Foiled in Congress, Trump Moves on His Own to Undermine Obamacare

President Trump is expected to issue an order on Thursday to allow the sale of health insurance plans that are exempt from some Affordable Care Act rules.

Comments: 266

  1. "In the past, some plans failed because they did not have enough money to pay their customers’ medical bills, while some insurance companies were accused of misleading people about exactly what the plans would cover." Sounds like a Trump style business to me.

  2. So sad. If the President can write executive orders reversing or weakening laws, then what is the purpose of having a House of Congress and Senate? Isn't this undermining the root of America's form of government?

  3. The President reversed an Executive Order written by President Obama. The provision allowing formation of AHP's has been law since 1974.

  4. I am very surprised for such an advanced country like the US, you don't have universal healthcare access for your citizens. Shouldn't that be a basic rights for all citizens like in other countries.

  5. I would have believed it makes so much sense to vote for a government that protects its citizens rather than leave them to fend for themselves in their hour of need. What's the point of having a government that does not care about its citizens

  6. Thomas, you are being very kind to the truly capitalist characters on this comment section. I have come to the conclusion that the US is an advanced developing country, not a developed country. Anymore backwardness and it will soon become part of the BRIC countries.

  7. and yet, millions of people come here every year to be treated for their medical problems. I live in Arizona and during the winter months, our medical institutions are flooded with Canadians who saved all year to come down here and pay cash for medical services.

  8. There is no question that every American citizen should have health care, equivalent to what Trump and his family now have, at a cost that they can afford. If Trump doesn't destroy the economy in the next year, universal health care for everyone is something we can do. Maybe employers could contribute something, but employers should not decide what is adequate healthcare. Only a Congress that is not dependent on payoffs from the for-profit healthcare industry and insurance companies can accomplish this. Can Trump accomplish this?

  9. Unfortunately, RLW, actually providing universal healthcare would be so expensive that not even a state as progressive and rich as California is willing to pay for it.

  10. Along with "universal healthcare" comes "universal mandates" and the lack of options. Get cancer and you will be treated in the facility that they tell you. If you want to be a sheep that is up to you RLW, but for me and my people, I will choose freedom of choice.

  11. Actually, there is no question that the USA cannot afford to have the equivalent healthcare that Trump and his family now have. As a country, we can afford to offer healthcare for all, but not at the level which Trump receives.

  12. The election of Donald Trump was facilitated by the Democratic Party's inability to related to a significant portion of the electorate (see Thomas Edsall's excellent submission today). Since the Party's leadership concentrated so heavily on identity issues, the (most important) issue - the continuation of the ACA - is now in jeopardy of being functionally negated. And, seemingly, they still haven't learned.

  13. Hillary got almost 3 million more votes than 45 did. He was not elected, he was installed by Russia and people here who colluded with them.

  14. Kdknyc, I'm on your side. But you (and our Party) really need to pay attention to Thomas Edsall's recent articles. Our agenda depends on winning.

  15. Proponents of the ACA promised that the law would increase competition, instead, insurance companies have left markets and/or merged, so that in most markets, there is less competition than before passage of the ACA.
    While this is tinkering around the edges until Congress can fix the damage caused by the ACA, it is a welcome announcement.

  16. If the "risk corridor" payments - which were required by Law - were implemented, most of the insurance companies would have remained. Republicans now complain about a problem that they intentionally brought about.

  17. Let's say who did that: Marco Rubio. He was the one who inserted legislation into an omnibus bill that took away the "risk corridor" payments. Marco Rubio--a republican.

  18. There are lots of things that are required by law that are not funded. A wall on our southern border comes to mind.
    The federal government simply giving money to insurance companies hides the true cost of healthcare.

  19. Well at least we would know exactly who to thank

  20. God how I wish we had a president who put as much thought into ways to build our country up, as he does thinking of ways to tear it down.

  21. The legacy of Barack Obama, Mr. Johnson. Trump's is yet to come. I bet you won't like it when it does but will find some way to blame those not in office for it -- probably minorities and immigrants, I bet.

  22. If you follow Trump's itinerary, you can see that his primary guidebook to his presidency is to simply undo everything that Obama did. I don't think Trump will ever get over Obama's needling him at the White House Press dinner. People in Trump's orbit learn quickly that in order to stay in his good graces you must kowtow to him and praise him lavishly. You can see many world leaders doing it because they know it's the only way to get him to work with you on anything.

  23. Minorities, immigrants and the poor are always the go-to scapegoats of the wicked.

  24. Basic, low cost, relaxed standards, easy to get. This sounds like we are importing our health insurance from China.

  25. It is time Trump takes the Obamacare bull by its horns. He will have no one else to blame but himself if the executive order does not pass. Dr. Rand Paul, US senator from Kentucky has been working with the Trump administration on allowing Americans to band together and buy health insurance across state lines. With ex-president Bill Clinton the top democrat saying Obamacare is the craziest system on earth with the increasing cost due to premium rises and deductible increases, it would be nonsense to be in denial and not do anything to fix Obamacare if not replace it with a better plan and I would not like this Trump move termed as undermining Obamacare ,but taking out of Obamacare the restrictive mandates that do not enable Americans to have a truly affordable care but instead allows out of control monopolies to choke the American people by excessive profiteering off the backs of Americans.

  26. Affordable insurance and affordable health care are two, mutually exclusive items. Take automobile insurance: You can get cheap, and you can get good. Try getting both in the same policy.
    The difference is that in health care, you have no control over the future. What will make you ill next? Just the flu, or will it be a brain tumor?
    At least with a car, you have some control, and can see ahead of where you are.
    Additionally, auto insurance is a highly regulated industry. People are required to have some basic insurance, or they cannot register a car. And prices are regulated to some extent by various government agencies. Health care is the proverbial black box. When you have a medical procedure done, whether it be a checkup, or surgery, do you know exactly what it will cost in advance?

  27. Somebody that doesn't remember insurance rates rising 10 -15 present yearly before the ACA.

  28. Denise from Lafayette, LA. What I meant to say in terms of pass is it can still be challenged in the courts. Just like the travel ban was challenged and had to be reworded or rendered ineffective.

  29. I hope the American people take note of what is happening and reward the Republicans in upcoming elections with defeats.

  30. this is good news not bad.
    You democrats lied to everyone to pass your disastrous plan and now refuse to fix it. Premiums are skyrocketing, deductibles make the insurance unusable for most as well. Trump should be rewarded for having the guts to help people when congress is clearly in the pocket of big insurance.
    Every democrat and Rino needs to go.

  31. Neil, I'd like to think so, but don't bet on it. The GOP never seems to get the comeuppance it deserves...

  32. Wasn't it something like 26 Republican Attorney's General who sued claiming that Congress, not the President had the authority to overhaul the healthcare system?

  33. Silly--it's OK if you're a republican!

  34. A non medical person taking healthcare in his own hands - and with a presidential executive order!

    Fellow nurses - it is time for our Healthcare Providers March on Washington. Who else is in? Doctors, CNA's, NP's, PA's, anyone involved in taking care of patients. Let's go! Not only contained in DC but everywhere across this country. Let our healthcare provider voices be heard. We must protect our patients and fellow Americans!

    They gave us no hearings. They met in secret. And the opposition to ACA still did not survive. Donald Trump has no business dealing with the lives and healthcare of millions of Americans with his pen!

    This is a man who has never gone without healthcare insurance. He has tried to demonize the Affordable Care Act however he could find a way. Now this is the latest ploy.

    Anyone positively responding to this - you are being duped. You will be stuck with medical bills not imagined.

    More lawsuits down the road caused by someone who has no clue. Danger.

    And more people going without the healthcare treatment they need and deserve.

  35. Once again, this feeble excuse for a man attempts to kick sand at Obama, no matter the suffering, deaths, and economic wreckage he leaves behind.

    The most incredible truth about our country is not that we have this proudly ignorant and destructive man in the White House, but that a Congress so intent on un-leveling playing fields and on ensuring the wealthy never ever pay their fair share in taxes sits by while our country is destroyed.

    I’m a nurse too. I’m in, Mima.

  36. As President, Trump gets the most premier golden cadillac plan for him and his family. I hope he considers that while he jeopardizes millions of American families.

  37. On the one hand, I wonder if there's a benefit in continuing to save him from himself. How can he claim "fake news" when the market becomes destabilized and he's already announced that he's the one responsible? Those who cannot get their important health needs met will know the truth.

    Then again, the lives of our brothers and sisters. Our mothers. Our fathers. Our countrymen and women. Human life. Human suffering. It is hard to let go when it means letting go of our humanity.

