But it’s what the bill doesn’t say that makes the above mostly meaningless.
Yes, insurance companies wouldn’t be allowed to refuse to offer coverage to someone who, for example, has a history of cancer or is pregnant. But they could sell someone a policy that doesn’t cover cancer treatments or the birth of a child.
Sure, premiums wouldn’t be allowed to vary based on health status or pre-existing conditions. But prices could dramatically vary based on age, gender, occupation and other factors, including hobbies, in ways that are functionally the same as basing them on medical histories. Insurance companies have a lot of experience figuring out that stuff.
There’s no need to speculate about how insurance companies would respond to this, because this is how the system worked for people who bought individual policies before the Affordable Care Act. Insurers don’t make money paying claims; they make money by avoiding claims or refusing the pay them. If they’re allowed to keep the most expensive people and treatments off their books, they will.Before the Affordable Care Act, it already was illegal for health insurance companies to reject customers with pre-existing conditions or charge them more based on their medical histories if they got coverage through a group plan, like from an employer. And insurers and employers are limited in how much they could refuse to pay for treatments related to a pre-existing condition for group policyholders. The Affordable Care Act extended similar protections to people who buy their health insurance directly or via the exchanges the law created.
.. With Obamacare repeal off the legislative agenda ― for now, at least ― why would these senators write legislation to solve a problem that doesn’t exist? Because their party is the middle of unsolving it.
.. The administration, however, doesn’t want to throw out the whole law ― just the parts that protect people with pre-existing conditions.
Who’s Afraid of Nancy Pelosi?
What has Pelosi achieved?
First, as House minority leader, she played a crucial role in turning back George W. Bush’s attempt to privatize Social Security.
.. Then she was the key figure, arguably even more crucial than President Barack Obama, in passing the Affordable Care Act, which produced a spectacular fall in the number of uninsured Americans and has proved surprisingly robust even in the face of Trumpian sabotage.
She helped enact financial reform, which has turned out to be more vulnerable to being undermined, but still helped stabilize the economy and protected many Americans from fraud.
Pelosi also helped pass the Obama stimulus plan, which economists overwhelmingly agree mitigated job losses from the financial crisis, as well as playing a role in laying the foundation for a green energy revolution.
.. whenever you hear Republicans claim that Pelosi is some kind of wild-eyed leftist, ask yourself, what’s so radical about protecting retirement income, expanding health care and reining in runaway bankers?
It’s probably also worth noting that Pelosi has been untouched by allegations of personal scandal, which is amazing given the right’s ability to manufacture such allegations out of thin air.
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.
Impeach Rosenstein? C’mon, Man
In its latest futile gesture, the House Freedom Caucus sets its sights on ousting the man overseeing Robert Mueller’s Russia investigation.
..their public relations assault is not actually about his refusing to turn over this or that document related to the Russia investigation. It’s not really even about the lawmakers’ loathing of the broader investigation, though certainly President Trump’s congressional lackeys — Mr. Meadows and Mr. Jordan most definitely included — are increasingly desperate to derail it... For Freedom Caucus leaders, this impeachment resolution is about something at once much broader and far pettier: the need to make a huge, disruptive, polarizing political stink just as members head home for the long hot August recess. Especially with a critical midterm election coming, it never hurts to have some extra well-marbled meat to throw the voters. And it is unlikely a coincidence that, less than 24 hours after filing, Mr. Jordan — who, lest anyone forget, is multiply accused of overlooking rampant sexual abuse while an assistant wrestling coach at Ohio State University — formally announced his candidacy for House speaker.Not to make Mr. Rosenstein feel any less special, but this is the fourth year in a row that Freedom Caucusers have pulled a summer-break stunt so nakedly self-serving that it would be comic if it weren’t so odious in its quest to erode public faith in government and in democratic institutions more broadly. Indeed, for all those wondering how the Republican Party reached the point where Donald Trump could swallow it whole with his furious everything-is-awful-and-everyone-is-out-to-get-you brand of demagogy, look no further than the nihilists in the Freedom Caucus... In 2015, Mr. Meadows became an overnight political celebrity when, on the day before break, he filed a motion aimed at overthrowing the House speaker, John Boehner. That effort eventually bore fruit... In 2016, Freedom Caucus members filed a pre-break motion to force a vote on the impeachment of the Internal Revenue Service commissioner, John Koskinen. (Impeachment is all the rage with these guys.)And last summer, they filed a discharge petition demanding a vote on a repeal of Obamacare... it has only nine co-sponsors, and Republican leaders, including Trey Gowdy, the chairman of the oversight committee, have expressed a distinct lack of enthusiasm for the effort... Mr. Meadows didn’t even attempt to file a “privileged motion,” as he and his colleagues did against Mr. Koskinen two years ago, which would have forced a vote before members decamped on Thursday... the issue won’t get taken up until lawmakers return from break in September, if then. (That’s the beauty of pre-recess antics: They cannot fail before members get to spend several weeks touting them back home.)There is vanishingly little chance that House leadership will let this toxic nonsense advance — Speaker Paul Ryan already has publicly smacked down the effort — and
zero chance that the motion could amass anywhere close to the two-thirds support required for the Senate to actually remove Mr. Rosenstein.
.. This stunt is in fact so ridiculous, so unfounded, so poisonous to the Republic that Attorney General Jeff Sessions felt compelled not only to publicly defend his deputy, but also to suggest that the lawmakers involved find a better use of their time.
.. Sally Yates, the former acting attorney general who was fired in January 2017 for refusing to defend President Trump’s travel ban, tweeted a warning about the long-term damage of “using the Department of Justice as a prop for political theater.”
.. It’s not that the Freedom Caucus members don’t recognize the damage they’re doing — or even that they don’t care. It is that delegitimizing government is at the heart of their movement.
.. Conflict and obstructionism have always been their purpose, fueled by their relentless message that
- government is always the problem, that
- all experts are idiots, that
- cultural and coastal elites hate Real Americans and that
- all of Washington is corrupt and broken beyond repair.
.. As has often been noted, Mr. Trump did not invent the apocalyptic message that he has used to dazzle the Republican base. He merely distilled it to its essence. But the base had been groomed for his arrival for years, in no small part by lawmakers like Mr. Meadows and Mr. Jordan, who have repeatedly proved eager to tear down democratic institutions in the service of their own political aims.
.. So while the Freedom Caucus’s pitiful effort to oust Mr. Rosenstein should not be taken seriously on practical grounds, it is a tragic reminder of the bleak path down which the Republican Party has been slouching in recent years. The rot was there long before Mr. Trump showed up to exploit it, and it is likely to remain long after he is gone.