Since taking office, President Trump has advanced a number of policies to undermine the ACA: curtailing outreach, repealing the individual mandate and stopping cost-sharing payments that lower insurance costs for lower-income Americans. He and congressional Republicans also repeatedly attempted to repeal it outright.
Then in July, the president signed an executive order expanding the availability of junk plans—short-term health insurance plans that among other things circumvent the ACA's protections for pre-existing conditions. It followed his June endorsement of a lawsuit by 22 states to overturn the protections in court.
The sabotage is wrongheaded. Before the ACA, insurance companies could deny coverage or gouge people. We are talking about children born with life-threatening conditions and individuals living with chronic diseases. Women were denied coverage because they had a C-section, or were a survivor of domestic abuse. People like Melissa were afraid to follow their dreams, lest their new insurer deny them coverage.
In many ways, junk plans represent the failed healthcare system that the president is trying to take us back to. Junk plans are not bound by the ACA's medical-loss ratio, allowing insurers to raise their profits and commissions. They can use loopholes and fine print to avoid covering illnesses. For example, some junk plans cover emergency room visits, except on weekends.
Nor is the president's sabotage making healthcare cheaper. By expanding junk plans and repealing the individual mandate, premiums could increase 18% in nearly every state's ACA exchange, according to the Urban Institute, while costing the federal government $28 billion over the next decade, according to the Trump administration.
Clearly, we cannot afford to be going backward, something with which the American people agree. According to the Kaiser Family Foundation, 64% do not want to see protections for pre-existing conditions overturned.
Neither did the president, based on what he promised voters. During the 2016 campaign, he said with regards to these protections, “I want to keep pre-existing conditions. I think we need it.” Now the president can and must protect the 130 million Americans like Melissa with a pre-existing condition. All he needs to do is stop the sabotage.