As Obamacare continues its slow-motion collapse, liberals have latched onto a talking point: accusing Republicans of “sabotaging” the law by creating “uncertainty.” Nearly every elected Democrat, every major media outlet, and every liberal pundit has used the word to deflect attention from the unsustainability of the law.
Republicans have a long-standing position of calling for the repeal of Obamacare. So, for many of us, “sabotaging”—as in deliberately destroying, damaging, or obstructing—the ACA would be a welcome idea, as long as it wasn’t done illegally. The Obama administration ignored and weakened laws they didn’t agree with as a matter of policy. It would be nothing new.
That’s not the case, however. The word “sabotage” intimates that something corrupt or underhanded is afoot. The Democrat’s argument is that the Trump administration’s threat of ceasing the “cost-sharing reductions” subsidies for markets has undermined the viability of Obamacare exchanges. “Without them, insurers would have to jack up premiums to cover their costs or leave markets that would become deeply unprofitable to them,” The Washington Post wrote in a recent editorial, titled “The GOP’s Obamacare sabotage continues.”
There are a slew of things wrong with this accusation.
First of all, isn’t this exactly what conservatives had warned would happen when you created fake “markets?” Isn’t this exactly what the legislation was supposed to fix? When Obama was selling healthcare reform to the American people in 2009, he argued that the individual market exchanges would soon be almost entirely self-sufficient, driving down costs because insurance companies would have “incentive to participate in this exchange because it lets them compete for millions of new customers.”
As it turns out, the real incentive for many of these insurance giants was the presence of taxpayer subsides. Removing corporate welfare can’t “sabotage” a healthy marketplace, it can only expose the rickety infrastructure of a fabricated one. Nothing, it turns out, sabotages Obamacare quite as well as Obamacare.
Meanwhile, the Trump Administration hasn’t even stopped these payments. The President only threatened to withhold them, reportedly as a way to impel Democrats to negotiate on healthcare reform.
How can the president even threaten such a thing? Well, the Obama administration created cost-sharing reduction payments to entice insurance companies to participate in the exchanges. But since Congress had never appropriated any funding for such payments, Republicans argued that they were illegal. And, as the longstanding practice has it, they went to a court with the complaint. A federal court then found that Obama administration was acting unconstitutionally. The administration ignored the decision while appealing. (The specifics vary, of course, but imagine for a moment what the reaction would be if Trump simply snubbed a court’s position on, say, the travel ban.)
Congress has a responsibility to protect its Constitutional role—whatever drives them to do it is secondary. So there is no reason for Republicans to continue payments they claimed were illegal only a few months ago.
Yet, even with his threat, insurers had been fleeing Obamacare “markets” long before Trump was ever elected. The collapse of the individual market was predictable, and ongoing. Back in the days when most people assumed Hillary Clinton would be president, a Kaiser Family Foundation study estimated that over 664 counties would feature only a single insurer on Obamacare exchanges in 2017. In 2016, that number was 225.
Reminder: These are mandated markets with generous subsidies, and yet many insurers were fleeing because they were losing money. This is not Republicans’ doing. And yet, big Obamacare insurers like CareFirst Blue Cross Blue Shield have lost over $600 million since they began participating. They want another 50 percent increase next year. In Washington, large swaths of the state will now be covered by one insurer, creating a virtual monopoly. After Anthem pulled out of Ohio, around a fifth of the state’s counties could be left without any plan. And so on.
The one thing we can have some certitude over is rising premiums. The average monthly premiums in the individual marketplace have increased over 100 percent since the marketplaces were open.
So the “sabotage” argument is a hollow one. Despite the political grandstanding of many insurance commissioners, nothing is new here. As Chris Jacobs asks in the Wall Street Journal, where were all these liberal politicians and activists last year when the future of these payments were equally doubtful?
Now, obviously there’s going to be some level volatility in any market. But when you hand over a massive chunk of the economy to the bureaucracy—without any buy-in from around half the country—you’re creating a situation that will always be tied to the vagaries of partisan politics. Turning around, and then demanding the opposing party vigorously implement these policies to help stabilize a law they hate, is absurd. And if it’s not, and if certitude is paramount, will Democrats also sign off on whatever elected Republicans are working up behind closed doors? You know, to make sure everything goes smoothly? Off course they won’t. Because it’s a transparently partisan demand.