Does Anyone Understand This Health Care Fight?
Last week, during our semi-regular weekly survey of what’s goin’ down in the several states, we noted that Idaho seems to have determined that the way to kill the Affordable Care Act is simply to ignore the law. It appears that this is the administration*’s general plan, too, although they’re a bit more creative about it. From Vox:
The US Department of Health and Human Services’ new proposed regulations would allow Americans to buy short-term insurance for up to 364 days. That coverage is allowed to skirt several of the health care law’s core provisions: Plans can deny people insurance based on their medical history, charge them higher premiums because of their preexisting medical conditions, and craft skimpy benefits packages that will appeal mostly to young and healthy people. By broadening the definition of short-term insurance, the Trump administration is opening more loopholes for more people to buy insurance outside the health care law’s marketplaces. In the eyes of the administration, this is fulfilling a campaign promise that President Trump made to give people relief from Obamacare. “It’s one step in providing Americans with health insurance that is both more affordable and more suited to individual and family circumstances,” HHS Secretary Alex Azar told reporters on Tuesday... “This appears to be a backdoor way of undermining the Affordable Care Act,” Kevin Lucia, who studies the markets at Georgetown University, told me last fall when Trump issued his executive order to expand short-term insurance and association health plans, which set the stage for the new regulations.
The relentless assault on people’s health care is another thing about modern conservative Republicanism that is going to astonish our robot overlords in the 31st Century. The most successful attempt this country ever made at catching up with the rest of the industrialized world and the primary policy goal of conservative Republicanism is to gut it and return us all to the status quo ante. It’s an amazing phenomenon.
So, what is this brand-new DungWhopper that the administration* has dreamed up? It’s one step up from street ‘surance, and not a very big step at that.
That kind of coverage is totally free from the health care law’s insurance regulations: the mandate to cover essential health benefits, the prohibition on charging sick people more than healthy people or denying people coverage based on their medical history, and so on...
People who make too much money to qualify for subsidies could be stuck between paying the full price for the more expensive ACA coverage or buying a short-term plan. This might be fine if they are young and healthy but might not cover the services they need if they are older or have some medical issues... The ACA has proven remarkably resilient in the face of the Trump administration’s efforts to undermine it. Every county had at least one insurer selling Obamacare coverage last year, even as Trump sowed uncertainty and cut off key payments to insurers. Enrollment in marketplace plans held nearly steady at 12 million people, even as HHS dramatically cut its spending on advertising and outreach. But these new regulations are a reminder that the Trump administration still has more tools at its disposal to undercut the ACA - risking death by a thousand cuts, as some of the law’s supporters have warned.
This is a lot of intellectual energy being used to break this particular rock, and the effort is across the whole party at almost every level of government. This is a commitment not to improve health care for Americans, but to make the lives of the poor and sick miserable because (I believe) too many conservatives have a theological objection to allowing the government to help them. Injecting more uncertainty into their lives - just as is the case with the DACA beneficiaries - is simply strategizing the political utility of fear. That’s all they have left, in so many ways.
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