Shattered Health Security

Trump Has Shattered Health Security

As Maryland's attorney general, I am filing suit against the president's cruel Obamacare rollbacks.

By Brian E. Frosh

Many of us are lucky enough to take it for granted. We respond to a child's high fever by rushing to the pediatrician, never stopping to think about whether the visit will mean missing a rent payment. We counsel a friend who has been tired for too long to "get it checked out." So it can be hard to imagine the joy and relief on the faces of people across this country who, in the fall of 2013, eagerly enrolled in health insurance for the first time in their lives. Receiving, under the Affordable Care Act, enough financial assistance to make health insurance within reach, they felt a new peace of mind that comes with knowing they could take care of themselves and their families.

President Donald Trump has shattered that security. With a breathtaking disregard for the immediate impact it would have on millions of Americans who will lose coverage or pay more for less, he announced last week that the federal government would stop making cost-sharing reduction reimbursements to insurers. These critical payments reduce out-of-pocket costs for the poorest among those who rely on coverage through the state insurance marketplaces.

The effects of this perverse executive action will be enormous and destructive, rippling through the insurance markets, the health care system and the economy. As the Congressional Budget Office and other experts have warned, insurance premiums in the marketplaces could increase by 20 percent or more. Some insurers will pull out, destabilizing markets further. Because rates will be higher, the federal government will pay more in tax credit subsidies that help consumers afford their monthly premiums. These higher government costs will increase the federal deficit by $194 billion over 10 years.

It is difficult to understand how this trade-off makes sense; by stopping cost-sharing reduction reimbursements, the government will pay almost $200 billion more to provide coverage for far fewer people – hardly a good deal by any measure.

Those who do not qualify for financial assistance will be hit hardest, as their premiums will rise without a comparable increase in tax credit subsidies. Many people – most likely the youngest and healthiest – will be forced to drop coverage. Their departure will leave the risk pool older and sicker, which in turn will drive premiums even higher. With more uninsured, the costs of uncompensated health care will be borne by everyone. The president's action will leave no one untouched.

This precipitous decision confers no policy benefits to offset its devastating consequences. Trump's action is purely arbitrary and vengeful. With repeal-and-replace in the dustbin, the response is to destroy instead.

We will fight back. I joined a coalition of 19 attorneys general that filed suit immediately to protect millions of people across the country from this cruel threat to their health and well-being. We can also hope that Trump's recklessness will breathe new life into laudable, if faltering, bipartisan efforts in Congress to head off this calamity. And as they have so often before, the voices of hardworking people who want simply to take care of themselves and their families can be a powerful force in helping the country change course.

Echoing the wisdom of Mahatma Gandhi, former Vice President Hubert Humphrey counseled in one of his final speeches that, "[t]he moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped."

As the wealthiest country in history, and as a free people infused with a spirit that has overcome greater challenges, we must pass this test. Together, we can resist the worst impulses of the Trump administration. With the clarity of compassion and moral imperative, we can take care of the sick, needy and disabled, protect our elderly and give our children the healthy start in life they deserve.