard & Poor’s. The report examined insurance companies offering individual coverage — Obamacare insurance — in more than 30 states. Insurers reduced losses significantly last year, according to the S&P report, and most will break even this year and many could earn modest profits 2018.
The insurance “market is not in a ‘death spiral,’” the report said. This affirmed the conclusions reached by the Congress Budget Office in March during the Trumpcare debate. If the Trump administration wants a death spiral, it might have to lob grenades behind enemy lines.
Third: The threat of repeal by legislation wanes by the week. The battle of Trumpcare revealed ugly GOP truths for the world to see — and the world saw. By far the most important: There is nothing close to a Republican consensus about how to replace or even reform Obamacare. Trump seems to have no fixed views. Conservative purists want government out of health care pure and simple; a sizeable chunk of the caucus is not willing to essentially kick consumers (and voters) off the insurance rolls. Even if there were a unified philosophy, the Republicans seem baffled and rusty when it comes to turning a bill into a law.
Fourth: A genuine grassroots opposition movement has formed intent on saving Obamacare and harpooning Trumpcare. Many members are besieged in their D.C. offices and when they go back to their districts. Republicans in the middle-flank are especially vulnerable to that kind of pressure. Skeptics suspect this insurgent energy will sputter out soon, but activists are sure it won’t. The costs of gutting Obamacare weigh more heavily as Republicans calculate their re-election formulas.
Fifth: Public opinion has shifted substantially as “repeal and replace” went from campaign slogan to potentially losing health insurance. In the four years before the 2016 election, Americans consistently disapproved of Obamacare in polling. That flipped after the inauguration. Polls in February and March showed Americans approved of Obamacare, were wary of change and did not like what they were hearing about Trumpcare.
Beware of sharing this intelligence with opposition operatives who tried to interfere with the American health insurance system. But it is now possible, though not yet probable, that Obamacare will not only survive, but improve and flourish over the next few years.
If that comes to pass, voters in 2020 will be chanting, “Keep the government away from my Obamacare.”