  38. Unfortunately the Republicans have demonstrated innumerable times their skill at deflecting blame and the willingness of their "base" to believe them.

  39. He will blame Obamacare for the results, saying, as he has already said, that it was designed to fail after Obama left office. He will claim that any stories blaming him are fake news and his supporters and probably Fox news will agree.

  40. So the Republicans were right after all. Obamacare is nothing more than a transfer of wealth from young, healthy people who don't actually need health insurance to the old who use almost all health care provided.

    We were assured this wasn't the case when it was being passed. Next thing I am going to find out is that I will not be saving $2500/year and maybe I won't be able to keep my plan.

    Oh wait. I'm on my 4th plan since Obamacare was passed and I couldn't keep my doctor and my cost has increased from $6500 to over $30,000....

  41. Blame the Republicans for refusing to pass the necessary and proposed tweaks to strengthen and fix the plan and instead used every means possible to undermine it. You live in the one stupid country in the entire world that fails to and refuses to provide comprehensive health care to its citizens on the false and ridiculous premise that doing so protects their freedom.

  42. Short-term insurance policies are a travesty to consumers. I know this because my firm, Patient Advocators, gets the calls from people who bought them and are faced with tens of thousands of dollars in unexpected bills. Most people are not savvy enough to understand what is and isn't covered in these policies and then Murphy's law strikes (they get sick and become a consumer of health care).

    Allowing short-term policies just kicks the can down the road to bad debt for doctors and hospitals and personal bankruptcy for the policy holder.

  43. Short term policies are important to allow individuals to maintain at least some level of insurance while they are between jobs as an alternative to COBRA continuation. Most employees are astonished when they discover how much their employers are paying for their health insurance. Are there abuses? Yes, but it's unfair to paint with such a broad brush.

  44. Saying that health insurance companies like Obamacare is like saying that vampires like blood. Most fundamentally, the ACA is a program to provide free or highly subsidized health insurance to favored constituencies. One of the ways it does so is by forcing disfavored constituencies -- predominantly the young, the healthy, and those who don't get health insurance at work -- into very expensive comprehensive insurance plans they don't want and may not need. In economic terms, this is a pure wealth transfer. Is it any wonder that insurance companies will fight tooth and nail to require every American to have one of their most costly policies? Is it any wonder that those who bear the brunt of Obamacare are not fans?

    The sad Gestalt of American liberalism is that once an entitlement is created, any attempt to curtail or reform it will be characterized as cruel and selfish. I am a retiree (63) living without a pension, company health benefit or Medicare. I exist on money I saved during my working life. I don't smoke, maintain a normal weight and have no chronic health problems. I am forced by law to get my health insurance via the public marketplace. Only one such policy exists in my state. It costs $11OO per month for me alone and has a $6800 deductible. Call me cruel and selfish, but I would like to have a market alternative. Until one exists, I am just roadkill in the path of progressive politicians seeking votes.

  45. I’m not sure I have ever read a better description of the problems Obamacare caused for so many, myself included. Because I can’t get subsidies, I am one of 7 or so million people picking up the tab for every sick and unhealthy person out there at the expense of my own healthcare. I am forced to essentially make more than a mortgage payment on a nice house for a criminally narrow provider network. I am so much worse off than when this garbage legislation started, it’s hard to know where to start.

  46. Funny, I live in Casa Grande, Arizona and am also 63 and I have a plan for myself that I pay less then $500 a month. It does have a large deductible, but since I am healthy, I only have had to use my "wellness" visits which are covered. So don't know why yours is that high.

  47. He's beyond incompetent. He's spiteful as well.

  48. A malicious streak is common to most wannabes. Of the seven deadly sins (lust, gluttony, greed, sloth, wrath, envy, pride) there isn't one Trump has left out. He is truly a model for our children.

  49. Obama is trump's target. That and increasing the wealth at the top. He will do it any shameless way he can. That he can do these things makes our Constitution look meaningless. The Rule of Law has been dead since Exxon Valdez.

  50. Hey, Donald! You're supposed to be a businessman. Well, there's a saying in business: "You break it, you own it."

  51. The plan for ACA, anything else, and everything else, seems to be that there is no plan. Simply seat of the pants, how do I feel about this today sort of thought waves that are flogged as The Plan for The Thing.

    Just getting tired, and scared, of all the winning.

  52. The ACA is not imploding, as Republicans love to state as fact. The ACA is being deliberately exploded with the actions of the very politicians making this claim, starting with Trump. Deplorable and unconscionable!

  53. Sorry, but it absolutely has imploded for me and every other individual not receiving subsidies. That’s a lot of people who are from from rich.

  54. Medicare for all.
    Solves all problems.
    Covers all.
    Already working.
    Universal Health Care.
    All should be covered.
    A moral responsibility.
    Cost covered by all.
    Impeach Trump
    Wildly irrational.
    Malignant Narcissist
    Where are our members of Congress?
    Their responsibility to run the country.
    I believe they already know it.
    All they need is courage.
    I pray for them all.

  55. The problem, Rosemary, is that only 60% of the U.S. population over 16 (we all know how much 16-year-olds make) are employed in a country with a population of approximately 330 million, so one-half of the population (including those 16-year-olds) will have to foot the bill for the other half.

  56. GOP failed, failed, failed and failed again to pass health care legislation so, like a bitter, angry toddler knocking over another kid's block tower, Trump will destroy ACA rather than try to shore it up.

    This is very bad for America and Americans, especially many of those who voted for Trump and rely on the ACA. Sad!

    Republicans this is ALL ON YOU. If you can't replace it, fix it - and I'm talking about both the ACA and our president.

  57. Actually Jill, many Americans do not rely on ACA......They can't afford it or they have a very high Co-pay which makes ACA almost useless. The only Americans that could use this type of coverage, need an abortion, sex change or have a Pre-existing condition......All Uninsurable because the Risk cannot be Actuarial determined.....Medical Insurance is not a gift, it's a Business (To make Money)!!!....The Government can't afford to Provide it to all Free of Charge (Note the High Premiums and higher Co-Pay) So ACA requires everyone who has a Job to pay whatever it takes to make up the Loss for those who can't afford it (sort of like Socialized Medicine) which is Failing or has Failed in Foreign Countries.....Trump has the Right Idea, let the Private Sector, the Free Market provide Health Insurance on a Competitive basis while the Government provides Coverage for those who cannot afford even Basic Health Insurance!!!.....The Health Insurance Industry was Never Broken!!!.....They are still in Business and always will be........Good Luck....

  58. @Richard Frey... I am curious... what is your yearly income? How do you purchase your health insurance? Are you on Medicare? Before the ACA my husband and I HAD purchased private sector, free market health insurance and we almost went bankrupt... our yearly costs were HALF of our income! Buy it on a competitive basis? Really? My husband has small vessel disease and we couldn't purchase other insurance because they would either not cover us or the rates were double what we were already paying! A lot of citizens rely on the ACA as they are self-employed, or their employer does not provide insurance, or they are between jobs. (Don't get me started on the ridiculousness of having employeree-provided health insurance!) We are both self-employed and the ACA was a godsend to us. Our rates before ACA were $1,800/month and they are now $400/month. And, by the way, we do not have the need for an abortion or a sex change. P.S. I'm in Pennsylvania which offers a variety of plans and I realize that every state has different plans (or lack of) and different price points... that's why, ultimately, I am for Medicare for ALL.

  59. Trump, the petulant child, will do anything to get his way, especially as it applies to attempting to erase achievements related to President Obama; healthcare, protecting the environment, etc.

  60. The Birther-Liar-In-Chief continues his personal and political passion of undermining the greatest accomplishment of one of America's greatest African-Americans as foaming white crowds cheer wildly from the country's political junkyard.

    Deplorable.

  61. Wrong. I would recommend you do the fact checking.

  62. " Association health plans". Sure, Donald. Sounds about as useful and valuable as a degree from Trump University. A SCAM. Consumers may think they have actual medical insurance, but when they actually need the coverage, surprise, surprise, surprise. Is there ANYTHING this " person"
    Can't spoil???? I'm very serious. Please, Trump supporters, answer.

  63. Until you get that unexpected bad diagnosis tomorrow.

  64. " Healthy" means nothing when you're in a car accident or shot, SIR.
    Who pays then???

  65. People used to be able to purchase plans that were more or less consistent with their risks. The ACA changed this by forcing young people to subsidize the costs of older people, men to subsidize the costs of women, and for everyone to subsidize the costs of those with pre-existing conditions.

