Republican Sabotage of Our Health Care System

Trump sabotage of Obamacare

EDITOR: Why does the self-styled “pro-life” party want so badly to raise the death rate through more guns and less healthcare? Some think it’s because white nationalists (aka white supremacists) fear that immigrants and minorities are getting more opportunities than they are. Others think it’s about wealthy elites maintaining political control in the face of sweeping demographic changes. Either way, it’s disgusting and tearing our nation apart. In the referenced article below, Congressional Democrats describe recent administration executive actions ACA Sabotage, to create a healthcare crisis, but Political Genocide may be a more fitting term.

If any of that makes you angry, watch the video at the end to learn why signing up for healthcare during the enrollment period os a good way to piss off Trump.


Since his first day in office, President Trump has created vast uncertainty in health insurance markets. Here are some examples:

His Administration has refused to commit to making cost-sharing reduction (CSR) payments and failed to commit to enforcing the individual mandate, putting the integrity of the risk pool and affordability of coverage in jeopardy. Trump’s obvious attempts to manufacture a crisis caused uncertainty in the marketplace and prompted insurers to sharply increase premiums for the upcoming plan year, or pull out altogether.

By another executive order in October, Trump will allow associations to offer group insurance plans with skimpy benefits and offer lower cost plans to members nationally across state lines. Trump’s order would allow association health plans to be exempted from core Obamacare requirements like coverage of essential health benefits. The ACA’s essential health benefits include hospital care, prescription drugs, maternity care, and mental health. The aim was to broaden the risk pool by preventing insurers from offering cheap plans tailored to young and healthy customers at the expense of older and sicker people. Experts worry this will damage ACA exchangers and result in overall higher costs.

Trump wants to make it easier for businesses to require employees to pay for their own insurance using reimbursements. He also wants to open more loopholes for people to buy insurance outside of ACA markets, attracting younger and healthier people away from current markets. Experts think this will destabilize Obamacare by leaving behind a smaller insurance pool of older and sicker people, resulting in fewer insurers and higher premiums.

Trump’s executive order finally terminates CSR subsidies paid to insurance companies to help people between 100% and 250% of the poverty level pay for the insurance and health care they get through ACA exchanges. Ironically, Trump’s constant threats to terminate CSR subsidies caused uncertainty in insurance markets that exacerbated two problems he blamed on Obamacare – namely, high premiums and the exit of insurers. This intentional sabotage will harm the 7.1 million people, or 58% of Obamacare enrollees, who qualified for subsidies this year.

Signing up for insurance under Obamacare will be a lot harder this year. Trump has shortened the annual open-enrollment period (Now Nov.1 to Dec.15) and announced plans to take offline for 12 hours at a time during peek enrollment times, “for maintenance.” He also cut ACA enrollment advertising by 90% and cut funding for Navigator groups who help people navigate the complex enrollment process and pick a plan under the ACA exchanges or Medicaid.

Trump and GOP attacks on Obamacare could come back to bite them politically, because although they have pleased their base, they also made health care more expensive and more unavailable for many Americans, many of whom are in the red states where Trump won.

It’s Not Just Me, or the mainstream press, Saying This

U.S. Congress seal
Analysis by the nonpartisan Congressional Budget Office has shown that every Republican House and Senate bill to replace Obamacare would (1) increase overall costs significantly and (2) cause tens of millions of people to get health insurance coverage. Sabotage can be even worse, and Congressional Democrats have weighed in on that issue.

Democratic members of the House Committee on Energy and Commerce and the Senate Committee on Health, Education, Labor, and Pensions recently released a report warning that Republican actions are causing uncertainty in health insurance markets that is resulting in higher premiums and insurers pulling out. A Manufactured Crisis: Trump Administration and Republican Sabotage of the Health Care System is summarized here with quotes from insurance companies and regulators across nearly 20 states.

