“Sabotage.” “What are you saying? Did you say sandwich?”

I started at the League right before the holidays in 2016. In those early days, when people asked me about the status of the Affordable Care Act (ACA), I joked that I thought the ACA would be repealed before I figured out how to use the office microwave. (They even had some time because we had to replace the office microwave a few months ago.)

As we head into fall and I approach my one-year workaversary, the ACA is still here. But while it hasn’t been repealed, it is important that we not ignore the blatant sabotage being done to the ACA and our entire healthcare system.
Let’s take a look at just a few of the things that have been done:

• On September 30, the Children’s Health Insurance Program (CHIP) expired. CHIP provides health insurance to nearly 120,000 Michigan children, and without reauthorization states are forced to pick up the costs or cut off enrollment to the program. The U.S. Senate had agreed to a bipartisan deal before the last ditch effort to repeal and replace the ACA. The House is expected to vote on a bill this week that contains many of the important pieces of the Senate bipartisan deal to extend CHIP but has some concerning provisions intended to produce savings in Medicare and Medicaid. The bill also includes funding to support Puerto Rico and the U.S. Virgin Islands that falls significantly short of the support families need following Hurricane Irma and Hurricane Maria.
• The Trump administration has announced that they will allow employers to opt out of covering contraception for women based on moral or religious objection. This could affect nearly 1.9 million Michigan women.
• The administration also announced a decision to end health insurance subsidies, known as cost-sharing reductions, that help low-income and middle-income customers pay out-of-pocket healthcare costs. This will only serve to add to the federal deficit and result in increased premiums. States have already announced decisions to increase premiums as a direct result of these payments being cut off
• President Trump issued an executive order that calls on federal agencies to consider actions to create a “noncompliant” market that could mean plans that are exempt from ACA rules including pre-existing condition protections and essential health benefits. We will not know the full impact of this order until agencies go through the rulemaking process.
• The Trump administration significantly cut funding for organizations charged with enrolling people into the ACA along with cutting funding to advertise and promote the open enrollment period.
• The administration also shortened the enrollment period for people to sign up for health insurance and announced that the website to do so will be down for “maintenance” for 12 hours on Sundays during open enrollment.

While the Trump administration continues to find ways to undermine the ACA, there is some good news. Recently, Sens. Lamar Alexander (R-Tennessee) and Patty Murray (D-Washington) announced a bipartisan agreement to stabilize the insurance market. The plan includes continued funding of cost-sharing reductions, restoring portions of cuts to ACA outreach and enrollment, expanding eligibility for “catastrophic plans,” and making changes to waivers that allow states to modify certain provisions of the ACA.

This proposed plan is a starting point and absolutely not perfect; however, in order to ease some of the uneasiness around the ACA and insurance markets, it must be enacted. This is something that remains to be seen, and if the plan does receive action, what—if any—additional reforms or funding might also be included?

As we’ve seen for many years, and especially evident during the first 10 months of the Trump administration, is that healthcare is still highly political. It really is something lawmakers cannot seem to move past. Whether it is the showy legislative attempts to repeal the progress made with the ACA, the less publicized expiration of CHIP or the harmful attacks on the upcoming open enrollment—we promise to make sure you know about it.

BONUS: If you were wondering about the title of my blog, it’s from one of my favorite episodes of The Office—BEACH GAMES!