There is absolutely no imaginable justification for President Trump's abrupt, cruel, capricious decision to eliminate $7 billion in subsidy payments to health insurance companies offering coverage on the individual market.
Critics have, naturally, exaggerated the implications of the executive order. It is not a "bomb" tossed at the Affordable Care Act or even a precisely aimed bullet. It is more like a random stabbing that will probably go mostly unnoticed on a crowded street. It will not affect the largest group of people who have benefited from President Obama's signature health-care law, namely, those who have received coverage thanks to the expansion of Medicaid. In fact, young, more or less healthy people purchasing coverage on the exchanges will stand to benefit substantially.
Overselling the number of people who will be hurt by Trump's move misses the point. The most striking feature of his decision is its arbitrariness. Actual "straight-up sabotage" would look very different from this executive order. This is not something you do when you are applying all your natural cunning and resources to the cause of hurting people; it's something you do because it is 1 p.m. and you are still in your pajamas feeling listless and bored and want to check at least one thing off your long-forgotten to-do list.
This policy-making as ennui therapy has been a long-running feature of the GOP's various undifferentiated attempts to "repeal and replace" ObamaCare. No sentient adult human being actually thought about the prospective changes, such as keeping but not funding the expansion of Medicaid, swapping an income-based tax credit with one based on age, and eliminating the tax penalty for the uninsured and replacing it with a handout to insurers. I am no statistician, but I feel comfortable saying that it would not take a room full of chimpanzees with keyboards a hundred years to come up with a bill objectively superior to the ill-fated Graham-Cassidy health-care bill and its many predecessors; it would take a single, possibly intoxicated ape about five hours, assuming he was a slow typist. Nobody thought about any of this. Nobody cared.
Few of them admit it, but virtually every Republican elected official, with the exception of a few designated bad cops, like Sen. Rand Paul (R-Ky.), have accepted that the Affordable Care Act is here to stay and that the real work ahead of them is not getting rid of the law but figuring out a way to market reality to their constituents.
Meanwhile eliminating subsidy payments will save the federal government a negligible amount of money and immiserate a few hundred thousand families. Households aren't like the Treasury Department. Seven billion dollars is a rounding error for the feds, but a few hundred dollars a month is more than enough to destroy the tight budgets of working people in a country where 70 percent of us have less than $1,000 banked.
Why is Trump trying to make Congress' job easier here? His popularity — which remains at a staggeringly high 99 percent approval rating among his core supporters — owes little to the Republican brand. Even if he did promise to repeal ObamaCare, explaining why it hasn't happened yet is the easiest thing in the world. Blame Mitch McConnell and the other Failing Losers. Blame the Democrats. Blame Colin Kaepernick. It's working just fine with the wall.
This country would be far better off if Trump spent more of his time suggesting that NBC's broadcast license be revoked or making fun of short senators from Tennessee and less, or even none, of it thinking about public policy. However comparatively decent his instincts might have been on a handful of issues — trade, entitlement programs, infrastructure — he does not care any more than the other leaders in his party do about details, much less consequences.
At the risk of repeating myself, allow me to suggest that next time Trump takes it upon himself to sign a ridiculous bill or executive order, some stolid do-gooder working undercover in the White House should surreptitiously swap the piece of paper with a peanut brittle recipe or the lyrics to "Should Have Been a Cowboy."
