On July 18, as Republican efforts to repeal the Affordable Care Act failed in the Senate, President Trump declared at the White House that the new plan was to “let Obamacare fail.”
But it isn’t likely to fail on its own. As the Henry J Kaiser Family Foundation noted in a report released July 10, the individual insurance market has continued to improve for insurance companies and appears to be stabilizing. In 2018 every American will have access to health insurance through employment, Medicare, Medicaid, the VA, their family’s policy, some other group plan, or the individual market. A large majority of people buying their own policies will have a choice of them from multiple insurance companies. (It’s true that there are a fair number of counties with only one insurer, but for the most part they are rural counties with sparse populations. The great majority of Americans live in a county that has multiple insurers.)
It’s true that premiums are continuing to rise, but except for those at the highest income levels, people buying individual policies are sheltered from those increases because of the way Affordable Care Act subsidies are computed. High deductibles are a concern, but there are efforts — in fact, finally bipartisan efforts among some members of Congress — to address such problems, and it wouldn’t be too terribly difficult to fix them (as noted in this earlier post). For more on how things stand, see this August 4 Kaiser Family Foundation overview of the status of the 2018 health insurance market. Basically, while it isn’t perfect, Obamacare is for the most part working and gradually getting better.
Or that was the case until the Trump administration started doing things to destabilize it. As I mentioned in a post August 14, a blogger named Charles Gaba looked at proposed premium increases in 20 states that more than 2/3 of the additional costs were attributed to politics, not the healthcare market itself.
One item of good news is that the administration does seem to have backed away, at least for now, from its threats to stop cost-sharing reduction (CSR) payments, probably because a lot of Republicans, even including Freedom Caucus head Mark Meadows (R-North Carolina), had opposed Trump on this. Governors of both parties don’t want Obamacare to go away.
But the administration has announced a greatly reduced time frame for signing up for 2018 health coverage, and rather than taking steps to alert people to the fact, it has slashed the budget for paid ads to inform the public about their healthcare options by 90 percent and has likewise cut in half spending for “navigators,” trained advisors who help people sign up for policies that meet their needs and budgets.
In late July The New York Times published this overview of how the administration is already undermining the Affordable Care Act and other steps it might take later.
A poll conducted in early August by the Kaiser Family Foundation (I reference them a lot because they’re pretty credible) found that by 78 to 17 percent, those surveyed wanted the administration to do what they can to make the Affordable Care Act work rather than try to make it fail. Among self-identified Trump supporters, 51 to 39 want them to try to make it work. (I do find it a little troubling that 39 percent advocate trying to make Obamacare fail, but perhaps they don’t grasp the potential harm to people needing medical care.)