If We Had A Real President...

If we had a real president in the White House, instead of a grifter pretending to be a clown, he would have announced that his party has tried and failed to repeal the Affordable Care Act and that the next step is to have the Republicans and the Democrats sit down together and figure out-- for the good of the country-- a nonpartisan/non-ideological approach (based on Trump's own campaign promises) for fixing the problems in the ACA. Instead, Trump lamely tried blaming the Democrats for his own party being unable get its huge congressional majority to even take up the bill they had spent 7 years "working" on. So rather than opting for something vaguely presidential, he sent out this mean-spirited and destructive tweet Saturday morning:

Ted Lieu (D-CA), one of the most effective and consistent voices of the congressional resistance, responded angrily at the implied threat-- and in kind:

People are worried-- rightfully so-- that Trump and Ryan will now go on an orgy of recriminations against people who get medical treatment based on the Affordable Care Act. They are committed to causing it to crash and burn and they can do tremendous damage-- as they already have. In fact, on Wednesday, even before their own TrumpCare bill went down in flames, Thom Hartmann, writing for Alternet, noted that the GOP has been sabotaging the Affordable Care Act even before Trump was sworn in.

When the ACA was rolled out, telling insurance companies that they had to insure anybody who signed up, regardless of previous conditions or sickness, everybody realized that the insurance companies would probably lose money in the first decade or so, until previously-uninsured-but-sick people got into the system, got better, and things evened out.

To get the insurance companies to go along with this danger of losing money, the ACA promised to make them whole for any losses in any of the first decade’s years.  At the end of each fiscal year, the insurance companies merely had to document their losses, and the government would reimburse them out of ACA funds provided for by the law.

The possibility of their losing money was referred to as the “risk corridor,” and the ACA explicitly filled those risk corridors with a guarantee of making the insurance companies, at the very least, whole.

And then something happened. As the NY Times noted on December 9, 2015, “A little-noticed health care provision slipped into a giant spending law last year has tangled up the Obama administration, sent tremors through health insurance markets and rattled confidence in the durability of President Obama’s signature health law.”

Rubio and a number of other Republicans had succeeded in gutting the risk corridors. The result was that, just in 2015, end-of-fiscal-year risk corridor payments to insurance companies that were supposed to total around $2.9 billion were only reimbursed, according to Rubio himself quoted in the Times, to the tune of around $400 million. Rubio bragged that he’d “saved taxpayers $2.5 billion.”

And, indeed, he had. But the insurance companies were thrown into a crisis. And, with Republicans in Congress absolutely refusing to re-fund the risk corridors, that crisis would get worse as time went on, at least over a period of a few years.

So the insurance companies did the only things they could. In (mostly red) states with low incomes and thus poorer health, they simply pulled out of the marketplace altogether. This has left some states with only one single insurer left.  In others, they jacked up their prices to make up their losses.

As Robert Pear in the Times noted, Rubio’s “plan limiting how much the government can spend to protect insurance companies against financial losses has shown the effectiveness of quiet legislative sabotage.”

This is a big problem going forward-- one that Trump and Ryan will pour gasoline on so they can repeat their bullshit about how Obamacare is collapsing. Democrats in Congress absolutely must be able to effectively communicate an affirmative health care agenda that moves toward Medicare for All (alongside alongside employer coverage that 150 million people now have). The Democrats should consistently be advocating for the public option-- in effect, Medicare for All-- along with the federal government setting prices for prescription drugs. The alternative is chaos and misery. Just ask Samantha Bee: