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Nope. Can’t even sabotage Obamacare right

Nancy Pelosi asked the Congressional Budget Office to do an analysis of what would happen if Donald Trump were to follow through on his threat to withhold government payments to insurance companies that make it possible for lower-income folks to afford health insurance with the Affordable Care Act. That analysis was released yesterday, and while it wouldn’t actually kill Obamacare, it would make insurance on the individual exchanges a lot more costly, with premiums going up sharply. And in some sad news for the greatest deal-maker ever, withholding the payments wouldn’t save the government money; it would actually cost about $200 billion. If that sounds nuts, it’s because Donald Trump is really very, very bad at killing Obamacare.

As Vox’s Sarah Kliff explainers here, the funds Trump wants to withhold, called “cost sharing reduction” (CSR) subsidies to insurance companies, are just one of the two ways the federal government subsidizes health insurance for lower-income people on the individual exchanges:

  • Premium subsidies, which reduce the cost of monthly premiums for Obamacare enrollees who earn less than 400 percent of the poverty line
  • Cost-sharing reduction subsidies, which reduce the cost of copayments and deductibles for Obamacare enrollees who earn less than 250 percent of the poverty line

The premium subsidies are tethered to how much Obamacare enrollees earn. They cap how much a given enrollee is expected to spend on his or her monthly premiums. Someone who earns 200 percent of the poverty line, for example, is expected to pay 6.4 percent of her income on premiums to purchase a midlevel plan. The government kicks in the rest.

CBO says the loss of the CSR payments would force insurance companies to raise premiums on “silver” plans about 20% right away, and more in later years. This is where the tax credits — which the president can’t unilaterally end the way he can the CSRs — would become a big factor. Since those credits kick in to ensure lower-income policyholders don’t have to pay more than a given percentage of their income — you know, the affordable thing — the government would pick up the bulk of the increased premium costs for most folks, resulting in about $194 billion extra in new subsidies. Bummer for Donald Trump: If he chops the CSR payments (which he misleadingly calls a “bailout for insurance companies), he’ll end up costing the government a lot MORE to pay for ACA insurance. Kliff sums it up pretty succinctly:

It will cost the federal government nearly $200 billion to end the cost-sharing reduction subsidies. For that extra spending, the federal government would have a market with higher premiums and less competition. Trump talks a lot about making deals. This does not sound like a very good one.

Oh, yes, and while Trump hopes ending the CSRs would cause Obamacare to “implode” — you know, because it would anyway, he’d just give it a little push — the CBO report actually forecasts that wouldn’t happen either. Insurance would get a lot more expensive for people who make too much to qualify for subsidies, and subsidizing the higher premium costs with locked-in tax credits would result in higher deficits. The disappearance of CSR subsidies would result in some short-term market chaos, with about 5 percent of Americans living in areas with no plans available at all on the exchanges “because of substantial uncertainty about the effects of the policy,” but no implosion or death spiral, at least not according to CBO’s projections. Things would be unsettled in 2018-2019, but after insurance companies figure out how their rates would need to be restructured, the individual market would stabilize:

By 2020, though, insurers would have observed the operation of markets in many areas under the policy and CBO and JCT expect that more insurers would participate, so people in almost all areas would be able to buy nongroup insurance[.]

Further, the report says that while some people would choose not to buy insurance at all, the overall uninsured rate would actually go down because the increased subsidy payments would lead to about a million more people being insured by 2020. In other words, eliminating the CSRs would make premiums jump, but the built-in protections of the tax subsidies would shield most individual policyholders — it would just cost a hell of a lot more for the government. You’d almost get the impression the ACA was designed to be fairly robust or something. A year of hearings, input from stakeholders, and debate probably helped there.

If Trump wanted to save money, he wouldn’t fuck with the CSRs, but he might do it anyway out of spite, because anything that adds more chaos into the system helps him insist the ACA is failing. Also, the CBO estimate only looks at the effects of ending Cost Sharing Reduction subsidies, and assumes the ACA would continue to be administered normally otherwise. But Trump and his crew, especially HHS secretary Tom Price and his merry band of healthcare vandals, are actively working to undermine the program through all sorts of administrative fuckery in hopes of making it fail.

