Trump’s Wrecking Company

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Health Care, Trump Maladministration

For a brief, shiny moment it seemed the Senate would save the cost-sharing subsidies and the ACA. Yesterday  Sens. Lamar Alexander and Patty Murray submitted a bill that was supposed to do that, anyway.

Yesterday, Trump appeared to approve of this plan. Today, he does not. He still thinks it’s a “bailout” of the insurance industry. Sarah Kliff explains:

Trump has said he will discontinue the second [cost sharing] subsidy program. But insurance companies are still required by law to provide these subsidies to their low-income enrollees. They cannot jack up the deductibles on someone who earns 200 percent of the poverty line, even though the government has stopped providing the money.

Insurance companies don’t want to lose money. They need a way to offset the sudden loss of billions in government funds. So, they looked for other levers to pull. And many settled on raising premiums as a way to recoup those lost funds.

Paul Waldman wrote today:

President Trump is facing a dilemma: Does he want to destroy the American health-care system or not? At this point, all evidence suggests that he genuinely can’t decide what the answer to that question is. …

… When the Alexander-Murray agreement was announced yesterday, Trump at first seemed supportive. “It is a short-term solution, so that we don’t have this very dangerous little period — including dangerous periods for insurance companies,” he said at a press conference. “For a period of one year, two years, we will have a very good solution.” But then this morning, he tweeted, “I am supportive of Lamar as a person & also of the process, but I can never support bailing out ins co’s who have made a fortune w/ O’Care.”

What gives? When you try to interpret the president’s shifting positions — and figure out how this is all going to end — there are a few things you have to keep in mind. First, it’s wise to assume that he has no idea how any provision of this agreement or the ACA itself actually works, and that will not change. For instance, he seems to have convinced himself that cost-sharing reductions are like an extra bonus given to insurance companies that they’ll just use to pad their profits. “That money is going to insurance companies to lift up their stock price,” he has said, when in fact the money is basically passed through the insurers to provide lower co-payments and deductibles for people with low incomes. He hasn’t bothered to learn what the law does, and he certainly isn’t going to quickly get up to speed on new proposals to provide technical fixes.

Still, it might be that if he were presented with a bill to sign, he’d sign it. However, Paul Ryan probably has more enthusiasm for cold oatmeal than he has shown for this bill.

“The speaker does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare,” a Ryan spokesperson told Axios.

So, not much chance anything is going to happen. Jonathan Swan and David Nather write at Axios that nobody has any idea what Trump actually thinks, “But it’s fair to say that everyone who is remotely conservative inside the administration is pushing not to keep funding the Affordable Care Act’s insurer subsidies without serious concessions.”

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9 Comments

9 Comments

  1. Doug  •  Oct 18, 2017 @8:42 pm

    Trump is holding the health care for millions hostage – in his mind when the situation is dire enough, democrats will negotiate. It’s all about deals in Trump’s mind. If democrats won’t negotiate, Trump will make thing worse and worse until they do.

    This is playing out in the same way with the Dreamers. There are 800,000 residents who haven’t gotten in trouble – many grew up in the US and know nothing of the country they will be deported to. If democrats want to spare them the agony of expulsion, separation from their families, and the uncertainty of adjusting in a violent third-world country, they have to finance his wall and fund his deportation gestapo.

    A lot of people are going to feel a lot of pain before this ends.

  2. c u n d gulag  •  Oct 18, 2017 @9:50 pm

    Swami,
    Sorry, but T-RUMPLE-THIN-sKKKon isn’t just a sack if shit, as you describe.

    He’s a massive, fat-laden, toxic waste dump, in a large, Cheetos-colored sack!

  3. Swami  •  Oct 18, 2017 @11:59 pm

    gulag … I can feel the love!

    nobody has any idea what Trump actually thinks

    Only Trump knows what he thinks, but you can narrow it down to know that whatever he thinks, it’s going to be centered on his perception of himself. He’s a black hole of narcissism who is disconnected to humanity. So whatever course action he takes it will only serve to benefit his own ego. He’s a sick sick man child who is causing me to lose faith in the integrity those that allow him to continue on such a destructive path t in tearing down our republic.
    I don’t begrudge him his pathologically abhorrent behaviors, but for the fact that he is destroying the foundations of decency and respect we should hold for the President of the United States. He’s an abomination!
    Maybe I’m just pissing against the wind in expecting a base level of decency, honesty, and humanity in the leader of my country. And in my expectations Trump doesn’t even come close to measuring up. He’s an non-redeemable bag of shit!
    I hope misery seeks him out and overtakes him.

    Well, I feel better, I got that off my chest.

  4. Swami  •  Oct 19, 2017 @12:03 am

    There is no substitute of good therapy. 🙂

  5. bernie  •  Oct 19, 2017 @8:40 am

    Here in the land of locked, we do not know much about boats or rudders.  We do know what happens when the wrong person is at the rudder.  It is like someone inexperienced trying to back a four-wheeled hay trailer, a metaphor that might be getting a little dated.  No matter how much you direct and yell, the thing is never going in the right direction.  So you get a bipartisan effort to take the wheel, and the incompetent has to retake control.  Crazy, evil, and stupid people never think they are crazy, evil, or stupid. 

  6. csm  •  Oct 19, 2017 @10:32 am

    Hopefully the democrats have learned from this, that Trump is never to be trusted. Not just because he’s a liar and cannot be depended on, but also because he will change his ind at the drop of a hat, to whatever position he thinks will be a winner for him.

  7. Swami  •  Oct 19, 2017 @1:13 pm
  8. priscianus jr  •  Oct 19, 2017 @10:35 pm

    “Yesterday, Trump appeared to approve of this plan. Today, he does not.”

    And you know why? Because he talked to one advisor yesterday (probably somebody from the senate) and a different advisor today (probably Bannon).

  9. elkern  •  Oct 20, 2017 @11:43 am

    I actually agree with Trump’s objection to the ACA as a “bailout for insurance companies”. I don’t really fault Obama & Clinton for creating this kludge, because “the greater good” at that time required political compromise (though I do blame my former Senator Palpatine, er, Lieberman, and other Dems for torpedoing the Public Option).

    OTOH, I’m appalled at Trump’s “solution”. He doesn’t recognize – and/or doesn’t care – that his “blow it all up” approach will get a lot of people dead.



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