Jay Bookman

Opinion columnist and blogger with The Atlanta Journal-Constitution, specializing in foreign relations, environmental and technology-related issues

Opinion: Obamacare is dead; welcome to Trumpcare

Humana has announced that it is withdrawing from the Obamacare individual marketplace. It will honor policies sold for 2017, but it will not offer coverage for 2018. Mark Bertolini, the CEO of insurance giant Aetna, told investors in a conference call that his company will probably do the same, as will other companies.

"We have no intention of being in the market for 2018," Bertolini said. "Currently where we stand, we'd have to have markets worked up, prices worked up for April 2017 in order to apply, and there is no possible way that we'll be prepared to do that given the unclear nature of where regulation's headed."

Since those statements, Bertolini has waffled a bit on his company's plans, but I sure understand his predicament. The insurance industry is built upon the concept of predictability, and as Bertolini explained, companies have no way to predict what the individual market will look like a year from now, and thus no way to write policies for it. All they know is that congressional Republicans and President Trump have promised big changes between now and then, while offering no idea what those big changes might be.

To add to that uncertainty, Trump signed an executive order on his first day in office basically telling his administration to undermine the Affordable Care Act by any means at its disposal. As a result, the Department of Health and Human Services immediately canceled $5 million in TV ad buys that were intended to draw the last-minute, healthier consumers that insurance companies need.

In another act of sabotage, the IRS has announced that due to Trump's order, it will no longer require taxpayers who are filing returns to state whether they are covered by health insurance, a move that will make the tax penalty for going uncovered much more difficult to enforce. Without that tax penalty pushing healthier Americans to buy coverage, the whole financial structure of the system collapses.

In short, in the individual market at least, Obamacare is already dead. Welcome to Trumpcare.

What does that mean? It means that whatever happens from here on out, the Republicans own every bit of it.  They have created and fed this uncertainty, they have sabotaged the market, they have refused to even consider the relatively small fixes needed to update the current system. More importantly, with total control of the House, Senate and White House, they have the power and responsibility to act. By this time next year, there will be no excuse whatsoever for not having their "better way" up and running so voters can render judgment in the 2018 midterms.

And they won't. The GOP Congress promised to show us a replacement plan by Jan. 27; they can't even agree among themselves on how to begin. More than a month ago, Trump claimed that his transition team was close to completing its own plan, and would announce it as soon as the Senate confirmed U.S. Rep. Tom Price of Georgia as secretary of Health and Human Services.

"We're going to be submitting -- as soon as our secretary's approved, almost simultaneously, shortly thereafter, a plan. It'll be repeal and replace. It will be essentially simultaneously," Trump said. "Probably the same day, could be the same hour."

Price was confirmed at 2 a.m. back on Feb, 10, but there's still not the slightest hint that a Trump plan exists or is even being drafted. They are caught in a funhouse mirror of their own devising, with no idea which way to turn or where the exit might be, and panic is beginning to set in.


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About the Author

Jay Bookman writes about government and politics, with an occasional foray into other aspects of life as time, space and opportunity allow.