Yr Wonkette is supported by reader donations. Please subsidize our premiums by clicking that “Donate” linky there.

[Congressional Budget Office / Vox]

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  • Well, reality never stopped the Republicans from doing something stupid out of spite before, so…

  • calliecallie

    First? No First! No First! You’re the First!

  • Ryan Denniston

    “Further, the report says that while some
    people would choose not to buy insurance at all, the overall uninsured
    rate would actually go down because the increased subsidy payments would
    lead to about a million more people being insured by 2020”

    I am just amazed at how poetic this whole thing is.

  • Joe Beese

    Killing Obamacare: $200,000,000,000
    Spiting Obama: Priceless

  • Rick Hill

    What? It won’t cost trump a thing.

  • Anna Rompage

    Seeing that the Paul Ryan & the GOP is looking to do away with standard middle class tax breaks, such as the mortgage interest deduction, so that they can deliver those tax cuts they promised to the wealthy on their GOP WealthCare bill, nothing is surprising…

    • Rags

      The mortgage deduction disprortionately benefits the wealthy. Eliminate 2nd home deduction and cut max deduction from $1.1 million (?!??) to maybe 100k then it becomes something worth keeping.

  • Indiepalin

    This whole thing reminds of the time I was stuck in a traffic jam when I was already late.

    • It reminds me of watching you.

    • doktorzoom

      It’s a lot like rain on your wedding day.

  • Robbertjan Brandenburg

    Yup, an endorsement from Donnie easily rallies the KKK et al to support the Marvel villain.

    https://twitter.com/realDonaldTrump/status/897833223501344769

    • Nockular cavity

      Wouldn’t Luthor + Strange be some kind of heinous Marvel-DC crossbreed?

      • A magic skilled failed real estate mogul with terrible hair?

      • Robbertjan Brandenburg

        A hybrid parallel universe supernazi villain.

  • Joe Beese

    You’re the best, Mr. Trump! We love you!

    https://twitter.com/realDonaldTrump/status/897833223501344769

    • Ryan Denniston

      He’s one of those guys the Mooch warned us about. Here’s a guy sucking his own dick, totally building his brand off the strength of the President.

    • Suttree

      I figured that he would be more of a Moore kind of guy. The shitass stupid is strong with Roy.

      • Roy Batty.

        • Suttree

          Replicant libelz!

    • TJ Barke

      Guess his endorsement ain’t worth much…

    • Bill D. Burger

      Embrace the KKK and the Nazis and you’ll help your candidate pick up votes in Alabammy’!

      Eazy peazy! ___

    • doktorzoom

      Strange finishes second, exactly as predicted. Trump proclaims self magic!

      (I heart Hyperbole and a Half)

      http://2.bp.blogspot.com/_D_Z-D2tzi14/TNiRrq56_fI/AAAAAAAAEDY/iaaOLq3S6N4/s400/dogs30alt.png

  • Suttree

    “Who the fuck cares what it costs? Kill It!”
    -Turnip

  • ManchuCandidate

    Trumpcare=Trump branded anything.

    End result is a shitty worthless but expensive product that causes a lot of misery and heartbreak with everyone but Trump getting fucked in the end.

    • Ryan Denniston

      But isn’t that what it’s all about, the shed tears?

      • nope.. I have it on good authority, it’s all about the hokey pokey.

    • jesterpunk

      But Obama was for it so it has to die, no matter what it does. They where even asking world leaders at the G20 if Obama was for something and if he was they where against it. Its just spite.

      • Mr. Blobfish

        Bingo.

        • jesterpunk

          I say we tell them Obama is in favor of breathing and let nature take its course.

  • FlemmishSpy

    Damned if you do. That’s all there is after 11/9.

  • beingreleased

    Anyone know what Sarah Palin is up to? It seems like our rational national dialogue has been missing her voice. I could probably look it up, but I’d rather someone with a stronger stomach did it for me.

    • BigCSouthside

      Drinking Boone’s Farm?

      • Ghenghis McCann

        Drinking Boone’s Farm dry?

    • She’s plagiarizing Coulter in pidgin for her new book.

