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Horowitz: Trump Makes Wrong Choice on Healthcare Again

Tuesday, October 17, 2017


The failure of repeated efforts to repeal and replace Obamacare provided President Trump with an opportunity to move to a politically smart and substantively correct reset. He could have embraced the achievable goal of reforming and repairing the existing health care law.  Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) are working on a bi-partisan effort to stabilize the insurance markets and give states more flexibility on implementation. There is a majority in Congress that would support these kind of common sense fixes, which would shore up a policy that is by and large working, which has resulted in a far higher percentage of Americans having access to quality health care, which the non-partisan CBO says is sustainable, and which is now backed by a majority of the American people.

Unfortunately, but not surprisingly, President Trump chose to continue placing a risky bet on a failed strategy, coming out against the bi-partisan compromise being championed by Alexander and Murray.  Even worse, he issued two Executive Orders last week designed to take a wrecking ball to Obamacare, either not caring or not knowing that the impact of his actions will be to dramatically raise premiums for middle class Americans in the individual insurance market. 

The most egregious of the actions announced that the Trump Administration would act to end cost-sharing reduction payments to health insurers, aimed at defraying the costs of insuring low-income Americans.  This action—if it survives court challenge-will likely result in more insurance companies pulling out of the individual insurance market and 15-20 % premium increases in 2019.

Governor John Kasich (R-Ohio), who does understand the real world impact of President Trump’s actions, blasted the President on Meet the Press this past weekend. Kasich said, “Are they just passing these things and people are praising what the president did because of politics? I mean, do they understand the impact that this has on families, on people?” Directly refuting the White House talking point that these payments are just pay offs to insurance companies, Kasich went on to say, “these were payments to insurance companies to make sure that hardworking Americans, who don't make a lot of money, can have their co-payments taken care of.”

Similarly, Governor Brian Sandoval (R-Nevada) called ending the payments "devastating."  Sandoval said, "It's going to hurt people. It's going to hurt kids. It's going to hurt families.”

These actions are not just bad policy; they are bad politics.   Trump will now be directly responsible for premium increases and lack of health insurance options.    He is now no longer tinkering around the edges of undermining Obamacare in ways that are difficult for the public to grasp. This time, he has taken a highly visible sledgehammer to it.

President Trump’s repeated mistakes on health care call to mind a famous saying of the legendary Israeli diplomat Abba Eban as he referred to the failed diplomatic approaches of Arab nations in the early 1970's.  It is  adapted for today’s purpose. “President Trump never misses an opportunity to miss an opportunity.”


Rob Horowitz is a strategic and communications consultant who provides general consulting, public relations, direct mail services and polling for national and state issue organizations, various non-profits and elected officials and candidates. Rob Horowitz is a paid consultant for the campaign of Brett Smiley. He is also an Adjunct Professor of Political Science at the University of Rhode Island


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