Trump Tries to Kill Obamacare by a Thousand Cuts

Having failed in its effort to have Congress repeal the Affordable Care Act, the Trump administration has been relentlessly trying to destroy the health care law on its own. The latest move in that demolition derby came this week, when officials proposed giving insurance companies more leeway to sell junk health plans.

The Department of Health and Human Services wants to let companies sell temporary health insurance policies that last up to 364 days, up from 90 days now. Officials say that would benefit people who are struggling with rising health insurance costs, because the plans tend to be cheaper than those on the insurance exchanges created by the A.C.A., or Obamacare.

Not mentioned in the department’s talking points is the fact that these policies often do not cover things like mental health services, substance abuse treatment, cancer drugs and maternity care. As a result, people who buy such skimpy plans could end up being hit with exorbitant bills if they actually need medical care.

The Obama administration limited these short-term plans to three months because they are meant to be a stopgap for people between jobs or in other temporary situations. The Trump administration would effectively encourage younger and healthier people to stop buying comprehensive policies on the Obamacare exchanges. As a result, insurers selling A.C.A. plans would be left covering an older and sicker population, forcing them to increase premiums.

This would not be devastating to most of the people who use exchanges, because they receive federal subsidies that limit how much they have to pay. But it could really hurt middle-class families who earn too much to qualify for government assistance (about $82,000 for a family of three) and are already facing big premium increases. People in this group would have the terrible predicament of spending a lot of money buying health insurance or taking a chance by buying a skimpy temporary plan, hoping that nobody in the family gets sick or injured.

This proposal is the latest in a series of steps the administration has taken to weaken the A.C.A. and the health care system. In January, it proposed allowing employers and sole proprietorships to form associations for the purpose of buying insurance policies that do not have to comply with the protections of the A.C.A. And it recently began allowing states like Kentucky to take Medicaid benefits away from people who are not employed, creating a system of red tape intended to hurt poor people who have lost their jobs or are unable to work.

If the administration were actually serious about reducing health care costs, it would try to improve the A.C.A., not dismantle it. For example, President Trump could work with Congress to offer subsidies to middle-class families who do not qualify for help under Obamacare. Or he could push for the creation of a national reinsurance program that would encourage insurers to offer policies in more parts of the country at lower costs by protecting them against steep losses from very sick patients.

But Mr. Trump and his Republican allies in Congress seem unwilling to pursue constructive health care policies because they are obsessed with undoing Obamacare. Regrettably, the cost for their rage will be the health care of millions of low-income and middle-class families.