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Trump's sabotage takes its toll on the health care system

With pointless threats and partisan games, Donald Trump is imposing a political surcharge on the cost of middle-class health coverage for no reason.
US President Donald Trump walks after arriving on Marine One on the South Lawn of the White House in Washington, DC, April 28, 2017.
Late Friday, with much of the political world focused on dramatic developments in the Russia scandal, the White House said Donald Trump was considering a radical move in the health care debate. The Republican president, reports indicated, was prepared to scrap cost-sharing reductions, deliberately destabilizing insurance markets, and taking coverage from millions.Trump had until yesterday to pull the trigger on this threat, but he apparently decided to take a different course. Instead of ending the cost-sharing reductions, the administration said it would delay a final decision by 90 days -- which had the effect of leaving industry and its stakeholders in limbo while Republicans plot their next move.In case this isn't obvious, insurance companies hate arbitrary uncertainty. It's in conflict with their business model. In fact, CNBC reported yesterday that the White House's political games will end up costing American consumers quite a bit of money.

Delay, delay, delay means Obamacare customers will pay, and pay, and pay a lot more next year.The Trump administration's move Monday to avoid for 90 days -- yet again -- making a decision on a major court challenge to key Obamacare subsidies paid insurers by itself will alone add up to 20 percent or more to the price of individual health plans next year, experts said Monday.Andy Slavitt, who until January oversaw Obamacare for the federal government, told CNBC that President Donald Trump has guaranteed higher insurance prices in 2018 by his indecision on what will happen to the $7 billion in subsidies insurers have counted on from the government.

"We need swift action and long-term certainty on this critical program," Cathryn Donaldson, a spokeswoman for America's Health Insurance Plans, told Bloomberg Politics. "It is the single most destabilizing factor in the individual market, and millions of Americans could soon feel the impact of fewer choices, higher costs, and reduced access to care.""It," in that sentence, appears to refer to Trump's increasingly ridiculous antics.This isn't some minor detail. Trump and his team have been threatening for months to sabotage the Affordable Care Act and the existing health care system, toying with the idea of creating intentional chaos, but what the White House fails to appreciate is the fact that the gamesmanship has an immediate detrimental effect.By threatening to make things worse, Trump and allies are already making things worse."Uncertainty is destabilizing the market and leading health plans to raise their rates for 2018 to account for the political risk brought on by Congress and the administration through a protracted debate over the fate of these reimbursements," Margaret Murray, chief executive officer of the Association for Community Affiliated Plans, told Reuters yesterday.I've been trying to think of a way to explain this to Trump in a way he'd understand. There are many aspects of the health care debate that are complex -- the president himself recently complained that "nobody" knew how "complicated" this is -- but this aspect is relatively straightforward. When private insurers don't know about the fate of existing federal subsidies, they need to protect themselves against potential future losses imposed by Republicans. It's Business 101.And so, by playing games, Trump and his GOP allies are effectively forcing insurance companies to start charging consumers more today because they don't know what the White House and Congress will do tomorrow.The president, in other words, is imposing a political surcharge on the cost of middle-class health coverage for no reason. That may sound insane, and it's the kind of problem that's easily avoided, but Team Trump believes this is the smart course of action.