To the great annoyance of its detractors, the Affordable Care Act is doing pretty well, but that doesn't mean the system is immune to sabotage. The Wall Street Journal reported over the weekend:
The Trump administration plans to shut down healthcare.gov, a website consumers use to sign up for the Affordable Care Act, for 12 hours on nearly every Sunday of the coming ACA enrollment season.The outages, which the administration says are for maintenance, will occur from midnight through noon on every Sunday other than Dec. 10.
Just so we're clear, the Republican administration has already shrunk the open-enrollment period, cutting it in half. On top of that, consumers will now have even less access to the federal exchange marketplace on Sundays, with Trump's HHS shutting down the website for 12-hour increments.
Frank Baitman, a former chief information officer for HHS, made the case on Friday that there's no credible technological reason for this kind of decision. He added that the move reflects a "lack of will and respect" for the American people.
Sen. Chris Murphy (D-Conn.) was even more direct on this point, arguing, "This is not normal maintenance. This is sabotage. Cold blooded. Clear. Out in the open."
Of course, if this were an isolated incident, it might be easier to give Team Trump the benefit of the doubt, but therein lies the point: this administration has abandoned all subtlety in its ACA sabotage campaign.
The Center on Budget and Policy Priorities recently published a list tracking each of the actions Trump World has taken to "sabotage the ACA by destabilizing private insurance markets or reversing the law’s historic gains in health coverage." It's not a short list.
On the contrary, it includes everything from scrapping ad campaigns to eliminating navigators, narrowing the enrollment window to threatening to cut off CSR payments. The evidence suggests the executive branch, responsible for helping administer the nation's health care system, isn't especially interested in making the system work as it should.
As we discussed a few weeks ago, there are practical effects to keep in mind. Americans who are most in need of care are likely to sign up for coverage, regardless of the sabotage efforts, because their health vulnerabilities require them to pay close attention to deadlines and enrollment windows.
But for the system to work well, insurers need plenty of healthy people to get covered, too. In other words, by taking steps that discourage enrollment, the system is more likely to end up with a more expensive pool of patients, which forces premiums higher, costs taxpayers more, and creates more volatile markets.
Taken together, there’s every reason to believe the Trump administration is doing all of this deliberately in order to make the health care system worse so that the president and his allies can run around saying, “See? Obamacare doesn’t work.” Instead of focusing on helping people, the emphasis is on creating partisan talking points.
If the Affordable Care Act were as dreadful as the right claims, shouldn't the sabotage campaign be unnecessary?