Does Donald Trump’s latest assault on health care finally count as some kind of signature legislative achievement? Because nearly a year in, he’s got all the momentum of molasses in March — at least, if you leave out all he’s done with via executive order.
Trump and the GOP’s desire to undo the Affordable Care Act has been as remarkable for its persistence as its futility — Obamacare has survived everything from court challenges to Mitch McConnell, but the president’s latest action will definitely leave scars. As a result, the subsidies that helped low-income people afford insurance will dry up, and the markets will be flooded with so-called “junk plans” that allow younger, healthier people to buy inexpensive plans with little protection, stopping the money for older patients from reaching the exchanges.
Ask yourself how long companies that live and die by the health of the Obamacare exchanges will survive with that level of uncertainty.
None of this is good, to put it mildly, for New Jersey. Here, as in many other states, hospitals and medical centers have adjusted their business models to accommodate life under Obamacare. For hospitals, there is the necessity to manage their large, growing and unsustainable charity care obligations, and insurance companies, if not turning cartwheels, have at least enjoyed some degree of predictability. Meanwhile, employers outside the industry — especially small-business owners — struggled to make sense of their own benefits packages for their workers, and will now likely find themselves in such unenviable positions again.
Obamacare is hardly perfect, as New Jersey health care, insurance and other industries will tell you. However, for its many problems, it has achieved some notable victories like extending coverage to Americans who otherwise could never come by it—such as those with pre-existing conditions. Reforming the law to make it simpler for companies to comply and injecting further stability for insurers would have been a welcome development.
As we were preparing this for press, the news was breaking that the U.S. Senate was reaching a deal on health subsidies, offering at least some short-term stability to insurers. But it won’t be enough to undo the damage Trump has created with his latest decree. We need Republican leadership in Washington — including those from New Jersey, most of whom have meekly fallen in line with the president’s shenanigans — to start holding the executive branch accountable when it makes decisions that are harmful to business and downright cruel to constituents. Let’s hope they’ve spent all this time preparing something to impress us, because so far, they’ve fallen very short.