    • Wild Cat

      She’s in deep regret that Todd, Trick, Tuck, Twat, Twit, Track, and Truck deep-sixed her neo-nazi clothing line in 2015—she’d be worth billions by now.

    • Ricky Gay

      I heard she has joined the Quilting Quitting Club of America.

    • wide_stance_hubby

      By this time, I would guess she’s up to the top step on her way to the shitter to puke in it.

    • chicken thief

      Having someone write her “I Told You So About Obama Pal-ing Around with Domestic Terrorists and What Would Happen” book so they can wash up the bus and go on grifting tour again?

  • I am enroute to my own version of self care- a double feature day! I am seeing Atomic Blonde and Deroit

  • Crystalclear12

    What’s a stupid, spiteful asshole to do?

    • TJ Barke

      FO&D?

  • Latverian Diplomat

    T:So, Mike, are we about ready to bankrupt this whole thing?

    P:You mean the ACA, sir?

    T:Nah, according to the Sea Bees, that won’t work. And I guess they would know, John Wayne was one of them. No, I mean the whole thing?

    P:Technically Sir, the whole thing can’t go bankrupt. Any nation whose debts are held in its own fiat currency can’t, because it can just issue more currency, though I wouldn’t advise doing too much of that.

    T: But when do I walk away with a huge payday while all my partners are screwed?

    P:Umm, the Presidency doesn’t really work like that…

    T: Given my belief in white supremacy, I really thought you;d be better at this. You’re Fired!

    P: Yes, sir, see you tomorrow.

    • pstockholm

      Nice, but maybe a little too plausible.

    • Bright Bart

      P: What are we going to do tomorrow Sir?
      T: Same thing we do every day Mike, try to take over the world.

  • TJ Barke

    I miss having a competent president.

    • Komsumverweigerer Ron

      7.5 billion human beings are right with you.

      • TJ Barke

        Jesus, we’re already up to 7.5?

        • Permit-holder Ron

          7,525,800, 700 as I type this.

  • Thiazin Red

    What a spiteful shitbag.

    • Republican strategy – anything anti-liberal.. especially crypto- racism… hate is free.

      The path to lower corporate taxes leads over the bodies of the left.

      • MrTusks

        Well, we can just drop the “crypto” part now. That was too much work anyway!

        • Can you imagine the discipline involved for *them*?

          It must have been exhausting!

    • beingreleased

      Did you listen to the press conference yesterday? Spite was when McCain was mentioned:

      TRUMP: Senator McCain, you mean the one who voted against Obamacare? You mean Senator McCain, who voted against us getting good health care?

      Reporter: Senator McCain said that the alt-right is behind these attacks, and he linked that same group to those who perpetrated the attack against Charlottesville.

      TRUMP: Well, I don’t know, I can’t tell you. I’m sure Senator McCain must know what he’s talking about. But when you say the alt-right, define alt-right to me. You define it to me. Define it for me, go ahead.

      Yes – he was so angry about McCain being mentioned that he accused him of voting against Obamacare.

  • wide_stance_hubby

    Impotent raging mockery of a human being says wut?

    • Nazis, some of them are good people!

      • wide_stance_hubby

        Only the best made-in-america nazis for Dolt 45.

      • I like the hot, naked ones giving away pussy.

  • Spotts1701, Nothingburger Chef

    If we had a rational opposition, they would understand this is not a good road. But unfortunately, we have an opposition who thinks the CBO is somewhere to the left of Greenpeace on the political spectrum.

    • DesertedPictures

      We have a rational opposition. We just have a crazy establishment. (They are in charge now!)

  • DesertedPictures

    So he could do it and claim to be responsible for higher insurance rates? Good thing he doesn’t read… otherwise he might do it and claim a weird sort of victory…

    • JoeChristmas

      Dems are the Nazi’s!

      • Well that’s just not possible, the Nazis were far too well organized to be Democrats

        • JoeChristmas

          The main point of this book is irrefutable: Nazis came from the left and were a left-wing movement which core program was essentially identical to that of a hard-core socialistic or communistic movement (rabid anti-capitalists, everything or almost everything centered around the State, no individual freedoms, censorship, repression, nationalizations, expropriations, state-guaranteed housing and income, etc etc).

