For a while, Republicans have argued—baselessly—that Obamacare is in the middle of a death spiral. Now the White House is flat-out trying to shove it into one.
Citing sources at Department of Health and Human Services, Politico reports that the Trump administration has “pulled the plug on all Obamacare outreach and advertising” for the last week of the current open-enrollment period, including “ads that had already been placed and paid for.”
There really is only one word to describe this: sabotage. (An HHS spokesperson apparently tried to spin the move to Politico as a cost-cutting effort. It’s saving a mere $5 million.) Americans have until Jan. 31 to sign up for health plans on the Affordable Care Act’s exchanges, and the final days of open enrollment tend to see a frenzy of activity from people who waited until the last minute to get coverage. It’s an absolutely critical home stretch, and without reminders from Washington, we can now expect fewer enrollees.
It’s hard to say exactly how bad the damage will be. But up to this point, enrollment was just slightly outpacing last year’s. In October, the government projected 13.8 million enrollees for 2017, compared with 12.7 million for 2016. Charles Gaba, who runs the absolutely essential ACASignups.net, told me on Twitter he now expects the final tally to be somewhere between 12 million and 13 million.
If Obamacare enrollment drops below last year’s mark, it will be easier for Republicans to argue that the program is unraveling, giving them cover to repeal and replace it with a less generous system. House Speaker Paul Ryan has previously argued, without any real evidence, that the ACA was in an actuarial death spiral—the cycle of rising premiums and declining enrollment that ends in a market collapse. That was absurd, of course, because all signs suggested that enrollment was set to rise. Now, thanks to Trump, it might not, and Ryan will be able to keep repeating his talking point with at least a shred of proof to back it up. If enrollment falls severely thanks to this move, it might also set up insurers for another year of large losses, with more big premium hikes to follow. Trump may be laying the groundwork for a legitimate marketplace crisis in 2018.
With that in mind, maybe it’s time to consider calling the law something other than Obamacare.