Everybody believes the Republican agenda is at best paused because of Donald Trump's Russia Scandal. Where Republicans are concerned, one should never make that assumption. The truth is Republicans know how to win. Remember how dead Trumpcare was? Then suddenly they revived it. Congresspersons were will to contort themselves like pretzels to find a reason to change their vote in the affirmative. And Republicans rebirthed Trumpcare.
Many Republicans and most Democrats in the Senate seem sure that Trumpcare is dead in the Senate. That surety is misplaced. Republicans will lose in 2018 if they appear to have done nothing, pass no legislation. They may lose if they pass the draconian Trumpcare bill. But not so fast.
Obamacare is in trouble in many places. Donald Trump and his administration continue to sabotage the law.
Since Jan. 20, the Trump administration has already acted to depress enrollment in Affordable Care Act plans, has instructed the IRS to back off enforcement of the requirement that most people have health insurance or pay a penalty and threatened to withhold billions of dollars owed to insurance companies. All of those actions make it more difficult for insurers to enroll the healthy people needed to offset the costs of the sick, who make it a priority to have coverage.
The president himself has made his strategy clear in interviews and tweets. "The Democrats will make a deal with me on healthcare as soon as ObamaCare folds — not long," Trump tweeted March 28. "Do not worry, we are in very good shape!" But the individual insurance market is not in such good shape.
It is doubtful Democrats will make a deal now. But 2018 will be a tipping point for Obamacare. The instability Trump and his administration caused are creating an excuse for insurance companies to leave the Obamacare Marketplace. Some people will be forced to shop for insurance on the individual markets which means they get no subsidies. Most will be priced out of health insurance altogether.
A growing number of insurers are asking for double-digit premium increases or deciding to leave the market altogether. In the latest announcement, Anthem said Tuesday that it was pulling out of the Ohio marketplace, where it serves more than 10,000 customers, next year. And while most analysts say the market probably would eventually rebound, in the short term things could get messy.
"Is the administration doing what it needs to do to stabilize the market? No, they're doing the opposite," says Kevin Counihan, CEO of the insurance exchange program during the Obama administration.
Trump's biggest weapon by far is refusing to reimburse insurance companies for billions of dollars in payments the law requires them to make to help policyholders with incomes up to 250 percent of the federal poverty level, about $30,015 for an individual and $61,500 for a family of four, afford their deductibles and other out-of-pocket payments. These "cost-sharing subsidies" are being challenged in an ongoing lawsuit filed by Republican House members against Health and Human Services in 2014, and Trump can effectively end them at any time by dropping the suit.
The individual market is here to stay in the long run. The short term chaos is designed to disrupt the market to reinstitute the very profitable predatory type health insurance policies with little to no protections. Under this scenario, healthy people will like find fairly competitively priced health insurance. People with preexisting conditions may find affordable insurance with exclusions of their preexisting conditions. Otherwise, they will be priced out of health insurance altogether. Older people can forget about insurance till Medicare kicks in.
Democrats have not done enough to prepare Americans for the spikes and disruption they will see in 2018 and beyond. And Republicans are very effective in false counternarratives. So it will be no surprise that the combination of Trump's Russia Scandal monopolizing most news media and Republican propensity to lie effectively will ultimately cast the blame on Obamacare and Democrats.
Chris Hayes said what a few Progressives have been saying for months now about the Russia story distracting from issues that are more immediately impactful to middle-class America.
I think there is a case to be made that Russia right now is helping the Senate pass a health care bill," Chris Hayes said. "I mean this totally, entirely, "Chris Hayes continued. "They would rather do this in secret with no public scrutiny, with no coverage. Which is what they are doing. And try to flip out a bill in forty-eight hours and vote on it. And that actually, you say they don't want to be talking about it. They would rather talk about this than the health care bill."
Obamacare is in crisis for 2018 because of uncertainty and Trump sabotage, and it is getting little coverage. Democrats and Progressives need to drive the correct narrative. Obamacare is not failing. The Trump administration is killing it. We need to see these stories multiple times a day. It will be the story of 2018.