There are many reasons that Republican efforts to repeal the Affordable Care Act, and to replace it with inferior plans that would have also gutted Medicaid, failed in Congress. One of the biggest reasons is that Republican leadership, especially in the Senate, tried to pass proposals that were hastily written, had no clear policy goals, and had no objective expert analysis. As a result, those proposals would have harmed millions of American people.
So, it is disheartening, but not surprising, that President Donald Trump is now trying to undermine the ACA through backdoor executive actions, which could have dire consequences for millions of Americans, rather than a bipartisan effort to fix what is really wrong with the health insurance law.
After the last attempt to repeal portions of the ACA, known as “skinny repeal,” failed last Friday morning, done in by “no” votes from Republican Sens. Susan Collins, Lisa Murkowski and John McCain, Trump said he’d let the insurance program fail, to make lawmakers more eager to reach a deal. “As I said from the beginning, let ObamaCare implode, then deal. Watch,” he posted on Twitter.
Trump has suggested that his administration will end payments to insurance companies that encourage them to take on lower-income subscribers by lowering their out-of-pocket costs such as co-pays and deductibles. Without the cost-sharing reduction payments, many insurers would likely increase premium costs and some would drop out of the ACA market.
The administration may also stop enforcing the individual mandate, a much maligned portion of the law, but one that is necessary to bring younger, healthier people into the market.
Congress must quickly step in to stop such disastrous moves. The Senate Health Care Committee announced Tuesday that it will begin holding hearings early next month on how best to stabilize the individual health insurance market. Congress must also appropriate the funds to continue the cost-sharing reduction payments, which are necessary to keep health insurance affordable for many lower-income Americans.
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