EXECUTIVE SUMMARY (full text, but without the citations)

The best thing politically is to let Obamacare explode. (President Donald Trump in an interview with The Washington Post, 5/24/17)

The Trump Administration dedicated its first six months in office to sabotaging the health care system for partisan gain, threatening to reverse years of progress that have reduced the uninsured rate to historic lows. These destructive efforts by the Administration are causing uncertainty for insurers, which is resulting in significantly higher premiums for consumers.

Perhaps even more egregiously, President Trump and Congressional Republicans are using this manufactured crisis to justify their efforts to pass Trumpcare, which will cut taxes for the wealthiest Americans and special interests while cutting nearly $1 trillion in funding from Medicare and Medicaid. Trumpcare will result in tens of millions more uninsured and impose higher costs on working families, including older adults and individuals with pre-existing conditions. Republicans claim that “Obamacare is in a total death spiral,” as a justification for passing this tax cut bill masquerading as a health bill. But they cannot pretend they are acting to improve the health care system while they are actively working to undermine it.

This report provides an overview of the emerging evidence of the damage that the Trump Administration and Congressional Republicans have inflicted on the individual market. It provides a preliminary analysis of the impact of the Trump Administration’s actions and the impact of legislative uncertainty on premiums and stability in the marketplace, by analyzing the insurance rate filings to date. It will be updated as additional information becomes available.


Why the hell would we? (President Donald Trump, on making CSP payments, 5/19/17)

Since President Trump assumed office in January 2017, his Administration has repeatedly acted to sabotage the health care system. On his first day in office, President Trump signed an Executive Order that directed the Secretary of Health and Human Services and the heads of government agencies to defer, delay, or waive certain provisions of the Affordable Care Act (ACA), creating vast uncertainty in the marketplace. Since then, his Administration has refused to commit to making cost-sharing reduction (CSR) payments [to insurers] and failed to commit to enforcing the individual mandate. These cynical attempts to manufacture a crisis have caused uncertainty in the marketplace and have prompted insurers to sharply increase premiums for the upcoming plan year. …


  • “There now is clear evidence that this uncertainty is undermining the individual insurance market for 2018 and stands to negatively impact millions of people.” (the American Medical Association (AMA), America’s Health Insurance Plans (AHIP), Blue Cross Blue Shield Association (BCBSA), and others, 5/19/17)
  • “The vast majority of this has been caused by the current administration and by Congress, not by the ACA.” (Community Health Choice, Texas)
  • “The continued uncertainty caused by fluctuating directions from Washington could have a disastrous impact on the individual health insurance market in 2018.” (Colorado Insurance Commissioner)
  • “The most immediate drivers of instability are the weakening of the individual mandate, the uncertain status of funding for the cost sharing reductions and the absence of funding for overall market stabilization measures.” (Pennsylvania Insurance Commissioner and five insurance companies)
  • “If the federal government’s full CSR funding commitments are in jeopardy, we believe that the viability of the exchange market is in immediate jeopardy of failing.” (Molina Healthcare of Washington, Inc.)
  • “This uncertainty adds more unpredictability to the rate process and introduces an uneasy level of market volatility, compromising the ability to set adequate rates responsibly.” (Anthem Blue Cross and Blue Shield of Connecticut)
  • “With the unknown of cost-sharing-reductions funding … we have great uncertainty for what insurers will be participating in the market and where rates could land for 2018.” (Utah Department of Insurance)
  • “[CareFirst] tacked an extra 15 percent onto its premiums because it does not expect the Trump administration to enforce the individual mandate.” (Chet Burrell, Chief Executive of CareFirst)
  • “Without enforcement of the coverage mandate, membership is expected to drop, with the healthier individuals more likely to forego coverage. This will drive up the average cost of health care for the individual market.” (Harvard Pilgrim Health Care, Maine)
  • “Failure to enforce the penalty for not having health insurance could result in total premium increases of more than 28 percent, and up to 350,000 consumers who would otherwise get coverage likely going uninsured in 2018.” (Covered California)

CONCLUSION (full text)

Republicans are undertaking concerted efforts to sabotage the health care system by introducing instability into the individual insurance market. By choosing not to make CSR payments, providing unclear direction about enforcement of the individual mandate, and generally creating uncertainty about the future of our health care system, the Trump Administration is forcing insurers to raise premiums for the 2018 plan year. These actions are threatening to make health care inaccessible and unaffordable for millions of Americans.

