{"slug":"trump-aca-sabotage-healthcare","title":"ACA Sabotage: Deliberate Undermining of Health Insurance for Millions","date":"2017-01-20","lastUpdated":"2020-11-01","description":"The Trump administration, after failing to repeal the Affordable Care Act through Congress, conducted a years-long campaign of administrative sabotage: cutting outreach and enrollment funding by 90%, shortening enrollment periods, eliminating cost-sharing reductions that kept premiums affordable, expanding junk insurance plans, and backing a lawsuit to strike down the entire ACA. The Congressional Budget Office estimated the administration's actions increased premiums by 20% and caused millions to lose or forgo coverage.","summary":"Having failed to repeal the ACA legislatively (defeated by the 51-49 Senate vote, including John McCain's thumbs-down), the Trump administration used regulatory and administrative mechanisms to undermine it: eliminating the individual mandate penalty, cutting navigator and outreach funding from $63 million to $10 million, supporting a lawsuit arguing the entire ACA was unconstitutional, and expanding short-term health plans that excluded pre-existing conditions. CBO projected these actions would cause 10-13 million people to lose insurance.","category":"federal-dismantlement","severity":"extreme","ongoing":false,"sources":[{"url":"https://www.nytimes.com/2017/10/12/us/politics/trump-obamacare-executive-order.html","title":"Trump Signs Executive Order on Obamacare, Opening Door to Cheaper, Skimpier Plans","publisher":"The New York Times"},{"url":"https://www.cbpp.org/research/health/tracking-aca-sabotage","title":"Tracking ACA Sabotage","publisher":"Center on Budget and Policy Priorities"},{"url":"https://www.kff.org/health-reform/issue-brief/navigators-in-federally-facilitated-marketplace-states/","title":"Navigators in ACA Marketplace States — Funding Cuts","publisher":"KFF (Kaiser Family Foundation)"},{"url":"https://www.cbo.gov/publication/53300","title":"CBO: Effects of Eliminating the Individual Mandate Penalty","publisher":"Congressional Budget Office"},{"url":"https://apnews.com/article/insurance-medicaid-health-insurance-legislation-us-news-d618c61a55334c1b8bc9c2a3e413de5e","title":"ACA sabotage — what the Trump administration did and why it mattered","publisher":"The Associated Press"}],"draft":false,"status":"published","tags":["ACA","healthcare","Obamacare","health-insurance","first-term","federal-dismantlement"],"relatedEntries":[],"timeline":[{"date":"2017-01-20","title":"Day one executive order — implement 'maximum extent possible'","summary":"Trump signs an executive order on Day One directing federal agencies to use 'maximum extent possible' regulatory discretion to waive or delay ACA requirements pending repeal legislation."},{"date":"2017-07-28","title":"McCain casts decisive 'no' vote on ACA repeal","summary":"The Senate vote to pass the 'skinny repeal' fails 51-49, with Sen. John McCain providing the decisive thumbs-down vote. Trump and administration allies immediately declare intent to pursue non-legislative means to undermine the ACA."},{"date":"2017-10-12","title":"Trump ends cost-sharing reduction payments","summary":"Trump halts CSR payments to insurance companies — payments that offset the cost of providing reduced out-of-pocket costs to low-income enrollees. Insurers respond by increasing premiums; the CBO projects the action will increase the federal deficit by billions due to larger premium subsidies required."},{"date":"2017-10-12","title":"Executive order expands short-term and association plans","summary":"Trump signs an executive order directing expansion of short-term health plans (not subject to ACA protections) and association health plans. The plans can exclude pre-existing conditions and offer fewer benefits."},{"date":"2018-06-01","title":"Navigator funding cut to $10 million","summary":"The administration reduces navigator funding — used to pay people who help consumers understand and enroll in ACA plans — from $63 million to $10 million, cutting consumer assistance capacity by approximately 90% in federally-operated marketplace states."},{"date":"2018-12-14","title":"Texas judge rules ACA unconstitutional","summary":"A federal judge in Texas rules the entire ACA is unconstitutional due to the elimination of the individual mandate penalty. The Trump administration declines to defend the law in court, instead supporting the ruling. The case eventually reaches the Supreme Court, which upholds the ACA in 2021."}],"location":{"name":"Washington, D.C.","lat":38.9072,"lng":-77.0369},"custom":{"era":"first-term","posture":"reported","warCrimeClassification":"enabling","internationalLaw":[{"statute":"International Covenant on Economic, Social and Cultural Rights","article":"Article 12","provision":"Right to the highest attainable standard of physical and mental health — deliberate government action to reduce health insurance coverage undermines this right"}],"iccRelevance":false,"victims":"Millions of Americans who lost health insurance or paid higher premiums as a direct result of ACA sabotage; people with pre-existing conditions denied coverage by short-term plans; those who avoided seeking care due to cost","structuredPerpetrators":[{"name":"Donald Trump","role":"President of the United States","institution":"White House"},{"name":"Alex Azar","role":"Secretary of Health and Human Services","institution":"HHS"},{"name":"Seema Verma","role":"Administrator, Centers for Medicare & Medicaid Services","institution":"CMS"}],"updateLog":[{"date":"2020-11-01","summary":"Updated with full first-term ACA sabotage record before election."}]}}