Morning Briefing
Summaries of health policy coverage from major news organizations
Thoughts And Analysis: Trump On Health Care ... Some Say 'Vandalism' And 'Cruel Sabotage,' But What About His Supporters?
President Trump isn't afraid to use his bully pulpit, or become an outright bully, to let us know what's important to him. We don鈥檛 see moral leadership 鈥 quite the contrary. Instead he revels in mocking senators, NFL football players, public officials in disaster zones, morning TV hosts, and news outlets that bring him bad publicity. (Andy Slavitt, 10/16)
Since Obamacare became law, it鈥檚 been subject to one challenge after another. Some challenges have truly been existential, like the 2012 Supreme Court case and this year鈥檚 repeal effort in Congress. Others have had the potential to do damage without undermining the entire law. President Trump鈥檚 actions last week are in the second category. (David Leonhardt, 10/16)
By scrawling his name a couple of times on Thursday, President Donald Trump added $194 billion to the deficit projection. He increased health care premiums for 12 million working poor and middle-class families by 20 percent and made health insurance unaffordable for 1 million of them. He further undermined the health care marketplaces and legalized cheap, bare-bones insurance sold across state lines. With two executive orders, Trump made the private insurance side of the Affordable Care Act 鈥 the part designed for working people 鈥 more likely to collapse. Trump would have been smart to recall the Pottery Barn Rule that then-Secretary of State Colin Powell applied to the 2003 Iraq invasion: 鈥淵ou break it, you own it.鈥 (10/16)
Trump鈥檚 lack of understanding of America鈥檚 healthcare system appears to be almost infinite, so it鈥檚 hardly surprising that he doesn鈥檛 grasp the complexities of the cost-sharing reduction payments. But the misunderstandings extend to congressional Republicans, and even Democrats.The truth is that Trump鈥檚 action could lead to more Americans receiving subsidized health coverage. It could also produce a windfall for states including California. (Michael Hiltzik, 10/16)
During the 2016 presidential campaign, Donald Trump repeatedly vowed to 鈥渕ake America great again" if elected. Many voters were never clear on what exactly that meant. After a Republican-controlled Congress failed to repeal the Affordable Care Act this year, the frustrated president said he would work with Democrats to create 鈥済reat鈥 health care for Americans. When he took steps on Thursday to undermine Obamacare, he again pledged to deliver a 鈥済reat鈥 plan. (10/16)
Unable to persuade Congress to kill the Affordable Care Act, President Donald Trump appears determined to do the dirty work himself. The president's unilateral actions are aimed at driving up premiums, steering healthy people away from the federal marketplace and ensuring his inaccurate description of the law as a nightmare comes true. Reducing Americans' access to health care as a political maneuver is a cynical, callous act by a president who once promised better coverage that would be available and affordable to all. (10/16)
While the president鈥檚 decision appears to have been designed to disrupt the Affordable Care Act exchanges, states now have an opportunity to restore order to their insurance markets.Specifically, states can step in to make the subsidy payments themselves 鈥 and then turn around and sue the federal government for reimbursement. The law is on their side, and while it might take months or years, the states are highly likely to be repaid in full, plus interest. In the meantime, the backstop provided by the states will encourage insurers to stay on the exchanges rather than rushing to the exits. (Daniel Hemel, 10/16)
For the past seven months, Americans have watched and weighed in as Congress considered the continued existence of the Affordable Care Act (ACA). Last Thursday, the Trump administration announced that the government would stop subsidizing insurers for making premiums and deductibles more affordable for low-income customers. Most of the discussion to date has been about whether these plans are good for families, and if so, which ones. But what if insurance had another value, beyond protecting individuals from financial and health risks? What if it was good for democracy? (Emily Nacol, 10/16)
President Donald Trump's two-step gutting of the Affordable Care Act, ending cost-sharing for insurance companies, and allowing them to cover fewer medical conditions should be a political nightmare for Republicans. That鈥檚 because the White House has miscalculated, apparently falling for the fantasy that it can sabotage Obamacare and then successfully pin the political blame for lost coverage on President Barack Obama and the Democratic Party. Trump and some other Republicans have developed 鈥淥bamacare is imploding鈥 as a talking point, trying to persuade Americans that the Affordable Care Act is collapsing under its own weight. (Albert R. Hunt, 10/16)
The subsidies offered to low-income individuals to purchase insurance on the individual market and to insurance companies to support this benefit under the ACA, provide the necessary hand up needed to help pull individuals up our prosperity ladder continually. Without this hand, the ladder becomes splintered and broken, forcing those affected to take an inadequate path鈥攁fter all other options have been exhausted. ... Without the subsidies, Medicaid will remain the best and often only realistic option for many Americans. The recently eliminated ACA subsidies supported working Americans and their families to move up the income ladder with a helping hand. Cutting off the subsidies cuts off the hand. (Jim Rickards, 10/17)
[N]ow looms another quiet threat to these hospitals and our neediest citizens. The Medicaid disproportionate share hospital (DSH) program provides crucial support to hospitals that treat patients whose care is not fully covered by third-parties like Medicaid, and it is essential to keeping hospitals that treat low-income patients open and running. Congress failed to act to renew the DSH program before October 1 allowing massive cuts. Missouri will be hit particularly hard, facing a devastating $2.2 billion in cuts through 2025 after having already passed on nearly $2 billion per year in Medicaid funds for working low-income families. (Judy Baker, 10/16)