Media's shrill coverage conceals some first-rate moves by Trump on Obamacare
To hear the press tell it, President Trump's executive order dismantling unbudgeted Obamacare subsidies for insurance companies is little more than the act of heartless, evil right-wingers pushing Grandma in her wheelchair straight off the cliff. The coverage is absolutely shrill:
Trump Administration To End Obamacare Subsidies For The Poor –NPR
Trump to Scrap Critical Health Care Subsidies, Hitting Obamacare Again –New York Times
Trump Will Reportedly Cut Vital Obamacare Subsidy, Potentially Throwing Marketplaces into Upheaval –Slate
Trump attacks Obamacare with executive order –NBC News/euronews
Opinion pages (one-sided, of course) and so-called analyses are even worse:
Throwing a bomb into the insurance markets, Trump now owns the broken health–care system –Washington Post
Trump's Obamacare Order Will Deepen Health Inequality –New York Times
Trump goes to war against his own country's health care system –MSNBC
It's hysterical, and not just because the tone and narrative is worthy of Ben Rhodes. This screeching "narrative" has actually worked pretty well up until now in the four attempts Congress made to end Obamacare, the costly, mandate-larded insurance law that has driven health care costs sky-high and thrown thousands of people out of the insurance market. With Congress proving itself useless in the face of this 'heartlessness' narrative, Trump has now taken matters into his own hands.
A look at President Trump's actual executive order Thursday tells an entirely different story from what the media is reporting, vindicating the arguments of Trump apologists such as Steve Bannon, that Trump's capacity to reach Americans directly without media mediators is key to his connection to the voters. Without the media's obscuring lens, Trump's actions really look pretty good – especially in this Obamacare instance.
To start, Trump's ending the subsidies is far from a heartless move. It turns out these subsidiies were illegally appropriated and not congressionally authorized, as is required by law. That makes them illegal slush fund payments to insurance companies to keep costly, larded-up Obamacare policies on the exchanges even though no one wants to buy them at what they are being offered for. If the cash payments to insurers are not legal and Congress refuses to authorize them, why should Trump keep issuing the $7 billion cash as a nonstop bailout? If Congress wants the subsidies, Congress can authorize the subsidies.
From Trump's spokeswoman:
"Based on guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare," White House press secretary Sarah Huckabee Sanders said in a statement late Thursday. "The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system."
One other thing: Those subsidies aren't going to the poor, as NPR claims. They are going to the middle and lower-middle class, which do not qualify for the full free ride the poor get through Medicaid. These are people who probably could afford health care insurance, provided it was offered at a genuinely affordable price and for services that actually serve their needs.
Under Obamacare, they get none of those things. Obamacare is larded up with costly mandates on things only a small minority of buyers will ever use, such as drug addiction treatment (which has a 90% fail rate) and pregnancy care. Not all buyers are going to want or need those services, ever, and don't want to pay for them. Yet under Obamacare, they must pay for them and they are sufficiently pricey to drive up the entire cost of health care policies disproportionately, and nobody can get out of them. Under Obamacare there's no such thing as tailoring an insurance policy to coverage consumers actually want. The mandates are entirely one-size-fits-all, with consumers having no input.
With the subsidies gone, President Trump is not leaving these and other health care consumers stuck in the individual Obamacare market high and dry. The rest of his executive order gives them an escape route so they don't have to buy these hated useless policies.
Consumers should soon be able buy insurance across state lines, which increases the pools of consumers who can buy into more responsive, relevant health care plans with lower costs.
They also should be able move into health plans together as associations so they can obtain the same deals employees at corporations get, the latter of whom aren't stuck with the costly mandates.
The White House executive order explains why it's doing this:
Large employers often are able to obtain better terms on health insurance for their employees than small employers because of their larger pools of insurable individuals across which they can spread risk and administrative costs. Expanding access to AHPs can help small businesses overcome this competitive disadvantage by allowing them to group together to self-insure or purchase large group health insurance. Expanding access to AHPs will also allow more small businesses to avoid many of the PPACA's costly requirements. Expanding access to AHPs would provide more affordable health insurance options to many Americans, including hourly wage earners, farmers, and the employees of small businesses and entrepreneurs that fuel economic growth.
Consumers stuck in the individual market also should be able to buy short-term health insurance plans to fill gaps instead of follow only the Obamacare one-size-fits-all-and-on-our-schedule policies. This, too will give them more options.
Better still, they will have expanded access to "health reimbursement policies" that corporate employees already get. These may include health savings accounts if I am reading this correctly, which have helped lower out-of-pocket costs on those high-deductible Obamacare plans and, up until now, have been highly taxed and discouraged by Obamacare's Democrat sponsors.
All of these moves will give consumers, including those who could get a price spike from the Obamacare insurance companies trying to make up their lost subsidies an escape hatch from the rigid awfulness of Obamacare. Up until now, there has been no way out. It all goes to show that the media coverage has been exceptionally dishonest in President Trump's moves to correct the legal mud of Obamacare and make the programs far more consumer-friendly and sustainable. That's leadership.
The media coverage of this has been utter rubbish.