FY Society

Uninsurance: Trumpcare

The stupidity and failure of Trumpcare: Government will spend $33 billion more to cover 8.9 million fewer Americans, as premiums soar.

Michael Hiltzik

Those fiscal geniuses in the White House and Republican-controlled Congress have managed to do the impossible: Their sabotage of the Affordable Care Act will lead to 6.4 million fewer Americans with health insurance, while the federal bill for coverage rises by some $33 billion per year.

Also, by the way, premiums in the individual market will rise by an average of more than 18%.

Heck of a job.

These figures come from the Urban Institute, which on Monday released the first estimate of the impact of two GOP initiatives. The first is the elimination of the individual mandate, which is an offshoot of the GOP tax-cut measure signed by President Trump in December. The measure reduced the penalty for not carrying insurance to zero as of next Jan. 1.

Those affected by these large premium increases would be disproportionately middle-income people with health problems.

The second is Trump’s plan to expand short-term insurance plans, which don’t comply with many of the ACA’s essential benefits requirements and allow insurers to reject or surcharge people with preexisting medical conditions or histories.

The Urban Institute broke down the impact of Trump and Republican policies thusly:


Eliminating the individual mandate, combined with such lesser acts of vandalism as eliminating cost-sharing reduction payments to insurers last year and eviscerating the outreach and advertising budget for the 2017 ACA open enrollment period: 6.4 million more people uninsured than under previous law, as the uninsurance rate climbs to 12.5% of the nonelderly population from 10.2%.

“Those affected by these large premium increases would be disproportionately middle-income people with health problems,” the Urban Institute researchers said. That’s because “they prefer health insurance that covers essential health benefits, are unlikely to have access to medically underwritten short-term limited-duration policies, and are not financially protected by the ACA’s premium tax credits.”

Millions of others, including the U.S. taxpayer and families who need treatment and have incomes too high to be subsidized, also are screwed.

That includes families with household incomes approaching or exceeding 400% of the federal poverty line: $48,560 for an individual and $100,400 for a family of four.

In other words, the Republican sabotage will continue to undermine health coverage in the U.S. The only alternative, it becomes clearer with every day, is some form of single-payer, Medicare-for-all coverage. That’s increasingly becoming part of Democratic Party orthodoxy, and it’s about time.


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