EDITORIAL: Obamacare isn’t out of the woods yet

Aug. 23--After Republican efforts to repeal and replace the Affordable Care Act failed dramatically in the U.S. Senate, President Donald Trump wavered between trying to cajole senators to try again and petulantly declaring that a deal would come after Obamacare implodes.

There's just one problem with the latter idea: On its own, Obamacare won't implode. In fact, there are clear signs the Obamacare exchanges are stabilizing. A Kaiser Family Foundation study released last month found the exchanges were increasingly profitable for insurance companies, indicating a healthier mix of participants.

We're especially lucky here. Covered California is one of the most successful state exchanges, and it is implementing changes to inoculate against uncertainty in Washington.

Obamacare could still collapse, though, and if it does, it will likely be because of sabotage, not because of irresolvable problems with the law itself.

Trump has threatened to stop paying subsidies to insurers that help reduce deductibles and co-pays for low-income customers. A new study by the Congressional Budget Office found that withholding those subsidies would drive up premiums by 20 percent next year and substantially increase the government's costs, increasing the deficit by $194 billion in the next decade.

Eliminating the subsidies would have ripple effects, too, driving all insurers out of some markets.

Even if Trump doesn't follow through on that threat, the administration has other ways of sabotaging the law, and it is acting on some of them. For example, it has curtailed outreach efforts to boost participation, abandoning work with the Latino Affordable Care Act Coalition and other enrollment promotion efforts.

In one of its bolder moves, the administration actually spent money budgeted to promote enrollment in Obamacare on a social media push to discredit the law with video testimonials of Obamacare "victims."

The Trump administration has taken additional steps to hamper Obamacare's effectiveness, including weakened enforcement of the individual mandate that requires all Americans to either buy health insurance or pay a tax penalty. It also fired people trained to guide customers through the enrollment process.

All of these efforts do nothing but add turmoil to the health insurance market. Trump clearly wants Obamacare to fail -- even though it would mean millions of Americans losing coverage and a large increase in the federal deficit. He seems to be operating under the delusion that the failure of Obamacare will make it easier for Republicans to reconcile the extreme differences among the party's conservative and more moderate factions.

But there's no reason to believe that the Republican Party could come to a consensus about health care after an Obamacare collapse -- and there's even less reason to believe that if a consensus were reached, it would actually be an improvement over the Affordable Care Act.

Trump isn't interested in policy. He promised a health care plan that would insure everyone, with lower premiums and deductibles. He either didn't know or didn't care that none of the Republican proposals to repeal and replace Obamacare fulfilled those promises.

Trump seems interested only in chalking up a victory -- though stripping millions of Americans of health care coverage, spiking the deficit and increasing costs seems more like a loss for everyone else.

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