    Regardless of whether you think all of these changes were morally righteous they raised costs for a number of people, who not surprisingly didn't like it. Some of them couldn't afford it and stopped carrying insurance, which made insurance companies raise premiums higher, which made other people drop out.

    If we really wanted to cover those with pre-existing conditions, lower the costs for elderly people and subsidize costs borne exclusively by women, it would have been much easier (and of course honest) just to raise taxes and transfer the funds to the favored groups. Trying to do it through the insurance market isn't working. But the Democrats didn't want to own a tax increase.

  66. The people who come up with these schemes, and the people who want to buy them, don't seem to realize that "healthy" is relative, and can be fleeting. Anyone, even the young, can be "healthy" today, but stricken with illness or involved in an accident, tomorrow. These short-term plans, or plans that only offer sketchy coverage are bought by people who think they'll never get sick. But, just because you're 25 doesn't mean that illness won't come calling.

    This TrumpCare plan is a con. It forces people to gamble with their health and their financial future. We all want to put the blinders on and pretend nothing bad will ever happen to us, or our families. But, every day, someone, somewhere, finds out that's not true. You get what you pay for, and cheap insurance plans might end up being very expensive in the end.

  67. Most accidents have other insurances. If you are injured in a car accident your car insurance pays, at work the workers comp, etc.

  68. When are we going to talk about the root problems, a massively overpriced health care market delivering poor results largely because of unnecessary fragmentation and perverse incentives?

  69. More noise... I cannot wait for the tweet that will change the entire system.

  70. Trump was giving one of his evasive comments about how many individuals would be affected by his healthcare plans, saying well some people say...He does not have a deeper understanding of insurance than he did when he declared it would be so easy to replace the ACA.
    Trump's determination to destroy President Obama's legacy on everything from the environment to nuclear containment to healthcare is itself pathological.

  71. The truth is nobody really knows. Think of all the estimates of several varieties about the ACA that did not come true.

  72. Gee what a novel idea, insurance premiums based on the risk that the insurer has to take providing the insurance....just like every other insurance product on the planet.

  73. Making mere human beings the equivalent of a car or a boat or a house.

  74. So don't have insurance, stay healthy. And many of these insurance companies are non profits, as are many hospitals as well.

  75. The insurance industry does not control our health care. Prior to the ACA you had the right to pay your own bills (another novel idea). The vast majority of people who have private insurance don't even use healthcare equivalent to 10 percent of the premiums they pay in a year. You are literally paying for other people's poor lifestyle choices.

  76. "They are generally not required to provide “essential health benefits,” such as emergency services, maternity and newborn care, mental health coverage and substance abuse treatment, although many do."

    I'd be interested in knowing what "many" means. Because employers should be forced to make CRYSTAL CLEAR to prospective employees that bills for an emergency room trip for a broken arm or their infant's 105-degree fever, or the birth of any child they might have while employed there, would be completely their responsibility.

  77. Such are always pretty clear if you bother to read the documentation. Even when there was no regulation many large employers covered these things.

  78. The one consistency in this administration is to empower employers over their employees lives and freedoms. The NFL, the birth control payments, and now this. Employers now have the ability to control even basic rights of their employees.
    Libertarians spend so much of their time talking about government overreach but totally ignore the private sector’s attempts at economic enslavement of the general population.

  79. President Trump was elected in part because he supported Republican promises to repeal and replace the ACA. Congress has been unable to pass legislation to fulfill these promises. to date.
    President Trump's response is to make legally permissible and necessary changes to the ACA as did President Obama. Executive orders by both Presidents have national consequences and will have both desirable and undesirable effects, depending on point of view.
    Unattenuated by executive orders, the ACA would have been recognized as a catastrophic failure from its inception, including by its most dedicated supporters. The continuing poor performance of the ACA could be rectified by legislation but that would require cooperation of and compromise by both parties, which has not been achievable.
    Redesign of the ACA is necessary and will occur irrespective of which party is in effective control of the legislative and executive branches.

  80. Trump has no legislation to pass, because all the other portion that have been proposed by his primary adviser the FOX News do not work.

  81. The stark difference between President Obama and Trump is that Obama was being proactive. His goal was to get more people insured. Trump's goal should be to get more Americans insured while improving ACA, not repealing it. Trump is merely reacting to President Obama not because he is a Democrat but a man of color. Republicans did not support Pre. Clinton's agenda to pass healthcare reform, but they never demonized Clinton as they have done to President Obama. You can try to justify this hateful man's behavior, but the fact remains that Trump is motivated by his personal hate for and jealousy of President Obama, which is why he has sought to rescind other Obama policies, such as those regarding climate change. So stop making excuses for Trump.

  82. Great points but the idea that insurance could ever work to get these things done is what is incorrect. You can't do that!!!

  83. If Congress doesn't stop Trump, he will dismantle all the progress made by this nation, and set us back at least a generation. Maybe he will set us so far back that we will never fully recover.
    Trump's presidency is a case of a nation shooting itself in the foot.

  84. Thank GOD ALMIGHTY for that. All the recent progress made by this nation has been progress towards socialism. What will you do when you no longer have choices?

  85. None of the following are signs of a bicoastal radical left tearing the country apart:

    "it's faith and trust in our institutions, in truth, in civility, in decency and compassion, in the NSA, the DOJ, the FBI, the main stream news media, the Congressional Budget Office, Inspectors General, science, the EPA, CEOs in favor of the Paris Accords (including Fortune 500 companies), NOAA, you name it."

    Voters did not vote for any particular policy of Trump's. His were not very different from the policy proposals of most of the GOP candidates during the primaries. What set Trump apart was this tapping into anger, promoting divisions, and being as ugly as possible to Obama and Clinton. Oh, and painting a gloomy picture of America being laid waste to carnage. So very far from the truth!

  86. Socialism? Far, far, far from it. Maybe socialism for the rich, socialism for Wall Street which the DOJ did not go after aggressively enough. Far, far, far from socialism!

  87. He's not stupid. He's ignorant and self-centered and most of all a bully, and I would guess a rather influential bully as the legal chief executive.

  88. American People, please look at what you have done. Trump is your work, don`t blame anyone else, you alone did it. Do you still think of yourselves as exceptional? Shame, shame on you.

  89. Besides such an order being illegal, the only one to benefit would be the cons like the moron who sell policies with no coverage, are under-secured and declare bankruptcy when its time to pay claims.

  90. We get it. Trump will undo anything that a black man did no matter what a good thing it was. Trump is that racist. Should we just accept his racism and find a Plan B or should we get rid of him? I believe he should go.

  91. Oh, please.

  92. No, you don’t get it. That’s the problem...

  93. Echoes of Trump University.

  94. Repeal and replace trump!

  95. As an independent engineering consultant, I run my own business through an S-Corp. ACA has worked out exceptionally well for my firm. If the ACA gets crippled via executive orders, I'm sure we'll change plans. And fortunately, we can afford whatever is thrown at us. However, I'm having difficulty imagining poor, rural America gaining any benefit from these actions by Trump. Is rural America simply dumb, ignorant, jealous, racist or uneducated? I'll go with everything listed because nothing else makes sense.

  96. Yes, rural America is all of those things. Don't forget hypocritical, as many of the Red Hat brigade are on Medicaid or collect SSD benefits.

  97. XXX, rural America is desperate. It was ignored by establishment Democrats, manipulated by establishment Republicans.

    The good factory jobs went overseas to low wage countries, low-wage workers immigrated here legally and illegally and reduced wages in occupations that were left. Blue collar American workers found themselves dropping out of the middle class.

    It was the failure of those of us who are educated and prosperous to recognize this that led to the victory of Donald Trump, and we, and the country, are now paying the price.

  98. Much of rural America prioritizes life with the following: God (their God, not someone elses), Guns, The Military, The Police, The Firemen, Truck Drivers, Whites, while disdaining liberals, anti-war protesters, non-christians, hollywood, non-whites, LGBT, and women. Dumb as he is, Trump is their man because he checks off all those boxes.

  99. So spiteful is Trump of our first black president that he is willing to jeopardize the health of millions. Trump should be impeached immediately. Whoever is harmed by these measures should know the cause of illness and death is the GOP and Trump.

  100. Hoxworth: Odd, my search of the internet shows that under ACA, life expectancy edged up.

  101. well said!

