Trump’s Sabotage of Obamacare Is Illegal

A president doesn’t have the right to dispense with laws he dislikes.

From the moment he took office, President Trump has used all aspects of his executive power to sabotage the Affordable Care Act. He has issued executive orders, directed agencies to come up with new rules and used the public platform of the presidency in a blatant attempt to undermine the law. Indeed, he has repeatedly bragged about doing so, making statements like, “Essentially, we are getting rid of Obamacare.”

But Mr. Trump isn’t a king; he doesn’t have the power to dispense with laws he dislikes. He swore to preserve, protect and defend the Constitution of the United States. That includes the requirement, set forth in Article II, that the president “take care that the laws be faithfully executed.”

Faithfully executing the laws requires the president to act reasonably and in good faith. It does not countenance the deliberate sabotage of an act of Congress. Put bluntly: Mr. Trump’s assault on Obamacare is illegal.

Among Mr. Trump’s first acts in office was to issue an executive order instructing his agencies “to waive, defer, grant exemptions from, or delay the implementation of” any part of the Affordable Care Act that they could. That order has prompted a series of administrative actions aimed at undermining the law.

To make it harder for people to enroll in Obamacare plans, for example, the administration

  • shortened the open enrollment period on the health care exchanges from three months to six weeks;
  • cut 90 percent of the funding that the exchanges had used to advertise open enrollment; and
  • slashed the funding available to groups that help people navigate the complex enrollment process.

To sow chaos in the insurance markets, Mr. Trump toyed for nine months with the idea of eliminating a crucial funding stream for Obamacare known as cost-sharing payments. After he cut off those funds, he boasted that Obamacare was “being dismantled.”

When Congress declined to repeal the Affordable Care Act, as Mr. Trump had requested, he said that he was taking on that job himself: “So we’re going a little different route.”

.. announced that insurers will have more latitude to sell “short-term” health plans that are exempt from the Affordable Care Act’s rules

.. These plans were designed to provide people insurance for small gaps in coverage, like those created when switching jobs. They had previously been limited to three months.

..  these rules are creating a cheap form of “junk” coverage that does not have to meet the higher standards of Obamacare.
.. The Trump administration’s goal is not only to weaken the Affordable Care Act but also to trick the public into thinking, as opponents of the law like to say, that Obamacare is “collapsing under its own weight.”
Never in modern American history has a president so transparently aimed to destroy a piece of major legislation.
What makes Mr. Trump’s sabotage especially undemocratic is that Congress has repeatedly considered repealing the law — and repeatedly declined to do so.
In addition, the Supreme Court has twice sustained the Affordable Care Act in the face of major legal challenges. Mr. Trump’s attempt to destroy the law any way he can is an unconstitutional usurpation of power.
..  a lawsuit — the first of its kind — filed this month in federal court in Maryland. Brought by several plaintiffs including the cities of Chicago, Cincinnati and Columbus, the lawsuit recounts the “relentless and unlawful campaign to sabotage and, ultimately, to nullify” the Affordable Care Act.
.. questions about whether the courts have the authority or the institutional competence to prevent violations of Article II’s requirement that the president “take care that the laws be faithfully executed” — especially given the wide discretion that presidents traditionally have to implement the laws.

Failure to Communicate

Trump has a solid record, but he’s too busy making noise to tout it.

If a tree falls in a noisy circus, does it make a sound? If the Trump administration announces its largest deregulatory effort to date while the president is in the throes of a Twitter rampage, will anybody pay attention?

No, and thereon may hang the balance of Republican congressional control. It’s never clear where Donald Trump gets political advice, if he does at all. What is clear is that this White House is doing an able job of whiffing one of the best political messages in decades, a reality that is demoralizing administration insiders and GOP candidates alike.

.. The Environmental Protection Agency and Transportation Department released a plan—announced on the website of these pages—to ax the Obama administration’s car-emissions standards, saving consumers $500 billion. Dollarwise, it may be the biggest deregulation ever.

.. The Treasury has recommended rescinding the “payday lending” rule, which threatened to cut off the poorest Americans from viable credit.

.. The Internal Revenue Service lifted a political threat to nonprofits by allowing them to shield the names of their donors.

.. The Department of Health and Human Services finalized its rule allowing more non-ObamaCare insurance options to millions of Americans. The Senate sent a $717 billion defense authorization bill to the White House, increasing active-duty strength and providing troops their largest pay raise in nine years. The Senate also confirmed the 24th Trump circuit-court judge.

.. The Labor Department released new numbers showing worker compensation increased 2.8% year over year, the fastest pace in a decade

.. Republicans have long known they don’t get a fair hearing from the press, which is why they shifted to talk radio and other alternative media. Mr. Trump understands that better than most—thus his heavy use of Twitter, live rallies and press conferences.

.. The president is certainly focused on his base, though with an eye to whipping them up with rallies focused primarily on the polarizing issues of trade and immigration. His tweets revolve around the same issues—those and Mr. Mueller—and are often defensive or whiny.

.. If Mr. Trump makes those centrists believe this election is about family separation, Republicans lose. If he refocuses it on voters’ newly thriving prospects, Republicans have a shot.

.. One remarkable aspect of the Trump administration is its productivity. The cabinet set a pace of reform in its openings weeks that has never lagged. If Mr. Trump isn’t going to spend every day embracing, elevating and making this product of his own presidency the dominant discussion, then no one will. The press isn’t going to do it. Democrats sure aren’t. And no other Republican has that megaphone.

