This article has been updated.
Let’s set aside for the moment President Trump’s decision to end Obamacare’s cost-sharing reduction payments (CSRs) to insurers, a system under which insurers are subsidized to help keep costs low for low-income insurance recipients.
Let’s also set aside the other ways in which the Trump administration has been deliberately undermining enrollment in the Obamacare marketplaces. We’ll set aside that the administration has slashed funding to outreach programs by as much as 92 percent, ended partnerships with state groups aimed at getting people enrolled, cut funding for advertising the enrollment period and even decided it would shut down the enrollment website for 12 hours a week for maintenance.
Let’s just pretend for a moment that none of this happened, since most of it hadn’t or hadn’t been reported in August, when the Kaiser Family Foundation polled Americans to ask their views on Obamacare-related issues. One of the questions was who should be considered responsible for the health law (formally known as the Affordable Care Act or ACA) moving forward.
Most Americans said that, given Republican control of the House and Senate and a Republican president, Trump and the Republicans were responsible for the law’s success or failure. That includes 7 in 10 Democrats, 6 in 10 independents — and even 40 percent of Republicans.
To put a fine point on it: Most Americans thought Trump and his party had ownership of the success of the health-care law even before the administration started undercutting the ACA.
Since the beginning of his administration, Trump has argued that Americans wouldn’t hold him responsible for any collapse of Obamacare. It was always an iffy proposition, given the control Republicans have had over policy development in the United States since Jan. 20. But it’s nothing short of baffling for Trump to apparently still believe this to be the case.
This tweet, posted on Friday morning, reads like a line from “Goodfellas” more than a statement from president acting in good faith to fix a problems with federal legislation.
INTERIOR, BAMBOO LOUNGE
(Henry HILL smashes the bar with a baseball bat. The BARTENDER cowers as glass falls around him.)
HILL: Your bar is imploding. (He hands the BARTENDER a card.) You should call me to fix.
Part of this seems to stem from impatience. Trump, an avid consumer of conservative media, appears to have believed that Obamacare was near complete collapse, despite the Congressional Budget Office repeatedly noting that the marketplaces were stable as it evaluated Republican replacement bills. It’s like an Agatha Christie novel: A guy grows tired of waiting for his wealthy great aunt to expire and leave him her fortune, so he starts slipping strychnine into her tea.
And then gets more impatient and runs her over with a bus.
Kaiser Family Foundation polls on Obamacare-related issues every month. In September, as rumors were swirling that Trump might end CSR payments, KFF polled on it. Americans didn’t think they should be ended — including 40 percent of Republicans.
Update: On Friday, KFF released new data from its October polling. It found that 60 percent of respondents thought CSR payments should be guaranteed — a slightly lower percentage than in September. The percentage of Democrats who held that view was 82 percent; 38 percent of Republicans agreed.
(The CBO analyzed how ending CSRs would affect the marketplaces and the federal budget, by the way. Premiums would rise 20 percent by 2018 and 25 percent by 2020. The budget deficit would increase by $194 billion over the next 10 years.)
That poll also asked people what they wanted to see Congress address in terms of health-care legislation. Three-quarters of Americans said it was extremely or very important for Congress to reauthorize the children’s health insurance program (CHIP) and to stabilize — not undercut — the Obamacare marketplaces. Even 57 percent of Republicans thought stabilizing the marketplaces was very important.
Far fewer Americans thought tax reform was a priority.
In August, KFF asked Americans explicitly if Trump should try to push Obamacare toward failure or if he should try to make it work, even if it was repealed in the long run.
Three-quarters of Americans thought it should be made to work, including a majority of Republicans. Including, in fact, 51 percent of Trump supporters.
Update: The newly released KFF poll found that 71 percent of Americans still think Obamacare should be made to work, including a plurality — but not a majority — of Republicans.
Again, all of these poll results are from before the administration’s efforts to undercut Obamacare enrollment (and therefore to undercut the viability of the system for insurers) was in full swing. Four-in-10 Americans already thought Trump was hurting Obamacare enrollment, including most Democrats and 38 percent of independents.
Update: In the just-released October poll, these numbers were similar.
Trump seems to think that somehow he will not get the blame for his more explicit efforts to undercut the law over the past few weeks.
Or maybe, like that ne’er-do-well with his bus, he no longer cares.