During a meeting of his presidential cabinet, Donald Trump pronounced the Affordable Care Act "dead," "gone," and said that "there is no such thing as Obamacare anymore." At the same time, however, he argued that the law, which has not actually been repealed, was still causing problems for Americans.
Trump made the remarks on Monday in reference to an executive order he made last week in which he agreed to stop payments to insurance companies called "Cost-Sharing Reduction" (CSR) payments which had originally not been fully budgeted under the Affordable Health Care Act. These payments primarily serve to provide lower premium prices for many individuals who purchase their own insurance. Because the money had not been explicitly approved within the ACA, however, congressional Republicans sued to stop the payments, in the hopes that a victory would destabilize the government-operated individual market exchanges.
Ultimately, several federal courts sided with congressional Republicans, but they did not say the subsidies could not be paid. Up until last week, the Trump Administration had been paying the subsidies even as it continually threatened to eliminate them. Because of the way that the ACA is written, however, the payments to the insurers must be made, even if they are not explicitly budgeted.
As a result of Trump's ending of the CSR payments, 16 states plus a bunch of insurance companies have begun filing lawsuits to force the funds to continue to keep going. The controversy is almost certain to lead to a lot of wasted funds for lawyers because the federal government has the money elsewhere. As health care expert Nicholas Bagley notes, "the question is thus not whether the government will pay, but when.”
Nonetheless, Trump was feeling quite confident about his action Monday afternoon.
"Obamacare is finished. It's dead. It's gone. It's no longer, you shouldn't even mention it. It's gone. There is no such thing as Obamacare anymore," he said. "It is a, and I said this year's ago, it's a concept that couldn't have worked. In its best days it couldn't have worked."
— Fox News (@FoxNews) October 16, 2017
According to Trump, his abrupt action to yank the subsidies has actually begun to foster bipartisan discussion.
"Republicans are meeting with Democrats because of what I did with the CSRs," he said. "Because I cut off the gravy train. If I didn't cut the CSRs, they wouldn't be meeting, they would be having lunch and enjoying themselves, all right?"
The president's recent history lesson is completely untrue, however. While it is true that several Republican and Democratic senators are currently trying to draft a bipartisan health care measure, they had been meeting for several months before the Graham-Cassidy health care bill failed in the Senate. Republican leaders put those talks on hold in order to make one last bid at a single-party measure on healthcare.
Obamacare fans should also not assume that just because Republicans are now agreeing to cooperate on a measure to restore CSR payments that the GOP has given up on its efforts to replace the law.
Toward the end of his press briefing, Trump vowed that the GOP was going to try again to pass a large-scale partisan health care bill "in March or April" after Senate Republicans had passed another budgetary bill.