          The main takeaway from this book is that Fascism and Nazism are branches of the left (just like International Socialism and Communism), and that all left-wing movements despise

          • DesertedPictures

            The nazi party had a leftwing element, that wanted redistributionalist policies for the Aryan population. They where led by Ernst Röhm and named the ‘SA’. (Sturmabteilung). The leaders where however murdered in the ‘knight of the long knives’ as Hitler more closely allied with corporate interests.

            The nazi’s where not, at any point, a true leftwing party however. Nationalism, militarism and racism where the core of the movement.

            There is a revisionist movement to rewrite history. I would advice you not to fall for it.

          • JoeChristmas

            Haha, I lifted that garbage from an Amazon review of D’Souza’s book. Interesting both ways — the negative reviews are great.
            FUCK Nazis. Punk or otherwise.
            I’ve been here 9 years and have studied. WW 1.5 for 50 years. I’ll defend myself at a bad attempt at humor, but all day I’ve been telling these idiots — Go Defend Nazi’s, You Fuck.

  • Lyly Sirivong

    What’s the actual cost of monthly premiums ? In the example above, we have someone who earns 200% of the poverty line. That’s $24164 a year (according to this site : http://www.irp.wisc.edu/faqs/faq1.htm). That’s $2013.67 a month. They have to pay 6.4%. That’s $128.87. What’s left for the government to subsidize ?

    • Latverian Diplomat

      It depends on the state, but it can be much more than that…

      http://money.cnn.com/infographic/economy/healthcare-premiums/

    • bbayliss

      A better question might be ‘ Why do we allow private for profit companies get between us and our doctors?”

    • chicken thief

      $128 a month won’t cover a dental family plan in NJ.

      • MrTusks

        $128 per month might get you health insurance for your dog.

    • MrTusks

      Well, for the family plan I get from my employer, I contribute about $400 per month through payroll deductions, and my employer covers waaaay more than that.

    • That would include the subsidy (so the max they would pay would be 128/month).

      Here in cook county our plans (unsupported by subsidies) range from about $150 (v v bare bones, for a youngun) to about 1000 if you’re in your 60s and smoke. Most folks plans cost b/t 300-600.

      The problems we (and everyone) are finding are for folks (like me) who make over the tax credit threshold (in my case – just barely). $500 plans are basically unaffordable. However, I’m stumping up the $$$ because i bike everywhere (for the ACA) and i’m too scared to be uninsured biking in chicago in December.

      the CBO score suggests i might actually qualify for tax credits under trump’s ‘improvements’.

  • schmannity

    Nazicare 2017

    • The Wanderer

      Aktion T-4 Redux?

      • schmannity

        Finally, a Solution to the health insurance debate!

    • TJ Barke

      Do not fill out the race or ethnicity section on your paperwork…

      • schmannity

        It’s just data collection, don’t worry. Your great grandmother wasn’t Jewish, was she?

    • Bill D. Burger

      And we have a template for development. Save a lot of money.

      ~entrance to the Republican Reich hospital~

      http://i.imgur.com/zuNO9fu.jpg

    • President in Exile Firefly

      KKKare.

      • schmannity

        Darn you, you’ve got that Kars 4 Kids jingle stuck in my head.

    • Resistance Fighter Astraea

      Because you will definitely not see care!

  • Daredevil

    “Pro-life” my ass.

    • It’s not your ass.

    • jesterpunk

      They are only pro life until they are born. Once they are born they are moochers who need to pull themselves up by their bootstraps and should have born rich.

  • I am thinking i probably should have filled my flask for today

    • foiled again

      Too late- I stole it for myself. Hope you like really, really cheap vodka.

      • So, a potato?

        • foiled again

          The vodka I drink is made from old phone books.

          • Opiwan

            Gives new meaning to “paper vodka”

  • Mr. Blobfish

    But how do you explain that to a dunce with no attention span and little interest? Sock puppets?

  • (((Alt-Sedagive)))

    If there’s one thing that Nazis were known for it was being ruthlessly efficient. They really knew how to kill a lot of people quickly.

    American Nazis are lazy, and they take half-measures. Sure: gutting healthcare will eventually kill a lot of people (especially the old and the sick), but it’s the opposite of cost-effective, and it will take years.