Obamacare Is Proving Hard to Kill

As health insurers across the country begin filing their proposed rates for 2019, one thing is clear: The market created by the Affordable Care Act shows no signs of imminent collapse in spite of the continuing threats by Republicans to destroy it.

In fact, while President Trump may insist that the law has been “essentially gutted,” the A.C.A. market appears to be more robust than ever, according to insurance executives and analysts.

.. regulators are not grappling with the prospect of so-called “bare” counties, where no carrier is willing to sell A.C.A. policies in a given area.

.. “The market is in a better position now than it has ever been since the exchanges have opened,” said Deep Banerjee, who follows insurers for S & P Global Ratings. The companies first began selling policies in the state exchanges, or marketplaces, five years ago. After years of losses, the insurers are now generally making money.

.. A midlevel policy in Baltimore could cost $622 a month, roughly a third higher than the average of the other states reporting to date.

.. A midlevel policy in Minneapolis is priced at $302 a month.

..  The Justice Department recently sided with the Republican states in arguing that the provisions protecting people with existing medical conditions are unconstitutional, which would upend the market entirely.

..  Insurers in Pennsylvania are seeking average increases of just under 5 percent

.. People whose income levels are low enough to qualify for federal tax credits are largely insulated from price hikes ..

.. the number of people buying A.C.A. plans at full price dropped by roughly 20 percent from 2016 to 2017

.. Premiums soared an average of about 30 percent in 2018 for those who did not qualify for a federal subsidy.

.. with 10.6 million customers buying plans in the state marketplaces for 2018.

.. the overwhelming majority — 9.2 million — qualify for some federal assistance.

.. Centene, the market’s largest player with 1.6 million customers, to Oscar Health, the venture-backed outfit that struggled in the early years, are expanding next year. More than a dozen carriers are entering new markets.

.. The company wants to nearly double the number of places where it sells policies, including entering three new states: Arizona, Florida and Michigan.

.. doing away with the so-called individual mandate that encourages healthier people to enroll. The administration has also been pushing the adoption of much cheaper and flimsier policies that compete with A.C.A. plans by issuing new rules on association plans.

.. Without the administration’s actions, he said, rate increases would have been in the single digits for 2019.

.. In New York state, about half of the 24 percent increase being sought by insurers is because of the removal of the mandate. Insurers think fewer healthy people will enroll

.. Underlying medical costs are forecast to go up around 6 percent next year, in line with recent increases

..  the percentage of people who are uninsured appears not to have grown since Mr. Trump took office: it’s been about 9 percent since 2015.

.. insurers are increasingly comfortable with the current state of the market.

.. Most insurers think the Republicans will not be successful in their legal efforts to undo the law, and they are holding off on making any dramatic moves.

.. “The big game changer would be the lawsuit in Texas,”

.. insurers are discovering their customers were loyal.

.. “Last time, they tried everything,” said Michael Neidorff, the chief executive for Centene, including eliminating the subsidies aimed at reducing people’s out-of-pocket costs if they were low income and slashing the outreach efforts. But Mr. Neidorff said the vast majority of people remained enrolled. “People want insurance,”

.. Those who can afford coverage are also remaining because they have little choice. “It’s a very price inelastic set of enrollees,”

.. says insurers have become less concerned about the price increases

 

Trump: Trying to Remake America in His Own Image

 his Justice Department quietly indicated last week that it would not defend major parts of the Affordable Care Act that pro-Trump forces, having failed to kill it in Congress, are now trying to kill through lower courts. And this includes the requirement that insurance companies guarantee access to coverage without bias against people with pre-existing medical conditions.

The implications? Senator Susan Collins, the Maine Republican who voted against repealing Obamacare, put it best: The decision not to defend key provisions of Obamacare — in a suit filed by Texas’ attorney general and 19 other states — “creates further uncertainty that could ultimately result in higher costs for millions of Americans and undermine essential protections for people with pre-existing conditions, such as asthma, cancer, heart disease, arthritis and diabetes.”

.. Trump just picked a fight with our closest NATO allies, including Canada’s Prime Minister Justin Trudeau — who Trump’s team said “stabbed us in the back” after Trudeau’s mild-mannered defense of his own country’s trade policy on dairy imports. This after Trump has had nary a word of censure for Russia’s President Vladimir Putin, who stabbed us in the chest with the biggest cyberattack on our democracy ever.

.. But in the case of climate change — where an overwhelming majority of scientists in Trump’s own government say human-induced climate change is 100 percent real and we need to join with the other major industrial powers in the Paris climate agreement to reduce carbon emissions to avoid the unmanageable aspects of climate change and manage the unavoidable ones — Trump chose to scrap Paris, throw away any insurance and move to revive coal... Sure, if climate change turns out to be a hoax, it won’t matter that we have a president who doesn’t believe in science. And sure, if we get consecutive years of exceptionally high growth, and no recession, maybe we’ll grow out of the massive increase in the national debt Trump took on with his corporate tax cuts.

Maybe China, Canada and our European allies will indeed bend to our will on trade and it really will be easy to win multiple trade wars at once. Maybe if another 9/11, or global recession like 2008, never materializes we won’t need allies and we really can cozy up to Putin. And, sure, if health care costs miraculously drop on their own, it won’t matter that Trump destroyed Obamacare without putting anything in its place, let alone something better and cheaper, as he vowed.