  102. Hoxworth, where is your evidence that the ACA is not improving health?

  103. Want real change you need real action.
    General Strike until this playing with the American peoples lives ends.

  104. Go for it, don't expect to eat very well.

  105. The president doesn't want Obamacare to work so he's going to utilize "the power of the pen" to destabilize the ACA and then justify why it failed. As expected, in spite of multiple failures of Congress to repeal and replace Obamacare, the president refuses to give up his campaign to destroy Obamacare and is taking not a pen but a bulldozer to make good on a longstanding Republican platform pledge.

  106. The GOP leadership has deluded itself into thinking that at some point Mr. Trump will either mature into the job, or become docile and allow folks with better judgment to make Presidential decisions for him. Neither has happened, and our government operations are spinning out of control.
    trump is dead set on destroying our international relationships, our healthcare, and our long term budget. His efforts with Congressional assent are undermining our society and what it stands for in the world.
    For Gods sake, yesterday he went after the first amendment and our nation's news media. NAFTA, immigration, the Paris Accords, the ACA, the EPA, and our national parks are all being threaten or changed for no good reason. Congress does nothing but wait for that big tax cut they promised their moneyed backers.
    America is in trouble.

  107. Nobody with half a brain thinks that. He promised some things and now by whatever means possible he is going to deliver. The US is not in trouble, but rather we see some light at the end of the tunnel.

  108. I'll agree with the "by whatever means possible" part of your response....legal or illegal Trump is on the take.

  109. The light you see is a nuclear explosion, which is the last light you'll ever see.

  110. Hey, a guy who knows nothing about health insurance markets and cares zero about what happens to actual human beings who need coverage, mucking around with a system that comprises one-sixth of our economy.

    What could go wrong?

  111. Trump will do anything to erase Obama's programs.

  112. For Trump, it’s an opportunity to push people around and make a few bucks at the same time.

  113. I don't know, you weren't too worried about another guy who knew nothing about health insurance, nor anything about running a business, or dealing with employees, or competing markets etc? AT least President Trump has Held a Job! Run companies! Hired people! Provided health care for his own employees! Has NOT been on the government dole for his whole adult life! Give him the same chance you gave the nobody from chicago - show your integrity

  114. I've owned a small business for 31 years. Decades ago I joined an association health plan. One of the families in the plan had a child born with catastrophic health problems. My premiums quadrupled a year later. That was the end of that.

    Even if Trump's ploy weren't motivated purely by malice, it's still not a panacea.

  115. Nothing is a silver bullet, now if that family had some support from government and charity your group probably would have been fine.

  116. This is why risk needs to be spread over the entire population, as any rational country does.

  117. Premiums increased under President Obama. While it's easy to blame President Trump, the trend of fewer companies offering fewer plans at increased rates continues from one presidency to the next. There are structural issues in the ACA that neither party wants to address.

  118. Massive job losses also continued from the George W. Bush administration into Obama's. However, the impact of Obama's initial financial interventions, however imperfect, was to put the brakes on the rate of job loss.

    Similarly, the ACA banned practices that redlined people with a history of expensive healthcare issues (effectively reducing their costs from full out of pocket expense to some greatly reduced expense as part of an insurance plan) and gave positive and negative reenforcement to encourage healthy people to get insurance with mandatory preventative care provisions, thus reducing the per capita burden of the insurance pool while reducing demand for expensive chronic illness treatments.

    It was a first step in stemming the tide. It was also a capitulation to insurance companies that had created the dangerous and anticompetitive market conditions in the first place. It does need tweaking and some propping up. But even if it is left alone, from a public health and total cost of care (or lack thereof) standpoint, ACA is still better than what the insurance companies were doing without such regulations. Even in regions where premiums are escalating and insurance providers are scarce, the affordability of plans offered through employers has been found to benefit from the ACA. It is a net positive intervention in a complicated and often dangerous insurance marketplace.

  119. Just how well did block grants to Tennessee work? Your health scores are lower that the national average BTW, Tennessee gets more Federal money than it pays in taxes, yet ti condemns all the federal programs and claims that its federal taxes are going to larger states. Why should the rest of us pay for your health care?

  120. Premiums increased EVERY YEAR FOR EVERYONE FOR THE LAST THIRTY YEARS !! Where we're you??

    What changed under ACA was that more poorer working people finally were able to buy subsidized.

    My employer coverage and then my selfcoverage went up annually.

  121. Everywhere this man goes and everything he touches, he brings anger, frustration, despair and destruction. He has no capacity for nor any desire to improve the lives of any of us, with the exception of himself. As such, he is unfit in every way for this office. He needs to be removed and/or driven from office by any (legal) means possible.

  122. Yes to you and your associates, some others are happy and just want these changes much more rapidly. And so far there are no legal means possible, so perhaps you should just adapt.

  123. Ditto

  124. Putin could not have done it any better.

  125. The relentless attack by Republicans on the ACA will only lead to high healthcare costs, not lower, and will push low and middle income people to going back to using the ER as their main source of healthcare, the most expensive manner to do so. Where the attacks on the ACA by Republicans is supposed to lead is never articulated but is intended to play to their unenlightened , white base, who know nothing of healthcare financing. This is just another attack by white racists and insensitive Republicans on the black and poorer members of our society.

  126. Oh, that's right. I forgot, healthcare costs were dropping by 15% per year under the democrat administration.

  127. Perhaps you could cite some examples of whom 0bamacare has really helped.

  128. The vast majority of people do not know that the people without insurance using the Emergency room costs the rest of us an astronomical amount of money.

  129. Perhaps if NYT and others would stop referring to the ACA as "Obama's signature achievement" the President and his cohort could assess its merits and deficiencies more rationally.

  130. What you propose is giving in and giving up! Giving in to Trump rewards his crazy behavior. We MUST expect more from our president. This man is stark raving mad and dangerous. You don't just make it OK for him. Your suggestion would not work because he already knows that the ACA is Obamacare AND Obama's signature achievement. The biggest reason your suggestion won't work is because he & his band of misfits are incapable of thinking rationally.

  131. You couldn't include the partisans on the other side, now could you? Why?? OH, they are not to blame of course, it is only "the President and his cohort."
    Keep drinking the kool aid, my friend. One day it will have the desired effect, I am quite certain.

  132. President Trump is determined to destroy this country.

  133. Putin could not have destroyed us any better.

  134. Long overdue, now get the full time to be 40 hours, eliminate vast things that are "essential services". The idea that insurance would ever address the desires of many to have affordable care in any and all circumstances. It could be affordable for healthy people, and perhaps some subsidy for those with serious medical issues.

  135. To paraphrase -- let the poor stay sick and suffering

    Nice Trumper!

  136. The ACA is the law of the land. When Trump takes action to impede or sabotage it, he is violating his oath of office. He does not get to pick and choose which laws he will or will not administer. That way chaos lies. He is the executive whose job is to run the country. He needs to quit tweeting, quit show boating, and do his job.

  137. What of the Immigration Laws "of the land"? I suppose you support every executive order 0bama signed that thwarted many "laws of the land"..

  138. You should probably do some homework on your conclusion. Most of the ACA is left to executive action and decisions by unelected and unaccountable bureaucrats.

  139. "He does not get to pick and choose which laws he will or will not administer. "
    Sorry. The previous administration did just that. Principled people on the left pointed out at the time that President Obama would not be the last president.

    But his supporters ignored that. They (and I include the NYT) said that President Obama had _no choice_ but to go it alone on (insert issue here) because Congress refused to act (pass the law that President Obama wanted).

    Executive orders and administration decisions are a clumsy way to make changes. But Trump gets to use them just as previous Presidents did.
    Goose gander; pot kettle.

  140. Dear Trump,
    Many of us work for companies that do not really have our well being at heart. Please do not do anything that would raise our premiums or cause us to have less coverage. We wanted change, yes. We wanted something that was better and cheaper than Obamacare. Please give us what you promised.
    From a concerned citizen that pays way to much for what I have now.

  141. You'll be able to go into a HSA now & save a bundle.

  142. To ask a malignant narcissist to "do what you promised" is like asking a 3 year old to clean up his room. It is literally impossible. The combination of his warped psyche and a lifetime of indulgence and privilege ("spoiled" doesn't cover it) has created a kind of anti-decent human being., and non-voting made this monster OUR PRESIDENT.
    If you stayed home when you should have voted, if you fell for the "pox on both their houses" propaganda, YOU are to blame. Make up for your error and throw every ounce of energy you can brew up to make the midterms next year the biggest rebuttal any politician ever received. VOTE!

  143. The problem with "healthy" people, no matter how young and in great shape they are, is that they can turn into seriously ill or injured people in a heartbeat. And then their job (or their family's job) is to find a way to handle crushing medical bills and treatments that aren't covered in a low-priced "junk" policy.

