EDITORIAL: Trump administration tries bureaucratic sabotage to kill Obamacare

Sept. 10--While attention was focused last week on President Donald Trump's move to end the Deferred Action for Childhood Arrivals program, his administration was moving to sabotage another, much-larger Obama-era achievement: the Affordable Care Act.

The Department of Health and Human Services is cutting the budget for outreach programs intended to help Americans sign up for health insurance coverage in 2018. In addition, HHS has cut the sign-up period that begins Nov. 1 from 90 to 45 days.

And let's not forget the U.S. Senate, where Republicans are discussing a last-ditch effort to replace Obamacare before Oct. 1, when the 60-vote cloture rule goes back into effect. A bill by Sen. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., would send block grants to state governments, which would decide how to take care of the uninsured.

The Trump actions mean that fewer Americans will sign up for coverage. Those who do will tend to be sicker and thus more alert to the need for insurance. Younger, healthier Americans won't bother, or won't hear about the program, meaning more insurers are likely to lose money in 2018 and bail out of the program in 2019.

Trump continues to threaten cost-sharing subsidies to insurance companies, which keep coverage affordable for some 7 million low-income Americans. The Congressional Budget Office says eliminating them would drive up premiums by 20 percent and add $194 billion to the deficit over 10 years.

Cutting the outreach budget is likely to have a similar effect. Millions of people will rejoin the ranks of the uninsured as insurers pull out of markets where they can't make a profit. Many insurers already have taken that step, pulling out of low-population rural counties -- counties that voted heavily for Trump. Centene Corp. of Clayton has filled the breach in many counties, including 25 in western Missouri, confident it can make a profit. The cuts in the outreach programs could make the math there more difficult.

Since its inception, the ACA has recruited customers to HealthCare.gov in two ways: By heavy TV advertising during 90-day sign-up times and by paying social service organizations to help people navigate the complicated process of signing up. Last week HHS announced it would cut the $100 million advertising budget to $10 million. The budget for navigator programs like CoverMissouri.org has been cut by 41 percent, from $62.5 million to $36 million.

HHS justified the cuts by saying Americans already were aware of the ACA program, though polls show at least a third of the population knows nothing about it.

Like the DACA action, the sneak attack on the ACA is cruel, cowardly and ultimately costlier to taxpayers. Social service, civic and church groups must pick up the slack by helping those who need insurance sign up for it.

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