    Sad American Nazis. Weak.

    • Bill D. Burger

      And those fucking titi torches??? WTF. ___ SAD

      The Night of the Lawn Tikis

    • The lone and level sands stretch far away

    • Latverian Diplomat

      “A few weeks on the Eastern Front will whip them into shape…”
      — The Wehrmacht

    • WeaselPoo

      Also.German Nazis were snappy dressers. Amerocan Nazi’s outfits very low energy, not tremendous.

      • Ghenghis McCann

        The Hugo Boss “Potato Sack” range does seem popular these days.

      • black and silver is pretty nifty – they ruined it forever.

        • Zyxomma

          Not for me. Of course, I’m just a curvy little Jewess.

        • Cat Cafe for the Prosecution

          Hugo Boss was pretty nifty… and is still the uniform of corporate exex everywhere….

      • phoenix00

        Their firearms were also very well built and robust. British and American troops were known to drop their Stens and Thompsons in favor of MP40s scavenged from dead German solders. While the Kar98K rifle is still in use today.

  • Daredevil

    America: A place where a black man who was beaten by Nazis in a parking garage near a police station needed to create a GoFundMe to pay his medical bills because we don’t have single payer and the cops couldn’t be bothered to help.

    • Sean McLaren

      Or, so far, arrest or prosecute any of the attackers. Though the police in Durham got right on arresting the people that took down the Confederate statue.

      • marxalot

        Cops move on easy targets. Those militia thugs have guns.

        • Rags

          That was McAuliffe’s excuse for lax enforcement in Charlottesville; we wuz askeered of their guns. Transparent backpacks only for the Women’s March; open carry assault rifles in Charlottesville. What could possibly go wrong?

        • Unmutual Tetsu Kaba

          Plus, one of the people arrested in Durham had been giving interviews; so the sheriff didn’t have to work to find him.

    • We wonder,—and some Hunter may express
      Wonder like ours, when thro’ the wilderness
      Where Monticello stood, holding the Wolf in chace,
      He meets some fragment huge, and stops to guess
      What powerful but unrecorded race
      Once dwelt in that annihilated place

    • Latverian Diplomat

      “Hey, give us a little credit…at least we didn’t join in.”
      — The police

      • chicken thief

        If he’d been selling loose cigs or eating Skittles, though….

        • Aaron Wise

          Notice that the Right only calls for minorities to respect law enforcement, while they themselves are anti-government and all fucking freedom pissin’.

      • Vagenda of Rebel Scum

        “Stop resisting!”

        • Aaron Wise

          ‘Put your hands behind your back! Put your hands behind…put your blood on the ground! Put your blood on the ground!”

    • Covfefe’s Evil Twin

      But did they have a permit?

      • The cops, the dark skinned person, or the Nazis?

        • Cat Cafe for the Prosecution

          Cops, a dark skinned person, and the Nazis march into a bar….

    • toughsister

      Is this a great country or what?

  • SayItWithWookies

    Gee, for a guy who hated the ACA as much as Assmouth does, he sure doesn’t know shit about how it works. If the ACA was the Death Star, it would still be perfectly fine after the plucky band of oligarchs attacked its guns and ignored that little opening at the end of the trench.

    • Latverian Diplomat

      They never even got that far…the T-wing fighters Rebel Leader Trump insisted on all crashed after takeoff.

      • Vagenda of Rebel Scum

        They couldn’t even make a decision on what to do with it. They promised to blow it up, but then…well that’s a not good analogy. I don’t think the Death Star was benefitting anyone outside the Empire.

      • I can’t figure out if I should be more upset about number or tense.

    • Liquid Tomato

      The signature is his main objection to the ACA. He really would sign the exact same law.

      • BeachBum

        I thin so too. It’s killing him that a Black Mooslum, Socialist Kenyan from Hahvard and Coloombia did something that people want to keep and DON’T want his sorry ass bag of bullshit and lies as replacement.

      • Biel_ze_Bubba

        Il Douche will sign any danmed thing they put in front of him. He doesn’t know – and he’s too fucking lazy to find out – what it does. Just tell him the general topic, and he’ll lie about it on national TV.
        (Had they given him a straight-up repeal of the ACA, he’d have spouted bullshit about how it meant cheap, terrific insurance for everybody.)

