The Atlantic had a good article explaining the six signs that show how Trump will sabotage the Affordable Care Act.
- Withdraw the appeal of the lawsuit that allows cost sharing reduction subsidies to insurers. The ACA subsidies at the center of the suit—otherwise known as cost-sharing reductions, which are different than the ACA tax credits for premiums—limit out-of-pocket costs for the 6 million people who both bought insurance through the ACA exchanges and who earn up to 250 percent of the federal poverty level. If insurers do not receive these funds, they may leave the exchanges altogether—ending coverage for customers.
- Refuse to enforce the individual mandate which is a Conservative idea to insure personal responsibility and accountability is designed to ensure healthier and therefore more stable insurance pools. The second major test to determine whether the President is choosing sabotage over governing will be if he directs his administration not to enforce the current individual-mandate provisions within the ACA.
- Refusing to advertise enrollment and shortening the time to enroll. If the Trump administration reduces, it will be a clear indication that it is choosing sabotage over governing.
- Limiting risk corridors—a piece of the ACA designed to help health plans adjusting to new, unpredictable marketplaces. Additional funding is critical to ensuring stability in these relatively new marketplaces. The program also lowers premiums for even non-subsidized enrollees who have been exposed to the highest premium hikes. Whether the Trump administration supports or opposes efforts to stabilize insurance markets, then, offers another crucial test.
- Whether Trump uses tweets, cell-phone calls, or White House meetings, investing time and political capital in to spur major health-care players to constructively participate in the ACA or conversely, to fear that if they do they will be on Trump’s black list, will be his fifth test.
- Will he issue regulations that weaken insurance? The hardest thing may be to detect an administration that avoids the most blatant acts of sabotage, but looks to kill the ACA with a thousand cuts. If the overwhelming number of health experts and consumer groups like the National Association of Insurance Commissioners, Kaiser Family Foundation, the American Cancer Society, AARP, and the Georgetown University Center on Health Insurance Reforms conclude it is an attack on the stability of the ACA—it should raise red flag that it is indeed a concerted effort to weaken the ACA.
Health-care experts agree with the Congressional Budget Office and S&P that the ACA is mostly stable—and as The New York Time’s Margot Sanger-Katz recently put it, “Obamacare is not on the verge of explosion.
Will he follow the law as his Constitutional oath requires or allows his supporters to lose health care?