For the past year and a half, Republicans have waged a non-stop war against the Affordable Care Act. Throughout 2017, Republicans tried time after time to repeal the Affordable Care Act, slashed funding for outreach, ended cost-sharing reduction payments that helped low income Americans afford health care, and passed a tax bill that the Congressional Budget Office predicts will strip health care from 13 million Americans and raise premiums by double digits.  

Throughout their many layers of sabotage, Republicans have played ignorant, trying to cover up the fact that their votes will send Americans’ premiums skyrocketing. Just this morning, former HHS Secretary Tom Price called out Republicans’ lies, saying that the tax bill’s repeal of the individual mandate “will harm the pool in the exchange market, because you’ll likely have individuals who are younger and healthier not participating in that market, and consequently, that drives up the cost for other folks within that market.”

Just one month after voting for a tax bill that the CBO projected would raise insurance premiums by double digits, Sen. Ted Cruz acted as though he had wanted to lower premiums the whole time: “I think lowering premiums is a win-win for everybody…The number one reason people despise Obamacare is that premiums have skyrocketed.” As much as Republicans try to distance themselves from it, the fact of the matter is clear: they knew they were voting to raise premiums, and they chose to do it anyway.

EACH STEP OF THE WAY, EXPERTS WARNED THAT SABOTAGE WOULD DRIVE PREMIUMS UP

The Trump Administration Deliberately Tried To Reduce Enrollment Of Healthy Individuals By Halting Outreach, Despite Commonly Understood Consequence That This Would Increase Premiums.

  • January 2017: In “Transparent Effort To Damage Stability Of Health Insurance Marketplace,” President Trump Abruptly Halts Open Enrollment Ads. In the final week of open enrollment, President Trump ended ads that let people know they could sign up for the Affordable Care Act. As Politico notes, “The last five days of the open enrollment season are seen as critical because many individuals procrastinate and then join a last-minute sign-up surge. That’s particularly true for younger and healthier customers who are crucial to making insurance markets work.”
  • February 2017: Analysis Shows Trump’s Cuts To Outreach Prevent Nearly 500,000 People From Getting Coverage. Following Trump’s initial cuts to outreach, it was estimated that Trump’s cuts blocked nearly 500,000 people from getting coverage. When fewer healthy people are able to purchase care, experts agree that premiums increase.
  • August 2017: Trump Administration Cuts Aca Advertising Budget By 90 Percent, Despite Evidence That It Will Cause Premiums To Increase. [Vox, 8/31/17]
  • Because The Administration Still Refuses To Adequately Fund Outreach, Insurance Commissioners Warn That Premiums Will Continue To Increase. Peter Lee, the head of California’s ACA Marketplace wrote in a letter to HHS that premiums would go up because of the Administration’s failure to properly fund outreach: “The reality is clear: If the federal government maintains the current cuts in marketing and outreach, premiums will be higher than necessary, consumers will be hurt as a result and taxpayers will pay the price by supporting higher [than] necessary subsidies. This does not need to happen and can easily be avoided…Drops in new enrollment are a formula for a worse risk mix and higher premiums.” [Letter to HHS, 4/25/18]

Months Before The Trump Administration Ended Payments That Helped Lower Income Americans Afford Insurance, The CBO Warned That Doing So Would Raise Premiums By 20 Percent. President Trump Ended Them Anyway:

  • August 2017: CBO Warns That Premiums Will Increase By 20 Percent If Cost-Sharing Reduction Payments Are Terminated. “If President Trump follows through on his threat to stop paying billions of dollars of subsidies critical to insurance plans under the Affordable Care Act, insurance premiums for certain plans would rise by 20 percent next year, according to a new analysis by the nonpartisan Congressional Budget Office.” [Washington Post, 8/15/17]
  • October 2017: Trump Administration Decides To Halt Cost-Sharing Reduction Payments. Despite the CBO’s warning that ending cost-sharing reduction payments (CSRs) would cause premiums to rise by 20%, the Trump Administration decided to do so anyways. [Washington Post, 10/13/17]
  • After The Fact, Insurance Commissioners Did Exactly What The Cbo Said Would Happen — They Raised Premiums. Jessica Altman, Pennsylvania Insurance Commissioner: This is not the situation I hoped we would be in, but due to President Trump’s refusal to make cost-sharing reduction payments for 2018 and Congress’s inaction to appropriate funds, it is the reality that state regulators must face and the reason rate increases will be higher than they should be across the country.” [CNN Money, 10/17/17]
  • Now, Research Confirms That Ending CSRs Caused Premiums To Jump, And Is Expected To Do So Again In 2019. RWJ’s interviews with ten insurance companies found that the loss of cost-sharing reduction plan reimbursements drove premium increases in 2018 ranging from 10 to 20 percent. [Robert Wood Johnson Foundation and Urban Institute, 3/19/18]

