Crafting health care policy by fiat and wrecking ball is no way to govern.

Nevertheless, that is what is emerging courtesy of President Donald Trump in the absence of thoughtful health care reform from Congress.

Republicans in control of Congress repeatedly failed in their efforts to repeal and replace the Affordable Care Act, in part because a few GOP senators recognized the harm the replacement proposals might cause.

Rather than pursue a fully vetted, bipartisan fix to real problems with the ACA, Trump’s administration has resorted to sabotage. It has reduced both marketing to encourage ACA enrollment and the enrollment window.

On Thursday, Trump issued an executive order that could enable some health insurance plans to bypass important ACA consumer protections. He then announced that his administration would act unilaterally to scrap federal subsidies for co-payments and deductibles in ACA plans. Republicans argue those payments are illegal because they were paid by President Barack Obama’s administration, but never appropriated by the legislative branch. That question remains unresolved in the courts.

Trump tweeted that the ACA was a “broken mess” and that his administration will give America “great” health care.

Trump’s impatience is understandable, but no valid basis to pursue policies that will harm Americans. Hardball tactics are fine for corporate boardrooms. Resorting to them to dictate the nation’s health care reform is cruel.

Aspects of the ACA require reform, but it is not a broken mess. Pennsylvania recorded its lowest uninsured rate, 5.6 percent, in 2016. “Our market was on a path to stability,” said Jessica Altman, acting commissioner of the Pennsylvania Insurance Department.

As a result of Trump’s decision to end cost-sharing payments to health insurers, we learned Monday that premium hikes for Pennsylvanians enrolled in ACA plans are expected to increase an average of 30 percent. That is nearly four times the 8 percent price hike for ACA health insurance plans the Pennsylvania Insurance Department had previously predicted, absent Trump’s actions.

The rate hikes will hit hardest about 85,000 Pennsylvanians who make more than 400 percent of the federal poverty level and who are enrolled in ACA silver-level individual plans.

Others who earn less will be shielded by ACA tax credits that will increase as the premium rates increase. While that keeps coverage in place, it also has the unwanted effect of increasing the federal deficit. The nonpartisan Congressional Budget Office predicted an end to cost-sharing payments would hike the federal deficit by $194 billion over a decade. How is that great?

State officials are urging those impacted to shop for other plans, as well they should. Still, they should not be left to scramble on a matter of such importance.

Better if Congress simply did its job.

— Erie Times News

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