In defending Republicans’ attempts to jam Trumpcare through Congress, Senate Majority Leader Mitch McConnell recently said, “Doing nothing is not an option.” Yet independent experts agree that the individual market would be stable if not for the Trump Administration’s sabotage.

President Trump and Congressional Republicans are manufacturing instability in the marketplace as a false pretense for passing a major tax cut for the wealthy and special interests. This cynical effort is being paid for with draconian cuts to the health care system, and on the backs of millions who need access to affordable coverage. Both President Trump and Congressional Republicans should be held responsible for these cynical and destructive actions.

WHAT’S THEIR MOTIVE? Harvard Medical School studies of mortality rates among people without health insurance have shown that up to 20% would die unnecessarily as a result. How can Trump and his GOP allies justify causing tens of millions of Americans to lose their health insurance from Obamacare repeal or sabotage? How can they justify allowing over one million to die as a result, all because of their own hatred of President Obama? I think the answer is both racial and political. See my article on Politics and the Modern Killing Fields.

Piss off Trump

Comments on “Republican Sabotage of Our Health Care System


    Imagining Obamacare in 2020 (Vox) — Insurance actuarial experts examine the likely effects of 3 years of Trump’s sabotage.
    Republicans are begging Trump Not to sabotage Obamacare (Vox)
    Trump told HHS to deny request to fix Iowa ObamaCare market: report (The Hill)
    Trump To Cut Off Billions In Key Obamacare Payments To Insurers (Huffington Post)
    Trump’s executive order to undermine Obamacare, explained (Vox)
    Trump Administration To End Obamacare Subsidies For The Poor (NPR)
    Trump administration is making it even harder to sign up for Obamacare (CNN)
    Here’s how the Trump administration is hurting enrollment in Obamacare (The Washington Post)
    Throwing a bomb into the insurance markets, Trump now owns the broken health-care system (Washington Post – This is not “letting” Obamacare fail; it’s causing it. And you break it, you own it.)
    Obamacare whiplash leaves states, insurers with dueling price plans (Reuters 10/20/2017)
    [Baby-Killer] Trump guts critical health care for poor children while nobody noticed (SALON) Trump is at it again…

    “Letting CHIP lapse is an act of violence not just against poor kids, but against all of America’s children. No matter how rarefied the air, deadly diseases are communicable. ‘It may create a pool of vulnerable children who won’t be vaccinated to prevent measles, whooping cough or meningitis outbreaks.'”

    Now Baby-Killer Trump has gone too far, taking his spiteful sabotage of our healthcare system to children and babies. (

    Bipartisan senators reach small deal on health care (CNN) I commented:

    Trump’s Sabotage, designed to kill Obamacare, is also killing people. Don’t lose your health insurance and become one of them. It is more important than ever to research your insurance options for the 2018 enrollment period, including Medicare Supplement plans. Insurers have already increased their premiums, thanks to market uncertainty caused by the current administration. And it’s unlikely they will have time to roll back these increases, even if this new bipartisan negotiation flies through Congress and gets signed into law.

    How Iowa Became An Obamacare Horror Story (POLITICO – I commented)

    No insurer wants sick, unhealthy and expensive clients, so the obvious solution is to share risks in one large pool — i.e. Single-Payer Universal Healthcare, like Medicare-for-All — but that’s just a debate over how to PAY for health care. We also need to reduce the need for it in the first place through wellness programs, and dramatically improve care delivery and efficiency. But Republicans been sabotaging the our healthcare system for years, recently defunded CHIP (low-income Child Health Insurance Program), and have now proposed big funding cuts to Medicare and Medicaid too. Wake up Iowans; you’re being screwed and need to ask tougher questions. Start with… Why does the self-styled “pro-life” party want so badly to raise the death rate through less healthcare and more guns?

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