The Base

There is a great deal I can say about the recent executive orders regarding health insurance, but let's start with this from David Anderson (formerly known as "Richard Mayhew" on Balloon Juice.)

The executive orders basically do three things:

• Eliminate the cost sharing reduction payments to insurers, which subsidize premiums for low-income individuals
• Allow people to buy insurance through "associations," which does not meet the minimum benefit standards of the ACA
• Allow people to buy so-called "limited duration plans" for up to a full year. These also offer limited benefits and can exclude people with pre-existing conditions

There are two basic effects from this. First, it will enable people who are relatively young and healthy to evade buying insurance with the minimum benefit standards. Over time this will have the effect of segregating lower-cost and higher-cost people into separate risk pools. That, along with elimination of the cost-sharing subsidies, will drive up premiums on the ACA exchanges.

Funny thing though -- people with incomes below about $48,000, or families below $98,000, are eligible to receive subsidies for buying ACA policies on the exchanges, and the subsidies are based on cost. So their subsidies will go up along with the rising premiums, and their insurance will remain affordable. The subsidies, of course, come out of tax dollars and so this will increase the federal deficit. However, people with incomes above those amounts do not receive subsidies -- they will bear the full brunt of the premium increases.

By the way, contrary to conventional wisdom, that's where the Trump voters are. Funny thing about that.

The only reason for doing this, of course, is to try to wreck the ACA, since it was stubbornly refusing to wreck itself. In other words, the purpose is to screw people out of spite.

And you don't have to take it from me. Well known Communist Chuck Todd and friends say that these moves, along with other efforts to sabotage the exchanges:

[M]ake a strong case that the Trump administration is deliberately trying to break Obamacare. After all, if fewer people enroll in the marketplaces, premiums will go up and fewer insurers will participate.“Cutting health care subsidies will mean more uninsured in my district. @POTUS promised more access, affordable coverage. This does opposite,” Rep. Illeana Ros-Lehtinen, R-Fla., tweeted last night in response to the Trump administration’s subsidy announcement. Trump himself seemed to suggest that he was ending this subsidy to force Democrats to negotiate (which they’re ALREADY doing, given the ongoing negotiations between Sens. Patty Murray, D-Wash., and Lamar Alexander, R-Tenn.)

So even if you don't think the ACA is the greatest, why deliberately make things worse? Maybe because you're a psychopath.