    A person's life shouldn't be ruined by a financial crisis when they are trying to recover from, or learn to live with, a catastrophic health event. And whatever level of treatment they eventually manage to get will undoubtedly be underwritten by taxpayers.

    Single-payer NOW, to support people's health needs from the time they are in top physical condition to when (inevitably) they AREN'T.

  144. HSAs are a better answer.

  145. Only if you have that kind of money to put away. If you put away the maximum, and live a relatively low-care life (medically), you can end up with a ton of money that could help take care of a major illness. But if you can't afford to put away the max (what is it, around $5k a year?) you'll end up spending it as you put it away. And while it becomes an investment fund, wouldn't you rather invest in money to live on, rather than to hand over in huge sums to hospitals?

  146. So Trump will rally his base by telling them he single handedly overturned Obamacare. The damage will not become evident until after the 2018 elections. People will not realize what kind of coverage these association plans have until they need to use them, and then it will be too late. Cheaper plans are cheaper for a reason. Most have high deductibles, co-pays, and often only pay a percentage of medical costs. When illness or an accident strikes, is when it becomes evident that these plans provide nothing more than catastrophic coverage, and only a portion of costs will be covered. People will face enormous medical bills, and some will have to make the decision of whether or not they will have a life saving medical procedure.
    Congress has let the people of this country down, and now Trump is playing king. Will no one challenge him?

  147. I'm a licensed insurance agent and the whole ACA experiment has brought nothing but misery to my clients. It was designed to fail from the beginning and it started collecting taxes in 2010 and didn't cover the first person until 2013. The authors of the ACA did not understand how health insurance works, is priced, or is even sold to my clients. Anyone defending the ACA is merely parroting partisan rhetoric and clearly NOT looking at the facts.

  148. The ACA is flawed but some of those flaws were because of deliberate republican sabotage for things they had supported as recently as February 2009 (Wyden bills in 2008 and 2009). If republicans had worked together with the administration on this and other crucial issues, we'd all be better off.

    Other flaws were because it was a first step (Obama has stated as much), improving access, and the hope was that the other necessary pillars of healthcare reform would follow. Any discussion about it's real shortcomings, however, were drowned out by conservative screeds of socialism etc., and both parties adopted a dig in the heels against any change strategy.

  149. I think we all understand that the PPACA cut into the private medical insurance agency business.

  150. @Robin Lee: I've been a freelancer for more than twenty years, ten of those in Europe, where health insurance was never a problem. When I returned -- a decision I regret increasingly as time passes -- health insurance was borderline affordable. I was able to get a policy with BCBS that covered me and my son for just under three hundred dollars a month. Expensive, but do-able for a single parent with one income. Fast forward a couple of years, though, and soon the cost of that same policy was approaching four hundred dollars. No longer affordable on my income. I had to drop my insurance and insure my son through CHIP. Paid for my own medical expenses out of pocket. No big deal, right? I'm healthy, in excellent shape, under fifty, no major health issues.

    Fast forward again: I'm over fifty and anemic, but can't afford to get the thousands of dollars worth of lab tests my doctor suggests. Am taking iron supplements instead, which aren't much help. The ACA comes into effect, we qualify for subsidies, and for the first time in several years, I have insurance again. Less than a week later, boom, am losing blood rapidly. In a few hours, I have a cancer diagnosis and a twelve thousand dollar medical bill. Which my ACA insurance covers.

    Three years later I'm alive and cancer-free because of the ACA. I'm also now uninsurable by your industry's standards, despite the fact that I'm in good shape. You will literally have to go over my dead body to take my ACA insurance away from me.

  151. Something tells me that corporations will be very cautious about selling anything that is beyond what the law requires.

    Corporations won’t be able to call on Trump to protect them from lawsuits, if they deny care that the law mandates.

  152. Not corporations - - little associations of small biz owners who will get suckered into buying trash policies

  153. Now we're finally knocking down the bowling pins and that's exactly how Obama did it.

  154. I prefer not to think of my fellow Americans as bowling pins, thank you very much.

  155. Forget his campaign's collusion with the Russians. This guy is carrying out the Russians mission singlehandedly by wreaking havoc on our federal government and under minding everything that is good about our system. Does he really hate Pre. Obama so much that he would seek to destroy all of his accomplishments? And to think that Pre Obama is half white, I can only imagine how he would have been treated if he were black. Oh right, he would not have been elected.

    Nonetheless, if Pre Obama had said or done any of the things that Trump has done or plans to do, Republicans would have begun impeachment proceedings a long time ago. The fact that this privileged, but uneducated and incompetent, white male can get away with such deplorable behavior and be rewarded is another example of white systemic racism. He needs to be stopped, and Republicans who enable him should not be rewarded with re-election.

  156. Lesson learned from this Presidency: never elect a deeply insecure, incurably flawed, and monstrously unhappy person again.

  157. Lower insurance costs for the healthy. That alarms Democrats?

  158. DO you remember junk bonds? Junk mortgages? The economic crash of 2008?

  159. No one is healthy forever. That's why we buy insurance. Trust me, you'll need it some day. If you don't have the coverage and can't afford to pay your medical costs, those who do have insurance will end up paying for you.

  160. Why should a single man or older couple be forced to purchase plans that include maternity care? Why should a younger person be forced to buy a plan that is more accurately priced for someone thirty years older?

    That's not insurance. That's wealth transfer.

  161. Civilized countries figured out long ago how to provide universal healthcare. What's so-called "Christian" America's problem?

    For Trump, though, this isn't about providing great health care. This has nothing to do with health care. This is the vindictiveness of an infant who's been seething with anger since his predecessor dared to make fun of him in public. Donald Trump is a very dangerous man; he's driving this country towards the cliff and we're just sitting here, letting it happen.

  162. Let us not forget what provoked the "making fun of" in the first place. It was Donald Trump who jumped on the birther bandwagon and took it to the extreme. It was Donald Trump who tried and is still trying to delegitimize the Obama Presidency.
    He can dish it out, but can't take it from anyone. And if you're a black man or a woman, or anyone he feels is inferior to him (and that's a pretty large pool), he complete goes off the deep end.
    He's worse than an infant. Infants grow out of infantile behavior.

  163. Cool heads, everyone! Yes, this wrong and harmful, and we should clearly say so. But it is also another provocation designed to illicit anger and hate, which is what energizes the 37% and convinces them they are victims of a culture war. When we take the bait, we help Trump propagate hate.

    Trump is destabilizing health insurance markets in any way possible. I think part of his idea is to make things so uncertain and unaffordable that if the ACA is repealed, the lack of government regulation and protections will be less painful than the chaos and costliness Trump is creating. For that reason, it is important to clearly note the damage being done and its source, every step of the way.

    I did not see that the new order undoes pre-existing conditions protections. Does anyone know if that is in or out?

  164. You're entire statement is based on false premises and is invalid on its face. The ACA was designed to fail. It was designed so that when Hillary Clinton won election in 2016, she could usher the US into the Single Payer system the people have been rejecting for the last 100 years. Trump doesn't have to do ANYTHING to undermine a law that is failing and will fail, guaranteed -- it's written into the law! Why do you think Obama kept having to illegally and unconstitutionally delay parts of the Un-Affordable Care Act? It's because it was failing TOO fast, and there was no way under the written language of the law it would have survived until 2016 for Hillary to offer single payer.

  165. Over time, it's out: the whole point is to undermine the PPACA on behalf of sleazy insurers.

  166. As long as Donald occupies the White House the United States will have its ideals under attack and become more divided. We're stuck with him, love him or hate him, so let Donald have his way with health care. He's going to roll up his sleeves and attack the problem that even he admitted was "more complicated than anybody knew". Trumpcare will serve only the affluent, low risk, with no preexisting conditions and will drive up costs for the rest. Fine. It will seal his legacy of incompetence and help convince a large swath of his supporters what a blunder it was to cast their votes for him. There will be pain and suffering, but having him in office hurts anyway and is slowly driving us all mad.

    Since he's in a problem solving mood, maybe he'll put on his hard hat, pick up a hammer, and go to Puerto Rico and fix their problems too.

  167. We might share the same ideals (which tend to be human ideals), but we do not share the same ideas on how to accomplish those ideals.

  168. Wasn't the GOP always constantly criticizing Obama for his go-it-alone dictatorial mandates? Why are signing statements strong leadership for Trump, but evil when Obama produced them? Why does the budget deficit and US debt no longer matter, when it comes to more tax cuts for the rich?

