This war, often operating below the radar, entails the use of a quintessentially conservative strategy, and the cooperation of Congressional Republicans. In a way, it’s pretty simple: You cut the budget, impose debilitating regulations, track the subsequent missteps and then attack the program as a failure.
.. “Democratic legislation,” the conservative strategist Bill Kristol arguedafter President Bill Clinton proposed his health care plan in 1993, poses “a serious political threat to the Republican Party.”
If enacted, Kristol continued,
it will relegitimize middle-class dependence for “security” on government spending and regulation. It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government.
.. Over its first six months in office, the Trump administration has used its power to
- dismantle the A.C.A. limb by limb — to
- halve the enrollment period, to
- reduce the value of many of the A.C.A. insurance plans and, somewhat spectacularly, to
- use Obamacare funds to finance a public relations drive against it.
.. Most recently, with little fanfare, the Trump administration terminated contracts for health care “in person assisters” in 18 cities, including Chicago, Dallas, Cleveland, Miami and Philadelphia. These “assisters” are personnel trained to guide Obamacare applicants through the multipart A.C.A. enrollment process.
.. In April, the Trump administration issued a “Rule to Increase Patients’ Health Insurance Choices for 2018” that effectively reduces the value of an Obamacare linchpin, the premium tax credit.
.. this “rule allows insurers in the individual market to offer plans with higher deductibles and out of pocket costs in 2018 than have been permitted previously.” Because of this, “the rule is likely to reduce the premium tax credit for many people.”
.. Trump has warned that he may drop the appeal and end the subsidies — both of which he can do unilaterally — to deliver what Politico called“an immediate and fatal blow to the Obamacare marketplaces.”
.. By taking this ambiguous position, Trump has heightened uncertainty about the future of Obamacare, and that uncertainty has itself become a major factor in weakening the program.
.. The department has produced 12 videos intensely hostile to Obamacare. All are available to the public on YouTube.