Republicans Knew That Repealing The Requirement That Most People Have Insurance Would Drive Up Premiums, And Rushed To Do So Without Public Comment:

  • November 2017: Congressional Budget Office (CBO) Estimates That Repealing The Individual Mandate Will Push Premiums Up By 10 Percent Annually. Last fall, the nonpartisan Congressional Budget Office released numbers that repealing the requirement that most people have insurance would increase premiums by roughly 10 percent each year for the next decade. [Congressional Budget Office, November 2017]
  • November 2017: Sen. Susan Collins Acknowledges That Repealing Individual Mandate Would Raise Premiums. “‘One of the major concerns I had was the impact on premiums of repealing the individual mandate,’ [Collins] said Tuesday, referring to government estimates that repealing the mandate would raise insurance premiums by at least 10 percent as healthier consumers leave the market.” [Talking Points Memo, 11/29/17]
  • December 2017: Republican Senate Hurries To Pass Final Gop Tax Bill, Which Repeals Individual Mandate Despite Cbo Analysis That It Will Drive Premiums Up, In The Dark Of The Night And Without Public Hearings. Senate Republicans were determined to stop discussion on their tax bill from ever seeing the light of day. In December, they passed their tax bill in a matter of weeks, without hearing any public hearings. The process was so rushed that entire pagers were crossed out of the final version of the bill, and amendments were handwritten and barely legible.

After Sen. Collins Exchanged Her Vote On The Tax Bill For A Promise To Pass ACA Stabilization, Republicans Sabotage Bipartisan Efforts To Pass Bill That Would Help Control Premium Hikes:

  • December 2017: To Counteract The Increase In Premiums That Would Follow Repealing The Individual Mandate, Sen. Susan Collins Exchanges Tax Bill Vote For Aca Stabilization Bill. Sen. In exchange for her vote on the GOP tax bill, Majority Leader Mitch McConnell, President Trump, and Vice President Trump committed to passing a health care stabilization measure. [Washington Post, 12/15/17]
  • March 2018: After Pushing The Stabilization Vote Into The Next Year, Republicans Refused To Vote On Stabilization Unless Democrats Agreed To A List Of Deal Breaking Demands. In the middle of bipartisan negotiations on stabilization, the White House released its list of demands, including: Expanding the Hyde abortion language, codifying the Administration’s Short-Term proposal into law that undermine protections for people with pre-existing conditions, expanding Health Savings Accounts (HSAs) that is essentially another tax cut for the wealthy, mposing an age tax on older Americans by letting insurers charge people over 50 five times more than younger people. [White House Document, obtained by Politico, 3/8/18]
  • March 2018: There Is No Vote On Stabilization. [New York Magazine, 3/26/18]

Ignoring Warnings From Health Insurers, Trump Administration Proposes Changes To Short-Term Health Plans That Would Drive Up Premiums For Americans In Individual Marketplace:

  • July 2017: In Letter To HHS, America’s Health Insurance Plans Warns That Allowing Short-Term Plans To Offer Coverage For More Than Three Months At A Time Will Drive Up Premiums. “A blanket extension of the permitted length of short term policies will draw lower risk people out of the individual market single risk pool and drive up premium costs for consumers.” [America’s Health Insurance Plans Letter To HHHS, 7/12/17]
  • October 2017: President Trump Signs Executive Order That Expands Access To Short-Term Health Plans. President Trump’s executive order allows short-term plans to last for 12 months and be renewable, a notable change from the previous rule, which limited these plans to three months and prevented them from being renewed. [The Atlantic, 10/12/17]
  • February 2018: Administration Releases Fact Sheet On Short-Term Rule That Would Allow Insurers To Sell Year-Long Plans. [Centers for Medicare & Medicaid Services, 2/20/18]
  • March 2018: Nonpartisan Urban Institute Says Premiums Will Increase By Nearly 20 Percent. Confirming what experts had warned of, the Urban Institute calculated that increasing the availability of short-term health plans, when combined with the repeal of the individual mandate, would lead premiums to increase by an average of 18.3 percent in 2019. [Urban Institute, March 2019]
  • March 2018: AARP Analysis Projects Short-Term Plans Will Cause Older Americans’ Premiums To Increase By 16.6 Percent. As a result of President Trump and his Republican allies’ pushing junk insurance plans, AARP expects premiums for older Americans buying marketplace health coverage to increase by an average of 16.6 percent in 2019.  [AARP, 3/21/18]