  169. That is the problem with politics, both sides complain when the other side does what it wants.

  170. I pose the same question back to you. Why was it ok for Obama, but not ok for Trump?

    Alas, I think our circular logic is just a means to our ends.

  171. Trump claims to be a great and wise businessman. Of course, he is neither, given that many of his companies have failed and that he has made many of his billions of dollars by stiffing contractors and others who blindly supported his vision.

    Now this business Cheat thinks he's got the perfect health-care plan -- and further, that he's the only person with enough foresight and brilliance to craft it. Of course, on the contrary, his executive order will cause the U.S.'s generally stable insurance markets to destabilize, and will shut out hundreds of thousands or millions of Americans from affordable health care -- especially those who suffer from preexisting adverse health conditions that require ongoing care: and the financial resources to deliver that care.

    One more failure from a businessman loaded with failures.

    One more failure from a president who keeps failing the nation.

  172. "...Democrats and some state regulators are now greeting the move with increasing alarm, calling it another attempt to undermine President Barack Obama’s signature health care law."
    .
    Greeting with alarm? Not because Obamacare is collapsing in front of everyone. No, alarmed because President Trump, not nearly the cast of perfection that Obama is, deigns to fix it. Trump only took on Obamacare, because he knew if he just let it collapse, millions of people would be hurt.
    .
    And, That's What Happened.

  173. Incredibly underinformed.
    Trump is doing his best to make sure millions have no coverage.

    He is trying to kill the existing with no replacement.

  174. Thanks. The image of Brave Prez Trump Boldly Striding Forward Out Of His Lordly Concern for the Little Folks brought a happy smile to my face.

  175. My guess is that you are choosing to ignore the collapse of many states, and/or the consolidation to one or two providers within states as being some kind of evidence that there is a significant problem, aka collapse. I understand disagreement on Trump's using of the pen to circumvent the democratic process, but let's at least not deny the sun rises in the east.

  176. So why is it that it takes a President and a majority of votes in both houses of Congress to pass affordable health care but only one guy's "administrative order" to screw it up?

  177. Because both houses of Congress have been engaging in stalemate politics since 1992?

  178. He is making it better. For the past four years my family has spent about 18K on health insurance and we are very healthy, no meds or anything out of the ordinary has occurred. This is after tax dollars which is ridiculous that a family should spend this much. I work for a small business and this is the only thing that might help us to receive benefits affordably. Trump is a chump, I'm not a fan of him, but this is one of the few good things he says he will do.

  179. Stu, you are truly misguided if you actually think that the AHCA was affordable. It crushed millions of Americans budgets and left people scrambling to find doctors when theirs were taken away. It has been nothing but a massive failure.

  180. The tyranny of the minority.

    President Obama won the 2008 election with 10 million more votes than McCain.

    President Trump lost the 2016 election by nearly 3 million votes.

    Tyranny from a little man, Trump, a feckless coward of a president.

  181. Welcome to the Imperial President.

  182. I'm not defending Trump but Obama did the same thing. Many times.

  183. I think Obama held that title for 8 years.

  184. Forcing me to buy more insurance than I need is just another tax. I vote for the freedom to buy a "junk" car that serves my needs safely, and "junk" insurance that covers catastrophic events ONLY. I can pay for my other health expenses out-of-pocket. This is the prescription that will bring costs down for everyone.

  185. Does catastrophic health insurance cover cancer care? For how long?

  186. TM- Nobody is forcing anybody to do anything. You may be feeling healthy enough to think "junk insurance" is good enough a personal option for now, but in the future may end up having to swallow your words with some very expensive medicine.

  187. No. What you are describing is taxes, not insurance.
    Insurance is supposed to be priced and purchased according to your chance of experiencing certain catastrophic events. It's not about the common good.

  188. Trump knows more about healthcare than any doctor, patient or insurance company, more about international relations than any diplomat and more about war strategy than any general.

    He is a Colossus among men, perhaps the brightest man to live in modern times, certainly the most accomplished business person of our day and the nation is incredibly fortunate to have him as president.

    (DJT thoughts to self upon awakening)

  189. HILARIOUS. But.

  190. Send that post to Trump, you will get a job offer for Secretary of State.

  191. A move that will personally benefit me. I am a 51 year old male in great health and was paying $168 per month for healthcare before Obamacare. Now my deductible has doubled and my premium is $389 per month. But on the bright side, I now have maternity insurance in case I am the first man in history to ever get pregnant. The more Democrats fight common sense moves like this the less likely they are to ever win an election all the way down to dog catcher.

  192. Great health can change in a flash and accidents, even ones that are easily survivable, can run up great cost. None of us are immune from those risks. As long as you can pay the possibly immense out-of-pocket expenses that bare-bones coverage leaves you with, go ahead, take your chances.

  193. You weren't getting insurance for $168 a month; you were getting insurance for that plus what your employer paid.

    Your employer increased your deductible to lower their costs, and cut the percentage that they paid.

  194. Or when your wife or girlfriend gets pregnant. Insurance isn’t just for you. It’s a risk pool where we all share in the risks and benefits. That’s the basic concept of insurance. Since it would appear that you don’t believe in this concept, then perhaps you shouldn’t buy insurance at all.

  195. "Large employer-sponsored health plans are generally subject to fewer federal insurance requirements than small group plans and coverage purchased by individuals and families on their own. They are generally not required to provide “essential health benefits,” such as emergency services, maternity and newborn care, mental health coverage and substance abuse treatment, although many do."

    This is an aspect of the ACA I was unaware of, one of the many real shortcomings with the ACA that should have been talked about but got lost in the nonsense conservatives have raged about for 8 years (the items raged about were al present in bipartisan sponsored bills prior to the ACA, e.g., the Wyden bills). It's a market distortion, plain and simple, unequal treatment, unequal regulation that makes insurance plans more expensive for individuals and small businesses not just because of stricter regulations but the lower standards for large businesses raise the costs of higher standards for everyone else. This article, however, does not talk about the WHY - I assume it is because the Obama administration did not want a bigger fight on its hands, with more politically powerful large businesses.

    The solution should go in the other direction - have the same hig standards for everyone, which will raise the costs for large businesses some but lower the costs for everyone else. We'd all be better off, but that's not going to happen any time soon.

  196. Trump has openly shown his opposition and disdain for American Democracy and the Constitution. We all, whether on the Right, Left or Center, must fight Trump's goal of ending American Democracy.

  197. it's been said before, but it can't be repeated enough. The President and members of Congress should get the same health (or non health) care they want for everyone else.

  198. Yes they should, but that would require that they think of other people less fortunate than they are, and that may be a bridge too far for most of them except a few like Bernie Sanders.

  199. I must first qualify this post by acknowledging that I lack the understanding necessary to really evaluate the issues the article addresses. That said, I wonder whether there isn't a legitimate clash of values here, as opposed to Donald Trump simply wanting to attack our healthcare system while strafing sick Americans in the process.

    He seems to have one clear priority: The immediate financial needs of small businesses are more important than the needs sick Americans have for expensive treatments that can extend their lives and eases suffering. This is a tough position. I don't agree with it. But it's not indefensible.

    As well, there may be a wider agenda: With our aging population in the throes of a chronic disease epidemic, that will persist for decades, we simple can't afford to pay for comprehensive medical care. So we shouldn't try. Many Americans will die younger and suffer more, but the monies are needed elsewhere. Again, a difficult, perhaps even heartless, position: But not one that is indefensible.

  200. "the monies are needed elsewhere."

    I'm sorry, where exactly is that? In the $700 Billion, with a B, that we are spending on the military - a $70 Billion, again with a B, increase over last year.

    Or in the $678 Billion, another B, tax break that the wealthiest Americans will get over the next decade.

    Yes, we shouldn't try to help people live longer, better lives because that's what civil societies do. Just ask anyone in most of Europe and Canada. We, on the other hand should just build more multi-million dollar tanks and give people who don't need a single dime more money to spend on diamonds and Ferraris.

    Sounds like a great plan. And, it is completely indefensible.

  201. @ MikeB26 (second comment)

    Thanks for your reply.

    I have to admit that I don't understand what you mean by "treatment on demand" for poor people. In all Western countries, the poor are taken care of, in the sense that they get affordable healthcare. So why couldn't the wealthiest country on earth do the same? What exactly is the problem here, in your opinion?

    And yes, with poverty often comes a lifestyle that undermines your health, precisely because poverty means not having enough money to buy healthy food, living to far away from places where they can be bought, and having poor access to information so ignoring how and why to live healthier.

