Today, the Trump administration announced its latest effort to sabotage the Affordable Care Act by mounting an unprecedented attack on the ACA’s marketplaces.

Here’s what media, experts, and patient groups had to say:

Washington Post: Trump Administration “Demolishing” Basic Rule Of Affordable Care Act That Federal Subsidies May Only Be Used To Purchase Plans In Federal Marketplace. “The Trump administration is urging states to tear down pillars of the Affordable Care Act, demolishing a basic rule that federal insurance subsidies can be used only for people buying health plans in marketplaces created under the law…The changes go beyond a variety of other steps Trump administration health officials have taken in the past year to weaken the ACA, which the president has opposed vociferously…The new steps go further by undercutting the basic ACA structure of the insurance marketplaces created for those who cannot get affordable health benefits through a job.” [Washington Post, 11/29/18]

American Lung Association: New 1332 Waiver Guidance “Would Further Erode Patient Protections, Undermine Care For People With Lung Disease.” [American Lung Association, 11/29/18]

Wall Street Journal: “The Waivers Have The Potential To Be One Of The Most Decisive Factors In Letting States Go Separate Ways On Health Care.” “The waivers have the potential to be one of the most decisive factors in letting states go separate ways on health care. Some are likely to keep the current system, where premium tax credits go to consumers who buy ACA-compliant plans on the exchanges, while others may upend much of that system altogether.” [Wall Street Journal, 11/29/18]

Larry Levitt, Senior Vice President Of Kaiser Family Foundation: New Guidance Allows States To Offer Subsidies For Plans That Do Not Cover Pre-existing Conditions And Paves Way For States To Increase Subsidies For Higher-income People And Reduce Subsidies For Lower-income People. “The Trump administration has filled in details of ACA waiver guidance, illustrating how states could restructure premium subsidies, including subsidizing lower premium plans that don’t cover pre-existing conditions…Under the new ACA waiver rules, states could restructure premium subsidies so they are based only on age and not by income, increasing subsidies for higher-income people and reducing them for lower-income people.”“ [Larry Levitt, 11/29/18]

Sabrina Corlette, Senior Research Fellow At Georgetown University’s Center On Health Insurance Reforms: It’s “Really Hard To See How Any Of These Concepts (Except Reinsurance) Can Meet The Statutory Guidelines.” [Sabrina Corlette, 11/29/18]

HealthLeaders Media: “Verma Lambastes ACA, Giving States 4 Ways To Bypass It.” [HealthLeaders Media, 11/29/18]

And here’s how legislators reacted:

Democratic Leader Nancy Pelosi: Trump Administration Is “Cynically Working To Make Health Insurance More Expensive And To Leave More Americans Without Dependable Coverage At All.” “The American people just delivered an overwhelming verdict against Republicans’ cruel assault on families’ health care.  But instead of heeding the will of the people or the requirements of the law, the Trump Administration is still cynically working to make health insurance more expensive and to leave more Americans without dependable coverage at all.The Trump Administration is trying to push more Americans into junk insurance plans that do not cover essential health care, leaving families exposed to crushing out-of-pocket costs after an injury or illness.  Meanwhile, Republicans continue to push their monstrous lawsuit to strike down the vital protections for people with pre-existing conditions.” [Democratic Leader, 11/29/18]

Sen. Patty Murray, Ranking Member Of Senate Health, Education, Labor, And Pensions Committee: “The Trump Administration Is Brazenly Warping A Tool Meant To Help States Innovate And Lower Prices So It Can Further Gut Protections For People With Pre-existing Conditions And Drive Up Health Care Costs.” “These new templates are nothing more than a how-to guide for health care sabotage. The Trump administration is brazenly warping a tool meant to help states innovate and lower prices so it can further gut protections for people with pre-existing conditions and drive up health care costs. Congress created these waivers and included guardrails to allow for innovation while making sure people could get high-quality, affordable coverage—however the Trump Administration’s guidance takes us in the opposite direction.” [U.S. Senate Committee On Health, Education, Labor & Pensions, 11/29/18]

Sen. Ron Wyden, Ranking Member Of Senate Finance Committee: Trump Administration Has Created “Fast Lane To Flood Health Care Markets With Junk Plans And Quarantine Older Americans And Those With Pre-existing Conditions Apart From Everyone Else.” “The Trump administration has created a fast lane to flood health care markets with junk plans and quarantine older Americans and those with pre-existing conditions apart from everyone else…Section 1332 was created to generate new and better ideas that improve families’ health – the Trump administration’s approach warms over old and bad ideas that increase costs for consumers and lowers the quality of care. Trump’s sabotage crusade continues to deprive working Americans with the health care security they need, and today’s news accelerates America’s slide back to the days when health care was reserved for the healthy and wealthy.” [U.S. Senate Committee On Finance, 11/29/18]