Trump and the Stubborn Persistence of Obamacare

For more than eight long years we griped almost every day about almost everything President Barack Obama did, and were especially critical of his crackpot Obamacare law. Lately we’ve been griping almost every day about almost everything President Donald Trump does, though, and we even have some gripes about he’s going about undoing one of the worst mistakes of Obama’s administration.
Despite Republican majorities in both chambers of Congress and a Republican president in the White House, the Grand Old Party has thus far been unable to keep its seven-year-old promise to repeal and replace Obamacare, so Trump has chosen to hasten the crackpot system’s demise by executive action. First he signed an order that allows insurance companies to offer and consumers to choose low-premium but high-deductible programs that cover only catastrophic circumstances, which were previously disallowed by Obamacare, then he ordered a halt to federal subsidies for the low-income customers who have been forced to purchase the higher-premium but lower-deductible and more comprehensive coverage. Both moves would make perfect sense in an efficiently free market system of health care, but that seems unlikely to happen any time soon, and both are admittedly designed to wreck the crackpot health care system we’ve wound up with instead.
Obama’s promises that Obamacare would save you thousands of dollars and allow you to keep your doctor and your plan and not add a dime to the federal deficit while covering everyone have since proved complete balderdash, just as we glumly predicted back when we were griping almost every day about Obama and Obamacare, but even then what our anti-authoritarian instincts most hated about the crackpot scheme was the tyrannical notion of government mandating that individuals purchase a product and then limiting their choices of what to buy. We’re therefore grateful that Trump that has struck a blow for the liberty of those young and healthy and relatively low-wage workers whose best bet on the health insurance market is a low-premium and high-deductible catastrophic plan, and we fondly recall those halcyon days when we were among them, but our middle-aged have to acknowledge that without their coerced subsidies the rest of the current system is destabilized.
An end to those federal subsidies for low-income workers stuck with the high-deductible coverage is on even more solid constitutional ground, as the crackpot Obamacare law didn’t include them and they’ve been paid all along by executive orders of very dubious constitutionality, but Trump proudly admits that it’s intended to hoist Obamacare on its own petard, although we doubt he’d recognize the Shakespearean reference. Without those subsidies many insurers will will have no choice but to pull out of many markets, leaving millions of Americans without any coverage at all, and millions more paying higher premiums for the plans they’re still stuck with under the still-existing Obamacare law.
Trump’s plan is that the resulting catastrophe will force the Democrats to come begging for some efficiently free market solution such as the Republicans have been promising for seven long years, which we’d much prefer over the long term, but in the short-term it seems unlikely to happen. The plan assumes that the public will blame Obama and his crackpot law’s inherent flaws, rather than Trump for faithfully executing it to the letter and thus blowing it up, and it seems a rare case when Trump has over-estimated the public’s intelligence. If Trump expects the congressional Democrats to be so moved by the plight of those uninsured and over-paying low income workers that they will come begging for a efficiently Republican free market solution, rather than allowing the press to pillory him for admittedly blowing things up and gleefully watching his approval ratings further plummet, we think he’s overestimating them as well. He can plausibly blame those congressional Republicans, but he won’t have anything to claim to credit for, and it will make a complicated mid-term election next year.
In any case we won’t be any closer to that efficiently free market health system we’ve yearned for far longer than the past seven years, what we’re stuck with instead will wind up imposing misery on millions of Americans earlier than necessary, and there will be plenty of blame to go around.

— Bud Norman

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