    But it's not as if there's nothing that we can do about this. Michelle Obama's focus on these issues for instance has already changed a lot.

    All these things don't have to do with making insurance affordable, though, whereas that's what Trump claims to do here.

    So the question remains: HOW could you argue that his decision will achieve his promise (making HC affordable to more Americans than the ACA does)?

    Imho it's pretty clear that you can't ...

    In the meanwhile, let's remember that under the ACA, it's not poor people who don't have health insurance (overall), but those working poor who earn just too much to be able to receive ACA subsidies all while having to buy insurance on the individual market, so that's the problem that urgently needs to be solved. Instead of doing so, Trump is doing the exact opposite here.

  202. Show me where the (counter?) argument you're advancing has been made by any politician but specifically one that's a backer of Trump's non-existent healthcare plan that he claimed was cheaper, better, and would cover everyone?

  203. A question is how many members of the Trump Gang have shorted; taken long positions in put options; and/or written call options on health care companies in anticipation of the potential negative impact on their earnings. Can you say "insider trading"? Perhaps this is their primary motivation.

  204. Gee, ya think anyone in the Trump Administration will investigate any illegal insider trading? LOL My money tells me that those who should be doing the investigating have already made sure they can cash in.

  205. All the more reason for a single payer system subsidized with a progressive tax structure.

  206. Use your vote to gain benefits for yourself that someone else pays for. Bankrupting democracy.

  207. You're paying for it? I'm not.

  208. Why would I want to give up my employer based coverage AND pay higher taxes? How is that good for me?

  209. I hope this can be tied up in the courts until the end of time.
    Come on, Congress get with it and try to improve the ACA.

  210. This reveals a singular weakness of the Affordable Care Act and is actually a good example of why it should be replaced. Had Mr. Obama been a more seasoned politician and President, he might have foreseen this possibility and preempted it.

  211. How quickly will his executive order be implemented? Before 2018 mid-term elections? Doubtful. He wouldn't want to do more damage to Republicans than he's already done. During his term (assuming he makes it 4 years)? Probably and right at the end. trump won't run again (even if he's able to) and this will be a wreck for whoever comes next. The only hope is that trump's order will be sloppy and technically weak, because his team is compromised of B and C players, that it's a non-starter and won't hold up to a legal challenge.

  212. Is this fantasy or a lack of basic understanding? Or both? I think it is called cognitive dissonance. One must start with the basic premise that health care insurance is not a "market." The costs will be borne by someone, somehwere. Are the American people so entranced with the shell game that they fail to recognize that we have the largest and best "association" right in front of us. It is called The United States of America. Medicare for all and an all in effort to rein in medical costs is the only solution that works.

  213. I would like to have a low cost option to my family’s current health care insurance, which has been rendered virtually useless via increased deductibles and premiums the last eight years. I am a middle class taxpayer, who has actually paid higher taxes via these increased premiums and deductbiles. I voted for Obama and Obamacare because of the “promises”. It was a costly mistake. It remains to be seen whether Trump was another costly mistake. I am also amazed that the media does not make a bigger deal out of the fact that Congress receives a 75% subsidy of their Obamacare, at the middle class’s expense - it is simply wrong.

  214. In real life, Obamacare insures 20 million Americans more than the previous system. That's 40,000 American lives saved a YEAR.

    Overall, it also slowed down cost increases (for the federal government as well as for citizens buying on the individual market).

    You cannot take these facts into account and then call it a "costly mistake".

    It's just that indeed, the law simply isn't perfect, it was the best that the Democrats could do at the time, knowing that the GOP was investing millions in spreading lies about it. So yes, it still can and should be improved.

    But that doesn't mean increasing premiums for people who need HC, as Trump is doing here, it means expanding the Obamacare mechanisms that allowed it to insure 20M more Americans.

    A mere $110 million tax increase for the wealthiest Americans (= something they won't even FEEL) has been shown to allow people like you to get enough subsidies to make the current insurance plans affordable for you too.

    So that's what Trump should do, rather than destabilizing the individual markets even more and making insurance once again unaffordable for sick people.

    As to Congress: its members are part of a pool large enough to directly negotiate with insurers, so like all large businesses, they get insurance through their employer, whereas Obamacare mainly has to do with the 20% of the American people who don't get insurance through their employer and as a consequence have to buy it themselves on the individual market.

  215. It seems some people commenting here do not know how health insurance works. If you have health insurance and pay a monthly premium you are paying for everyone not just yourself. This is why premiums, co-pays and deductibles go up across the board. Donald Trump apparently doesn't know how health insurance works either.

  216. Insurance is to cover the risk of something very expensive occurring. It is not to cover the costs incurred by people who have high costs when they sign up, and who therefore need medical care, not insurance. That is the way all other insurance markets work, and the way the health insurance market worked pre-ACA.

  217. Not sure what point it is you're trying to make. I worked at Blue Cross of Wisconsin for 10 years. I stand by my comment.

  218. maybe someone smarter can explain this to me. Obamacare repeal failed. Twice. The law remains in effect. Now he simply plans to undermine the law? How is it, that the law isn't being enforced?

  219. (Actually, repeal failed about 60 times, going back to the last admin).

  220. Like so many of his stupid ideas, this one will be stopped by a court. More taxpayer money wasted on his vanity, immaturity and truculence.

  221. Trump and his Cabinet are clearly showing they don't care about wasted taxpayer money. They are the rich, priveledged upper crust who live by different standards than everyone else. "Drain the Swamp"? They ARE the swamp.
    What a disaster this presidency has been so far, and it's only just started.

  222. Our once Democratic government has failed. It does not matter anymore the selfish cruelty the recent Republic congress had imposed on us. They are fascist criminals and the only honorable thing to do is for intelligent Americans is to move to Europe where a few people are still stable.Many Honorable Americans have already left!

  223. Everytime I think we have reached the bottom of the hole of stupid remarks, our cartoon-like president digs it deeper.

    Does he have any comprehension of how rules and laws in our democracy works?
    Perhaps tomorrow he may even forbid the sun to rise!

  224. Trump's war on America continues.

  225. Red-state pundirs can now never again complain about Obama's executive orders. Let's stop with the double-standard, GOP: Either healthcare policy is approved by majorities in congress or it's not approved.
    Trump is a hypocrite.

  226. Of course they will keep complaining about Obama's executive orders.

  227. These tactics are just plain mean. Trump is a bully--always has been, always will be--and he has finally gotten the power that he has only dreamed about. No wonder nobody likes him.

  228. How was Trump "foiled" in Congress? He put a pathetic amount of effort into the whole debate, aside from a few moronic tweets. The real reason it failed is because the GOP majority in Congress spent zero time whatsoever working on an actual replacement for Obamacare.

  229. Because, as we know, since it's got Obama's name on it, it's got to go. That's the whole point of this exercise. Donnie got made fun of at a White House Correspondent's Dinner and is now exacting his revenge for everyone laughing at him.

  230. Trump must be removed from
    Office before there is a majority uprising.

  231. I'm afraid the uprising will occur if he is removed. Remember who has all the guns.

  232. well, if Fake president is not discharging his duties, isn't that a reason and a ground for impeachment?

  233. Soon the country will collapse economically and yet the Republican Party has done nothing to save their party and remove Trump from office. Why!!!

  234. I am exhausted by this man's mental illness and cruelty. Everyday is another assault. It has to end.

  235. If ObamaCare is a horrible as the GOP claims why haven't they repealed and replaced it with the various Better, Cover More, and cheaper plans,..they've been screaming about for more than 7yrs.

    Even POTUS Trump claimed/s he has a better plan, cheaper, covers everyone,..

    Obama isn't stopping you from succeeding. He's chilling on a beach.

  236. When millions of elderly people who voted for conman/serial sexual predator/bigoted Trump because they couldn't get past their own old-fashioned prejudices, suddenly find their healthcare rates are skyrocketing - excuse me if I sound callous - I'm going to have a difficult time feeling much empathy.

  237. By the end of his term we will have no country left as Trump is merciless destroying the US. Simple to favor of his alienated base, satisfy his childish and irresponsible temperament, at the cost of millions of lives ... We need to impeach this guy before is too late. #LetsSaveAmericaFromTrump

  238. Time for Trump to go- either the 25th or impeachment- that is all

  239. Isn't Obamacare the law? How can the executive branch undermine the law?

  240. You mean like not enforcing immigration law for decades?

  241. Why create when you can destroy?

  242. What a dangerous mixture to have in one individual. Ignorance, lack of empathy and a sociopathic mind. This man is trampling on all aspects of human dignity, not a day goes by that he does not insult some group of people, that he doesn't trample of some inherent rights or doesn't make me feel embarrassed for being a US citizen. hat on earth will it take to have him removed from office and committed? Are our elected official whose duty it is to keep us safe and look out for our well being going to remain oblivious to their duty and sit by idly while our country and possibly our world is driven to the abyss?

