If the Republican Party repealed the Affordable Care Act without a replacement, 18 million people would lose their health insurance, the budget deficit would rise, and tens of thousands of Americans would die.
These are all indisputably bad things — no politician, of either party, has ever campaigned on a platform of reduced insurance access, a higher federal debt, and more preventable deaths.
Still, one could not fairly claim that no Americans would benefit from ACA repeal. Millionaire investors would see their capital gains taxed at a lower rate; young, healthy people would likely see their premiums go down as insurers left people with preexisting conditions to their fates; and conservatives who believe that every American — no matter their color, creed, or annual income — should have the freedom to die from a curable illness would see their ideology affirmed.
But the Trump administration’s latest attack on Obamacare will benefit no one — except, perhaps, some “career politicians” in Washington, D.C.
This week, the White House cancelled advertisements alerting consumers to the upcoming enrollment deadline for 2017 coverage under the ACA — even though the ads had already been paid for, according to Obama administration officials who spoke with Politico.
Since human beings have a tendency to put off filling out boring paperwork for as long as possible, the final days of enrollment season are crucial. With the aid of increased advertising and outreach during this period, the ACA marketplaces have consistently enjoyed last-minute surges in sign-ups.
But now, the Trump administration is trying to prevent such a surge from happening.
Lower ACA enrollment does not help anyone. It is bad for insurers, bad for those who will go uninsured due to ignorance about the deadline, and bad for any American who wants to pay a lower premium next year — last-minute sign-ups come disproportionately from young and healthy people, for whom health insurance is not a pressing concern. The more such consumers get in the habit of buying health insurance, the lower the costs in the future should be for everyone else.
The only people who would immediately benefit from weaker enrollment are Republicans on Capitol Hill, who are struggling to find a way of throwing millions off of their health insurance — without getting blamed for having done so.
The best thing that could happen for Paul Ryan and friends would be if the ACA’s marketplaces just collapsed by themselves. As Jonathan Cohn explains in the Huffington Post:
If the program’s collapse is imminent, as they say, then there’s no point in worrying about the roughly 20 million people who now get coverage through the program. Because, under this scenario, no matter what Republicans do, those folks are going to end up without decent coverage.
And if the end result of repeal efforts is a disaster ― with millions more uninsured, millions more struggling with less reliable or less comprehensive coverage than they had ― Republicans can always say things would have been awful anyway.
But even as a piece of cynical, political sabotage, Trump’s move accomplishes little. By January 4, 8.8 million individuals had signed up for ACA coverage — already an increase over the previous year. While Trump’s actions could prevent the program from hitting its forecast of 13.8 million enrollees, no collapse-inducing drop-off is forthcoming.
Thus, the only genuine benefit of Trump’s decision to cancel the ads might be this: The president has just informed the American people that he cares more about tarnishing his predecessor’s legacy than improving our nation’s health-care system.
An earlier version of this post reported that the Trump administration had shut down email outreach on ACA enrollment. While sources within the Health and Human Services Department and Congress had told Politico that this was the administration’s new policy earlier in the week, on Friday, email outreach was resumed.