Having provoked much progressive sputtering and head spinning last Friday by issuing new regulations weakening the notorious HHS contraception mandate, President Trump is poised to sign an executive order that will further dry up Obamacare’s regulatory morass. The Wall Street Journal reports that the order will expand enrollee options restricted by the Obama administration — allowing coverage to be purchased through association health plans, encouraging the sale of short-term medical insurance, and permitting pretax funds from health reimbursement accounts (HRAs) to be used for premiums on health plans. The impending order has already drawn satisfying charges of “sabotage” from Obamacare apologists.
The always humorous effusions of the brainiacs at Vox, for example, are particularly entertaining. That mainstay of puerile progressivism laments the imminent order under the following portentous headline: “How Trump is planning to gut Obamacare by executive order.” This is the outfit that was founded by a guy who fawned over Trump’s predecessor and his “signature domestic achievement” in such a nauseating fashion, despite Obama’s outrageous misuse of executive orders, that he was named by the former president as one of his favorite columnists. Nonetheless, demonstrating an unrivaled gift for unintentional irony, this crew assures us that Trump’s executive order will wreak wrack and ruin:
Under the draft executive order as described, new regulations would allow association health plans to be considered large employers when it comes to health insurance. Large employers are not subjected to the same rules as individual or small-group plans under Obamacare. Most notably, they do not have to cover all of the law’s essential health benefits or meet the requirement that insurance cover a minimal percentage of a person’s medical bills.
Having trouble spotting the problem here? The “journalist” who wrote that passage seems blissfully unaware that allowing small employers and self-employed individuals equal privileges under Obamacare is a move in the direction of fairness for “the little guy.” Aren’t progressives always telling us that they want “equality” for that diminutive dude? Assuming there are actually progressives out there for whom this isn’t simply a pose meant to camouflage a statist agenda, it should be obvious even to them that loosening the rules associated with Obamacare’s essential health benefits (e.g., not requiring 59-year-old males to buy maternity coverage) will also render health insurance less expensive to purchase.
It’s also difficult to understand why progressives would object to changing the rules on short-term coverage. Such plans existed prior to Obamacare for purposes of accommodating a relatively small market consisting of people who, for one reason or another, expected to be unemployed for some period of time and therefore unable to purchase comprehensive job-based coverage. The premiums were generally low, but the deductibles were usually quite high. The point of such policies was to assure that the sudden onset of a major illness didn’t bankrupt the policyholder while he was between jobs. As the Wall Street Journal explains, Obama’s HHS secretary used Obamacare as a pretext for destroying that market:
The Obama administration banned the sale of those plans that offered coverage for more than 90 days, arguing they were inadequate for people’s needs. Some industry officials have pressed the administration to restore them, saying that when marketed honestly they can fit the needs of particular consumers currently priced out of buying the more generous coverage available as a result of the 2010 health-care overhaul.
The executive order under consideration by Trump would permit the duration of such plans to be increased from 90 to 364 days. There is only one reason anyone could have for refusing to permit the sale of such plans — to trap enrollees in an Obamacare exchange and force them to buy coverage with equally high deductibles and far higher premiums. Millions of Americans are paying astronomical premiums for Obamacare plans and are not eligible for subsidies. These people will not allow this to continue if they have any choice, and these altered plans will provide a less expensive choice. The real objection progressives have to such plans is that they will accelerate the collapse of Obamacare’s exchanges.
The third feature of Trump’s executive order will provide relief for a different class of Obamacare victim. As I wrote in this space last year, Obamacare has increased insurance costs not merely for Americans who buy coverage via the individual market, it also drives the price up for those with employer-based coverage. Employed Americans have been paying more taxes to cover Obamacare’s subsidies and its EHB requirements force them to accept high deductible plans to keep their own premiums as low as possible. Expanded HRAs, employer-funded accounts from which employees can pay out-of-pocket costs and premiums will help protect employed Americans from Obamacare’s depredations.
So, what’s not to like about Trump’s imminent executive order? The answer for progressives is that it will, as the kids at Vox put it, “blow a huge hole in the Affordable Care Act.” For most Americans, and the health care industry in general, that’s a feature not a bug. President Trump gets that and has grown tired of waiting for Congress to do its job. So, he is now using legitimate executive measures to drain the swamp. As we saw last Friday and through the weekend, the alligators are not happy. But the public hates gators, and they like Obamacare even less. They will reward Trump for doing what he can do. The man isn’t perfect, but anyone who can make the swamp creatures squeal with frustration can’t be all bad.
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