Politics, Moderate



Trump's sneaky backdoor Obamacare repeal is working

Catherine Rampell on

Last year, much of the country watched with growing fury as Republicans tried to undo President Barack Obama's signature achievement, the Affordable Care Act.

Americans stormed town halls. They jammed congressional phone lines. Some got hauled off to jail for acts of civil disobedience. Bill after bill attempting to dismantle Obamacare imploded. By October, it looked like Republicans had given up at last.

How wrong that was.

In the months since the last Obamacare vote in the Senate, the Trump administration and Republicans on Capitol Hill have engaged in a sneakier, backdoor repeal.

It's been less telegenic than those big congressional fights, but it has been more destructive.

In fact, next year there will be about 9 million fewer Americans with real health insurance coverage than would have been the case had pre-Trump policies stayed in place, according to a report released Monday by the Urban Institute.

By "real health insurance," I mean plans that actually cover things -- as opposed to plans that just take your money and then, legally, pay few if any claims. (These are sometimes nicknamed "buffalo plans," because they pay out pretty much only if you get run over by a herd of buffalo.)

A handful of relatively low-profile, boring-sounding actions are to blame for the drop-off in the insured. They include repealing the individual mandate (which encouraged young, healthy people to buy insurance, holding down premium costs for the overall pool), shortening the open-enrollment period, reducing outreach and advertising, and killing subsidies designed to help pay for low-income people's out-of-pocket spending.

Then last week, with little fanfare, the Trump administration released an even-more-damaging new policy: an expansion of "short-term" insurance plans.

Short-term insurance is supposed to provide just that -- short-term coverage. Maybe you need a stopgap plan before school starts, for instance. These niche plans are exempted from Obamacare's basic consumer protections.


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