    • Shibusa

      Same goes for the Iran nuclear agreement.

  • marxalot

    It’s a comfort to know, in these trying times, that the Wig is uniformly, consistently, incompetant. Fuckwaffle can’t even govern badly.

  • WhiskeyTangoFoxtrot

    So the Shit Stain is at least a great, bad example. I invoke his name now to scare my kid. “Do you homework or you’ll wind up as dumb as Donald.” “Just because Dumb Donald says it’s okay does NOT mean someone can touch you inappropriately.” So DJT’s got that going for him. His name will be the Freddy Kruger of future politics.

    • I hope when he unravels into a stuttering cloud of insults peppered with f-bombs and evil cunt epithets, it’s on camera.

    • Yeah I’ve been using his name as an action Verb. Stop Trumping that up! What a Trump up. Trump you you Trumping motherTrumper!

  • Next thing you know he’ll sign some EO that says to qualify for the ACA you’ll have to take weekly drug tests which are only available during a 1 hour window and only available out of Gnome alaska, and be gainfully employed all while standing on your head, if you somehow end up working while not standing on your head you would be disqualified.

    • overalls and white t shirt – that should be the new Nazi uniform.

      • phoenix00

        White button-down polos and khakis, apparently.

    • kareemachan

      And are owned by Voldemort of FL….

  • Raan

    Clearly, Trump never played SimHealth, the one thing he has in common with most people.

  • chicken thief

    BUT THE CBO IS NOBAMA HOLDOVERS WHO HATE AMERICA AND ARE FAKE NEWS!!1!!!

    There, took care of that, now we can proceed.

    ~ 45

  • Shibusa

    So, the Great Negotiator withholds payments, the insurance markets continue to limp along, premiums spike, and Uncle Sam ends up on the hook for an additional $194 billion. Thank God we have such a nimble and creative business mind at fixing the healthcare problems the US is facing.

    • Incoming Ham

      Sounds pretty much like how he ran his businesses. Someone else has to pay for his stupidity.

      • WIDTAP

        …and his bankruptcies.

  • So, relatively speaking, this is what passes as good news these days.

  • DesertedPictures
  • Iron Monkey

    By 2020, though, insurers would have observed the operation of markets in many areas under the policy

    The insurers would have figured out how to squeeze more blood from these particular stones.

  • Zyxomma

    Well, it looks like by the time these bozos undermine the ACA completely, I’ll be able to leave Medicaid and move to Medicare. Meanwhile, younger sister’s premiums will go up. That’s what she gets for not voting in ’16.

    • Cat Cafe for the Prosecution

      Don’t count on that Medicare, though. They’re coming for that next.

      • Zyxomma

        I’m not counting on anything. I’m really, really good at keeping myself in perfect, vibrant health. I’m glad I have Medicaid/United Health in case I have an emergency, because the last time I had an accident I paid out of pocket and really lucked out that I didn’t need surgery.

    • kareemachan

      I hope you reminded her of that – gently, tho.

  • Mavenmaven

    If by doing so, he souls raise the deficit and this sabotage the US economy, well, that would make his master Putin happy.

  • A Walker

    is this a typo? 400%?
    Premium subsidies, which reduce the cost of monthly premiums for Obamacare enrollees who earn less than 400 percent of the poverty line

  • Bitter Scribe

    If Trump wanted to save money, he wouldn’t fuck with the CSRs, but he might do it anyway out of spite, because anything that adds more chaos into the system helps him insist the ACA is failing.

    This is government by tantrum. We have a chief executive whose idea of policy is smearing shit on the walls.

  • TEX Dept. of Space Tacos

    at first i thought this was great news and would mean that the Republicans are now locked into the ACA…

    but i’m the cycnical type and assume trump will use his power to cancel the subsidies, forcing R’s to go to their districts and say, “sorry, it costs $200B, we HAD to repeal obamacare.”

    Sigh.

  • phoenix00

    – drains water from swimming pool
    – tosses algae and dead poisonous jellyfish into pool
    – starts crying “This pool SUCKS!”

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