the national interest

Republican Campaign Message: We Had to Jack Up Your Insurance Premiums to Help the Poor

Photo: Pacific Press/LightRocket via Getty Images

Unable either to repeal Obamacare or to design a better alternative, President Trump has spent the last year engaged in a multifaceted campaign of sabotage against his predecessor’s legacy: weakening the law’s consumer protections and eliminating its individual mandate. Trump is symbolically peeing in Obama’s bed.

Later this year, Republicans in Congress will have to lie down on that pee-soaked mattress. The Urban Institute has calculated that the various acts of legislative and executive sabotage against the law will increase premiums on the individual market by an average of 18 percent. Republicans in Congress have already formulated a plan to explain away the disaster their party engineered, reports Caitlin Owens. And the plan, astonishingly, is to explain to their voters that higher premiums is the necessary sacrifice they must make to help relieve low-income households of the burden of paying the individual mandate:

The strategy, per a senior House GOP aide: “Every time it is brought up, use that as an opportunity to remind voters who paid the mandate tax. It was people who already couldn’t afford [health care]. Not people choosing not to purchase. Most immoral tax we had.”


Although the October premium hikes will be a “big problem,” they can be spun: “Premiums going up is a ‘hey let’s chat about tax reform’ moment. But if mandate [repeal] contributes to higher premiums, it means that they were artificially made lower on the backs of low income individuals,” the aide said.

Uh, yeah, sounds believable. That’s the Republican brand, asking their voters to pay higher costs to help the poor. Everybody is going to buy that explanation.

In reality, the individual mandate has a financial hardship exemption. The effect of the Republican changes, as Jonathan Cohn explains, will be to help healthy people reduce their premium costs, either by going without insurance altogether, or by purchasing dirt-cheap insurance that doesn’t provide much coverage. The flip side will be that people who need medical care will pay a lot more. The Republican sabotage campaign isn’t going to transfer resources from the middle class to the poor on net. It’s going to transfer resources from people with expensive medical needs to people without.

The notion that Republicans feel morally compelled to do this because of their devotion to the financial well-being of the poor is belied by, oh, everything the party has been doing for a generation or so.

Republicans: We’re Jacking Up Your Premiums to Help the Poor