In late September the ACA survived yet another repeal attempt by the U.S. Senate. However, every time this happens, there is a tendency for supporters of the ACA to take a deep breath, celebrate the moment of victory, but then place that win on the back burner of our collective memory and attention. We do this primarily because there is a continuing Category 5 storm of assaults to weaken or destroy federal agencies, the social order, the world order, and the democratic system of government that we have come to know and cherish over the past 240 years.
So let me be crystal clear: this assault on the ACA continues daily in D.C., and each health care battle is only a handful of confetti in the ticker tape parade that Trump imagines in his reality TV show, “The President.”
Most recently, as reported in the Washington Post:
- Conservative Iowa sought permission from HHS to revitalize their health insurance market. Insiders reported that Mr. Trump instructed the director of HHS to tell Iowa No in an effort to undermine the ACA, even if it means hampering state efforts to keep premiums low.
- HHS is trying hard to suppress the number to enroll in the upcoming open enrollment period, November 1st –Dec. 15th, 2017.
- It has cut the enrollment time in half, and reduced the advertising budget from $100M spent last year to $10M. Scratching my head as I type, I can say I have seen absolutely no TV ads on the open enrollment this year.
- HHS has told regional administrators not to even meet with on-the-ground, grassroots organizations about enrollment.
- On October 6th, Trump directed a long-awaited revision to the ACA requirement that most employers cover birth control as preventive care for women. Under Obama, this applied to all FDA-approved methods, and most women no longer had to pay for contraception. However, Trump has repealed this requirement, effective immediately, to allow employers to opt out of the mandate to their health plans, by claiming “religious or moral objections.”
- On October 12th, the Trump administration announced it will end subsidies to health insurance companies designed to help low-income people with premium costs and out-of-pocket medical costs.
- Also on October 12th, HHS approved sales of cheaper plans that provide fewer benefits and weaker protections, aimed at younger, healthier consumers. This will explode the cost of stronger plans necessary for those who need better, ongoing coverage.
- On October 1st, funding for the Children’s Health Insurance Program (CHIP) expired, and a Senate committee quickly passed a bipartisan bill to fund it for $100 billion five years out. CHIP covers 9 M children, many born with life-long health care needs. While the Senate acted quickly, the expiration of CHIP touched off partisan conflict in the House, resolved eventually along party lines with the Republican bill taking funds from Medicare and the ACA to offset cost of saving CHIP. There will likely be delays until the end of the year when it may be included as part of an omnibus appropriations bill.
Trump, Pence and administration officials continue to beat their drum loudly that the ACA is failing, while not even sub rosa, they continue to do an “Et tu, Brute?” attack on it. In addition, the proposed tax plan/tax cuts to the wealthy will precipitate further cuts to Medicaid, Medicare, and even Social Security with the argument that they need to “cut these expenses” in the federal budget. Eventually more than the ACA will be shredded.
Americans’ health care and their health will disintegrate from these tactics, and the members of Congress who stand silent are complicit in the fallout from the actions of Trump & Co.
At the same time, the voices for single payer, Medicare-for-all grow stronger, louder.
It seems the chasm between the rich and the poor of our country continues to widen.
- “An ACA enrollment nears, administration keeps cutting federal support of the law.” https://www.washingtonpost.com/politics/as-aca-enrollment-nears-administration-keeps-cutting-federal-support-of-the-law/2017/10/05/cc5995a2-a50e-11e7-b14f-f41773cd5a14_story.html?utm_term=.72170a71d08d
- “AP FACT CHECK: Trump’s empty boasts on legislation, economy.” https://www.washingtonpost.com/business/ap-fact-check-trumps-empty-boasts-on-legislation-economy/2017/10/10/8d1de350-adf3-11e7-9b93-b97043e57a22_story.html?utm_term=.1637baa47254
- “Birth control: Trump expands opt-out for workplace insurance.” https://www.washingtonpost.com/politics/birth-control-trump-expands-opt-out-for-workplace-insurance/2017/10/06/426ddc62-aaaa-11e7-9a98-07140d2eed02_story.html?utm_term=.324e0eb8ed66
- “Trump to Scrap Critical Health Care Subsidies, Hitting Obamacare Again.” https://www.nytimes.com/2017/10/12/us/politics/trump-obamacare-executive-order-health-insurance.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0