Donald Trump in Wisconsin

The column below reflects the views of the author, and these opinions are neither endorsed nor supported by

The GOP-Trump health care debacle was mind-boggling in exposing their cruelty, incompetence and incoherence. After years of hissy fits, obstruction and blatant lies about the Affordable Care Act (ACA), GOP House Speaker Paul Ryan and Trump came up with an alternative: don’t get sick. The GOP-Trump plan would lead to 24 million more uninsured, higher private insurance premiums for the elderly, an end to Medicaid expansion – cutting Medicaid spending by $880 billion, elimination of health care coverage protections and a humongous tax cut for the wealthy. The so-called health care replacement collapsed from public outrage, GOP division and principled Democratic opposition. There’s more.

Don’t forget Trump falsely claimed that the ACA “covers very few people” (ACA covers over 20 million, including nearly 243,000 Wisconsinites). Trump also promised: “We’re going to have insurance for everybody” – with coverage “much less expensive and much better”. Then there was Trump whining: “Nobody knew that health care could be so complicated.” Predictably Trump blamed others for his own bungling.

The blame-shifting didn’t change Trump’s declining polls or his political downturn. Trump is still stewing. He can’t stomach being seen as a loser. Most of all Trump wants to protect his phony image as a dealmaker. It’s all about him, not regular folks. So Trump has a new scheme to make himself a winner: take health care (ACA) hostage. Threaten to blow it up. Extortion, until the ACA is repealed.

Trump, in a Wall Street Journal interview, signaled that he would not fund the ACA cost-sharing reductions (CSRs) to regular folks who buy ACA private insurance. The CSR payments to insurers allow them to sell ACA insurance with lower deductibles and co-payments to eligible consumers, with incomes between 100 and 250 percent of the federal poverty level. 7 million, including well over 100,000 Wisconsinites receive CSR benefits. It gets worse.

Politico reported: “But because of a clause in their (ACA) exchange contracts insurers could immediately cut off coverage if the federal government no longer provided cost-sharing subsidies” (CSRs). Moreover, insurers would be forced to raise their premiums or leave ACA exchanges. The American Hospital Association (AHA) said: “The most critical action to help stabilize the individual (health insurance) market for 2017 and 2018 is to remove uncertainty about continued funding for cost-sharing reductions ….The funding helps those who need it the most access quality care ….” The AHA was joined by the American Medical Association and U.S. Chamber of Commerce.

Former Senate Majority Leaders Bill Frist (R-TN) and Tom Daschle (D-SD), along with GOP health care policy experts, also called for “extension of cost-sharing reduction subsidies.” Moreover, Democratic congressional leaders have said they will use budget negotiations to include continued payment of CSRs. Some Republicans want to avoid the Trump train wreck. Time for House Speaker Ryan, other Wisconsin congressional Republicans and Governor Scott Walker to speak up. Wisconsin does not need a hostage crisis.

— Kaplan wrote a guest column from Washington, D.C. for the Wisconsin State Journal from 1995 – 2009.

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