The mainstream media has been promoting the idea that the Trump administration is intentionally sabotaging Obamacare. This article in the Washington Post, which uses the word “sabotage” in the headline of the paper edition, is an example of the talking point.
One way the administration is said to be sabotaging Obamacare is by cutting funds to groups that try to enroll people in the program and by reducing its advertising budget. Fewer enrollments by young, healthy consumers undermine Obamacare, which relies on their participation to “buffer the health-care costs of sicker customers,” to borrow the euphemistic language of Post reporter Juliet Eilperin.
I don’t know whether the Trump administration is trying to sabotage Obamacare. However, the case for cutting funds to activist groups that work to enroll people in the program, and for slashing the advertising budget, seems solid on the merits.
Obamacare has been around long enough to sell itself to those to whom it can be sold. If Obamacare is a good deal, and I’m sure it is for some, word of its virtues will have spread by now. The left may regard Americans as sheep in need of herding, but there’s no reason why the rest of us should.
The famous push to enroll Americans (“Pajama Boy” and all that) made sense when Obamacare was rolled out in 2013, though I always had reservation about using left-wing activists for this purpose. Four years on, it makes sense to cut back substantially on this effort.
In addition, there is a strong case that Obamacare is a bad deal for young, healthy Americans. That is the view of the Trump administration.
It is problematic for an administration to try to persuade these people to agree to what it considers a bad deal for them. This is especially true of an administration, like Trump’s, that doesn’t even believe their participation will serve a greater good — namely the preservation of Obamacare, a system it opposes.
The Post’s article also considers the unwillingness of the Trump administration to approve, so far, various requests from states — e.g., Iowa — to make changes in their ailing health insurance marketplace. These waiver requests require a case-by-case analysis, and Eilperin doesn’t supply enough information — e.g., the administration’s side of the story — to permit readers to evaluate the merits.
One of the cases involves Minnesota. There, the administration approved a request for more than $300 million in funds to establish a reinsurance program that will lower premiums by guaranteeing insurers limited financial exposure for customers with particularly high medical expenses. However, the administration also cut a slightly larger amount in funding aimed at residents who earn between 138 percent and 200 percent of the federal poverty level — in other words, residents who aren’t poor.
I can’t speak to the merits of this compromise. I will note that the assumption of the administration’s critics, and throughout Eilperin’s article, is that it is somehow illegitimate to be concerned about the cost to the federal government of patching up Obamacare. If Tom Price can fly on chartered jets, we are told, then the feds can be more generous with this or that program or subsidy.
This is an obvious non-sequitur. It’s reasonable for the Trump administration to be cost conscious for any program, and certainly for one it doesn’t like. However, the benefit of a particular waiver request, or program that might be used to offset the cost, must also be part of the administration’s calculus.
And I think Trump should be mindful that the collapse of Obamacare markets in states like Iowa might damage him politically.
UPDATE: A reader asks:
Did the Post and its fellow travelers publish stories that President Obama “sabotaged” federal immigration law with his executive orders? Did they suggest the Obama Administration “sabotaged” the Constitution’s treaty ratification procedures after it reached its nuclear arms agreement with Iran?
No. I don’t recall any such stories or suggestion.