On Tuesday, October 10, 2017, President Donald Trump said that it is likely he will sign an order in the coming days that will allow people to cross state lines to obtain “great, competitive healthcare.”
The general expectation is that the order will also allow small businesses and individuals to associate with one another and buy health insurance that would be exempt from some of the requirements under the existing Obamacare rules. This would allow healthy people to buy low-cost insurance not now available.
Topher Spiro, a senior fellow on economic policy of the Center for American Progress, responded with a Trump-scale twitter storm of his own. The Center for American Progress is a center-left think tank, which has sometimes come under attack from those further left, and which sees Obamacare as a legacy worth defending from political assault. So the fact that Spiro is not an admirer of the latest initiative from the President on this subject is unsurprising. The particulars, though, are worth examination.
Left Wing View
Tuesday afternoon, Spiro tweeted that Trump’s proposal would offer “CRAPPY health care, SPIKE premiums for people with pre-existing conditions, and DESTABILIZE markets.” Then he offered nine consecutive tweets on how “we” (the Resistance, presumably) must go about limiting the damage that Trump can do.
His concern is that Trump will change the system by letting healthy individuals adopt cheaper plans, and this will amount to siphoning off the healthy individuals. Without them in the pool, the pool will come to consist simply of the greatest risk individuals, which will impose impossible costs on the insurers.
The first rule for those who want to limit this: spread the word about open enrollment. It opens on November 1 and (due to another recent Trump administration decision) it will close in mid-December, so that the original ‘window’ for open enrollment has been reduced by half. The Trump administration has also slashed the advertising budget – it isn’t at all interested in getting the word out about when the open enrollment window opens and closes this year. So the Resistance has to get that word out itself. This is both point 2 and point 9 on Spiro’s list. He charges that “the timing of this executive order is to deliberately sow confusion right before open enrollment.”
The press, Spiro said, must play an “outsized role” in resistance to Trump’s sabotage of Obamacare and, thus, his sabotage of people’s health. So must the plaintiffs’ bar. “LAWSUITS, LAWSUITS, LAWSUITS,” he tweets.
Spiro refers his followers to a recent study by the Kaiser Family Foundation that shows that Obamacare has not been “blowing up” by itself. The KFF study indicates that though the system has had its difficulties, its condition improved in 2016 and has been stabilizing into the middle of 2017 “as insurers regain profitability.”
So (one might reasonably conclude) if the system does fail in coming months, the cause will not be the system itself, but sabotage.
Right Wing View
Trump’s tease of a forthcoming executive order produced some celebration on the right, for example in RedState.com. Sarah Lee there wrote, “Cue the collective applause of millions of conservative voters across the country.”
Ultimately, as the transition from President Obama to President Trump has itself proven, anything that can be done by the executive order of one President can be undone by the executive order of the next. President Obama, for example, could give some legal cover to the children of the undocumented – but Trump can now withdraw that protection.
Likewise, whatever Trump does to the healthcare and insurance system can presumably be undone by the executive order of a successor, if the underlying statutory system survives long enough to allow that to happen.
Conservatives continue to believe that the repeal of that underlying system is imperative, and the repeated failure of repeal bills this year continues to stoke anger among “the base.” Another author at RedState has written recently that only the credulous would contribute money to establishment GOP candidates on the view that “Mitch McConnell give’s a rat’s ass about anything more substantial than keeping power.”
Likewise, rightward pundit Michelle Malkin has received plaudits from social media conservatives of late for a comment arguing that Trump was right the first time, that Obamacare is dying of its inherent difficulties, not of anything Trump needs to do.