Mellman: Imploding ObamaCare

Mellman: Imploding ObamaCare
© Getty Images

Sadly, we have become largely inured to misleading, dissembling and dishonest statements from President Trump. Fact-checkers catalogue them by the hundreds.

Yet one lie that I consider particularly egregious has received relatively little attention.


The president has repeatedly referred to his plan “to let ObamaCare implode.”

This locution casts the president as a mere observer, watching from the distant sidelines as the Affordable Care Act (ACA) inevitably destroys itself.

Nothing could be further from the truth.

In fact, the president is not just looking on as events ineluctably unfold; rather, he is causing the very failures he decries. He is not just an observer, he is the causal agent.

Health insurers labeled the president’s threats to end cost-sharing reduction payments “the single most destabilizing factor in the individual market, and millions of Americans could soon feel the impact of fewer choices, higher costs and reduced access to care.”

Under the ACA, the federal government subsidizes insurers so they can offer affordable coverage to low-income Americans.

Absent those payments, insurers would be losing money by participating in the exchanges. They would face only two choices — stop offering coverage in the individual market or raise premiums 20 percent to 25 percent.

Businesses have to plan ahead, and their final rates for next year are due in just a few weeks. The uncertainty caused by Trump’s threats has already wrecked havoc.

One of the nation’s largest insurance companies announced it would cease participating in Ohio’s exchange and put the blame squarely on Trump, citing uncertainty around cost-sharing reduction payments as a key reason for exiting the market.

Some may see these payments as just another federal spending program. But every expert, from the Congressional Budget Office to the Kaiser Family Foundation, has demonstrated that ending these payments will not save the government money, but rather increase costs to the government by some 23 percent.

The only reason to end cost-sharing reductions, or to even threaten it, is to destroy the architecture of our current healthcare system. And that’s just what Trump is attempting to do.

And it’s not the only way he is working to undermine the ACA.

ObamaCare, and the protections it affords to those with pre-existing conditions, only works if sick people aren’t the only ones buying insurance. If you could wait until you were ill to buy insurance, many would. And if insurers had to cover that pre-existing condition, they would go bankrupt.

So everything the Trump administration does to limit enrollment in health insurance plans undermines the ACA.

And it’s done about everything they can think of.

The administration cut the enrollment period in half, ended advertising and outreach designed to bring in new enrollees, weakened enforcement of the requirement for the currently healthy to buy insurance and even used ACA funds to produce videos, chock full of misinformation, designed to discredit ObamaCare.

The administration also proposed making premium tax credits less generous, which means many will end up with more expensive plans or higher deductibles and co-pays.

While voters aren’t aware of the details, they are wise enough to understand that the president is more than willing to sacrifice their well-being in a cynical attempt to force the ACA to implode.

A June poll by the Kaiser Family Foundation found 59 percent of Americans saying Trump and the Republicans in Congress are responsible for problems with the ACA going forward. Only 30 percent put the onus for future problems on former President Obama and the Democrats for passing the law in the first place.

The GOP’s healthcare strategy has already backfired badly, giving Democrats their biggest advantage on healthcare since before Obama was elected.

Trump can’t hide behind deceitful statements. If he and the GOP cause ObamaCare to implode, they will pay an even more serious political price.

Mellman is president of The Mellman Group and has helped elect 30 U.S. senators, 12 governors and dozens of House members. Mellman served as pollster to Senate Democratic leaders for over 20 years and as president of the American Association of Political Consultants.

The views expressed by this author are their own and are not the views of The Hill.