  243. Increasing competition in the health insurance markets? The nerve of this guy!

  244. Except that in this case, it doesn't increase quality and lower costs for all, it lowers quality for some, which increase costs so much for those who vitally need this kind of product that it becomes unaffordable and they die.

    Any good reason to encourage this kind of "competition" ... ?

  245. How on earth is trump allowed to change or destroy anything he wants without going through Congress? They are the ones who make the laws. What is trump anyway, an imperial king? He thinks he is. Why is he allowed by executive orders to destroy the ACA, which is the established law of the land. I am so tired of the "elected" president acting like a dictator.

  246. Again, let's throw old and sick people out of the boat and let them drown in high-risk pools with crushing premiums and deductibles. That's what will happen if the President takes this action.

  247. You kill Obamacare by simply enforce the law as it was originally written. No bailouts. No waivers. No exemptions or exclusions. No subsidies.

    Lesson: Make laws in haste (and without bipartisan political support) and you can regret in leisure.

  248. You mean you STILL didn't read the law ... ?

    Subsidies are at the very heart of the law, and Trump is doing NOTHING here to get rid of them (he can't, precisely because they're part of the law).

    And Obamacare IS Romneycare, which itself is a Republican healthcare reform plan invented by the conservative Heritage Foundation. That in itself already proves that it's pretty bipartisan.

    But then there's the fact that the bill has been publicly debated on C-SPAN for more than a year, was written by a committee that contained Republican Senators until the very end, AND includes more than 200 Republican amendments. And each time, they waited to vote until the CBO had confirmed that it would indeed do what it was designed to do: to insure 20 million more Americans (= 40,000 lives saved a year), and overall slow down cost increases.

    That's how you get bills passed in Congress, you see? It even got passed by the super-majority of 60 votes.

    Compare that to what the GOP is doing: they write HC bills in less than a month, and put them to a vote before the CBO could score it, without any public hearings, and even before a majority in their own party could read it. Of course that's not the way to get things done in Congress ... . And as a result, they didn't even manage to get 50 votes ... (and of course, the fact that these bills would destroy the health insurance of 30 million Americans didn't help either ... ).

  249. Who says the GOP can't solve our health care problems? They just developed a new medical solution - Government assisted suicide (of the program).

  250. There is nothing rational about the Republican agenda. Sabotaging health care. Provoking North Korea. Killing Iran deal. Denying climate change. Withholding birth control. Building a wall. Suppressing voting. Reviving coal. Supply-side fantasy. More guns after mass slaughter. Banning Muslims. Criminalizing peaceful protest. Thanks, Jill Stein supporters.

  251. The agenda is just that, an agenda. As long as no legislation occurs, the country is doing fantastic. I haven't noticed one thing out of place since Trump was elected, but maybe because I am at work 70-80 hours per week and the only agenda I have is enjoying time with my family on my off hours.

  252. It seems this will never end, the assault this administration is making on health care is really endless. Years ago I was buying health insurance for me and my family in the marketplace, horrible options until I joined the Freelancers Union and i bought my insurance through them, good affordable insurance. Then Obamacare came and Freelancers had to transition to the new plan, and the ACA was good affordable insurance. Now they are going to bring back these terrible useless polices from the past which mean no coverage at all. Making America great again...

  253. Out of pure spite, Donald Trump is deliberately sabotaging the ACA and toying with wrecking the health insurance markets. The ACA is federal law. Is it really possible that Donald Trump will be allowed to defy congress and bring the entire system crashing down? How much more must we endure from this botched excuse for a human being?

  254. It seems no. 45 just hates this concept of health care and coverage so much, so very despises it, that he will do anything to destroy it. Maybe because it has Obama's name on it, maybe because he must tear apart anything that came before HIM, maybe due to ignorance or willful vile. But he approaches everything this way- trade agreements, treaties, environmental protections, etc. I'm so sad for this country which every morning faces a new way to get torn up and destroyed. Who knows how or if it will get repaired. Maybe not in my lifetime. This has been said before, but I feel it every day. I am distraught.

  255. If Trump truly wanted to lower costs, he'd avoid providing ways for the healthy to circumvent paying into the same pool sick people pay into. The ACA is essentially designed as a cost sharing measure where the healthy subsidize the unhealthy. Since we're all guaranteed to get sick at some point or another, we'll all get our chance to take advantage of these shared costs.
    Allowing the expansion of short-term and association health plans isn't necessarily incompatible with the concept of sharing costs. The easiest way to ensure healthy people didn't abandon marketplace plans for these alternatives would be to also mandate that they provide the same level of coverage. With no difference in coverage provided, these plans would essentially be melded into the marketplace, serving the same people, and thus increasing enrollment and lowering the average costs for everyone - including the sick.
    However, I have the feeling Trump does not actually care about lowering costs. He just wants to kill the ACA, so I don't have my fingers crossed for these rules to do anything aside from draw healthy people out of the marketplace and hence increase the costs for less healthy folks.

  256. How about mandating health? If you smoke, it will cost you a $2000 yearly tax. If you are obese, it will cost you $2000 per year. Significant taxes on all processed foods. Enormous taxes on alcohol and marijuana.
    The largest component of Americans' health care bills are self-induced chronic medical problems. Why not go after the source instead of the outcome?
    What is Americans' problem with eating healthily and at least walking for exercise? Honestly, we pay billions of dollars per year in health costs to satisfy our need for sloth and indulgence.

  257. It's become so abundantly clear that Trump's idea of "so much winning" is just undoing his predecessors' actions. That's not winning, or leading, that's just hitting the undo button. None of this if forward thinking but I guess we should've all realized this with the key word in his campaign slogan: "again".

    So much for progress in government, culture, environment, business, industry, and intelligence.

  258. Cannot his executive order be vetoed? Didn't the Republicans do this with some of President Obama's executive orders - with far less justification or even oversight?

  259. No. The Congress can not veto an executive order.
    An executive order can be blunted by Congress refusing to fund whatever agency has to carry it out. An executive order could also be challenged in court.

  260. Not surprising. What is surprising is that Democrats didn't predict the blowback. If you raise taxes on some to provide for all, many won't like it. In this case millions saw a downside in worse and more expensive plans--yes not everyone and millions were able to get insurance. It remains a Rube Goldberg contraption. I'm a Democrat but we are nuts in the way we deal with health insurance and healthcare. I don't see a way out.

  261. It's not a matter of "people who don't want or need the broad coverage provided under the ACA."

    EVERYONE needs broad coverage. That's the point.

    Everyone can get sick, and everyone will want healthcare when they get sick. Those without broad coverage obtain care nonetheless, or they die. Both are unacceptable; people in a decent country shouldn't die for lack of basic healthcare, and those who obtain care nonetheless are free riders on all the people who responsibly take care of their own situation by paying for their healthcare plans one way or another.

    Repeat after me: Everyone needs the broad coverage mandated by the ACA, whether they want it or not.

  262. The solution is single-payer universal coverage.

  263. "Repeat after me: Everyone needs the broad coverage mandated by the ACA, whether they want it or not."

    The mandates are too broad. Far too broad. That's the problem.

  264. The idea that everyone needs a one-size fits all policy is precisely the sort of overweening liberal arrogance that gave us President Trump.

    Why not just work on helping people with pre-existing conditions and preventing insurance companies from throwing sick people to the wolves? Those were good goals.

    Making young people pay rates that are closer to those paid by elderly people or forcing single men to purchase maternity and contraceptive coverage were bad ideas.

  265. Before ACA, I bought my own plan. I always purchased a high deductible plan with no drug coverage. Adding drug coverage added something like 35-45 per cent to the premium. For me that as acceptable. Just maybe, I repeat, just maybe options aren’t bad. I don’t know.

  266. I agree that the ACA is an imperfect solution to our health care crisis. However, the ACA does hold insurance companies accountable for providing a baseline level of coverage. Allowing people to purchase cheaper insurance plans that don't cover basic medical services doesn't solve any problems. It is a complete waste of money. And, yes, I do think that all insurance policies should cover maternity care. We were all born at some point, maternity care benefits all of us.