Each Of The Administration’s Decisions Is Designed Drive People Off Of Health Care And Increase Premiums:

  • Katherine Hempstead, health insurance expert at Robert Wood Johnson Foundation: Anything That Undermines The ACA-Compliant Risk Pool Is Bad For Premiums.  “Anything that undermines the ACA-compliant risk pool is bad for premiums in the ACA market…Every exit ramp makes that market more expensive and less competitive than it otherwise would be.” [Modern Healthcare, 4/26/18]

NOW, THE CONSENSUS IS IN: REPUBLICANS KNOWINGLY DROVE UP PREMIUMS

Vox: Republican Sabotage To Blame For Premium Hikes. “The Trump administration’s multifaceted crusade against the health care law — slashing outreach budgets and pulling the law’s cost-sharing reduction payments to insurers — were already to blame for a 20 percent premium hike this year. Then Congress repealed the individual mandate in their tax bill, a huge political victory given the GOP’s vehement opposition to the mandate but one that insurers have said would drive up premiums even more next year.” [Vox, 4/25/18]

Washington Post: “The Pottery Barn Rule Comes To Mind: You Break It, You Own It.” “This is not ‘letting’ Obamacare fail. Many nonpartisan experts believe that these active measures are likely to undermine the pillars of the 2010 law and hasten the collapse of the marketplaces. The Pottery Barn rule comes to mind: You break it, you own it. Yes, the plate you just shattered had some cracks in it. But if you dropped it on the ground, the store is going to blame you.” [Washington Post, 10/13/17]

The American People Agree: President Trump And Congressional Republicans Are Playing Politics With People’s Health Care. A poll conducted last September found that 61 percent of voters believed President Trump was “trying to make the Affordable Care Act fail,” and 64 percent of voters said Trump is “playing politics with people’s health care.” The poll also found that the American people seriously disapprove of how Republicans in Congress are treating health care: 80 percent of voters disapprove while only 20 percent approve. [Garin Poll, 9/5/17]

RECENT HEADLINES PAINT A TELLING PICTURE

EVEN REPUBLICANS ADMIT THEY’RE TO BLAME

Sen. Lamar Alexander: “Rates Will Go Up…They’re Going To Blame Every One Of Us, And They Should.” On the topic of failing to pass a stabilization bill, Sen. Alexander said: “Rates will go up. The individual market will probably collapse…There will be 11 million people who are between jobs, who are self-employed, who are working, who literally cannot afford insurance, and they’re not going to be very happy. And they’re going to blame every one of us, and they should.” [Vox, 4/25/18]

Lindsey Graham: Republicans “Own The Outcome” On Health Care. “Sen. Graham told Breitbart News, ‘In October, premiums are going up. Obamacare cannot be fixed. It’s going to continue to collapse, and then, we own the outcome. By repealing the individual mandate, which is a step forward in the eyes of the public, we own the issue. We have a responsibility to do something about the collapsing Obamacare system. I believe that we’re going to get blamed more than Democrats because we stopped trying to repeal Obamacare, and to suggest that we don’t own it is just simply politically naive.’ Graham continued, ‘It can hurt us in 2018. It can hurt by our base feeling like we betrayed them. It can hurt us from people suffering from Obamacare, like we don’t have a solution. It will energize Democrats. It can undercut everything we did on the tax cut side.'” [Breitbart, 2/6/18]

Rep. Charlie Dent: Republicans “Own” Health Care Now. “Rep. Charlie Dent (R-Pa.) argued Friday that President Trump was ‘ill-advised’ to end key ObamaCare payments, warning that the GOP now ‘owns’ whatever happens to ObamaCare. ‘I think the president is ill-advised to take this course of action because … we, the Republican Party, will own this,’ Dent, a key House moderate who is retiring from Congress at the end of his term, said on CNN. Asked about Trump’s previous comments blaming problems with ObamaCare on former President Barack Obama, Dent pointed out that Republicans currently control the White House and have majorities in both chambers of Congress. ‘Barack Obama is a former president. President Trump is the president and he’s a Republican, and we control the Congress,’ Dent said. ‘So we own the system now. We’re going to have to figure out a way to stabilize this situation … This is on us.'” [The Hill, 10/13/17]