The threat from Trump and Republicans to take health care away has hit alarming levels

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https://www.nytimes.com/2018/12/06/opinion/the-ticking-time-bomb-under-obamacare.html

The Ticking Time Bomb Under Obamacare
The threat from President Trump and Republicans to take health care away — including a pending case that would strike down a large part of the law — has hit alarming levels.
By Abbe R. Gluck and Erica Turret
Dec. 6, 2018

Yes, the Democrats reclaimed the House. But you should not assume that your health care coverage is now safe. The biggest threat is President Trump himself: His administration has been relentlessly assaulting the Affordable Care Act for two years, and that threat has not abated. Democrats may have made significant electoral gains by running on the protection of the pre-existing-conditions guarantee to insurance, but Republicans apparently aren’t listening. The president and his party remain focused on taking health care away.

The administration has instituted administrative rules and guidance letters intended to undermine the insurance markets, trick the healthy into buying junk plans, and leave the less healthy with unaffordable premiums. It has also succeeded in reducing enrollment, making access to health care harder for the poor and immigrant populations and, for the first time in a decade, raising the number of uninsured children. To add insult to injury, it refuses to defend the A.C.A. in a ludicrous lawsuit in Texas — in which it now appears the judge may very well strike down a large part of the law, including the ban on pre-existing conditions. The entire A.C.A. is at stake. Don’t be fooled by the president’s claims that these problems are inherent in Obamacare.

Let’s start with the insurance markets. Combining healthy and sick people into a single insurance pool as the A.C.A. requires drives down the cost of insurance. The administration is destroying this pool to isolate less healthy people in their own market with skyrocketing premiums so the public and the insurance industry will turn against the law.

First, it promulgated a rule that expands A.C.A.-exempt “short term” plans — previously just band-aid plans for a three-month period between jobs — to yearlong exceptions that can be renewed for up to three years. It passed another rule allowing expansion of so-called association health plans, once a limited exemption from some A.C.A. requirements for some small businesses but now open to virtually anyone. Many of these plans are so bare-bones that they do not cover even prescription drugs or maternity care. Short-term plans can exclude people based on pre-existing conditions, and exclude full categories of benefits including substance abuse — even though the president claims to care about solving our national opioid crisis.

To make matters worse, just last week, the administration relaxed the requirements for states to get waivers from A.C.A. provisions, making it easier for states to make excuses for not covering their citizens. It is another potential avenue for keeping young, healthy people out of the insurance pools and driving up premiums for the Americans who remain.

In addition, the administration cut the period for open enrollment in half. It also significantly reduced funding for “navigators,” given the task by the A.C.A. of linking individuals to insurance. It seems these efforts to discourage enrollment are working: The enrollment period ends next week, and so far, sign-ups are down about 10 percent compared with last year.

Add all this up, and premiums for baseline A.C.A. plans in 2019, so-called silver plans, are 16 percent higher than they would have been absent the Trump administration’s acts of sabotage.