Republicans succeeded at raising insurance premiums for too many

For the past year, health care experts, patient groups, and providers have been warning that actions taken by the Trump administration and the Republican Congress to undermine the individual insurance market would raise premiums. President Trump said last year, “The best thing we can do, politically speaking, is let ObamaCare explode.” Now that people are starting to see the intended results of his actions, lawmakers who helped him are rushing to shift the blame.

But there is no room for debate. They sabotaged the market, plain and simple. Before Trump and Congress took these actions, they were warned that doing so would drive up premiums and hurt the market. They seemed not to care, and even acknowledged that they were taking these actions to drive up premiums and hurt the market. Now we are seeing the results. Their actions are driving up premiums and hurting the market.

{mosads}Health care experts point to three significant actions taken by Trump and Congress to increase premiums over the past two years. These were cancelling billions of dollars in federal payments to issuers that were intended to keep deductibles and copays low, ending the individual mandate, and expanding access to junk plans. While the third step has not been finalized, it is widely believed that Trump will do so soon. In each case, there has been ample warning from nonpartisan sources that these actions would drive up costs for Americans.

Prior to Trump cancelling payments to insurers, the Congressional Budget Office estimated that doing so would increase premiums by 20 percent. Before Trump and Congress repealed the individual mandate to pay for tax cuts, the CBO estimated that doing so would increase premiums by 10 percent. It also estimated that it would result in 13 million fewer people with health insurance by 2027. The federal government’s chief health care actuary has estimated that expanding access to junk plans would increase premiums by 3 percent next year and 6 percent by 2022.

Trump and his team have been clear that they understand the effects of their actions, and that driving up premiums and undermining the insurance market is the point, so they can lessen support for the Affordable Care Act. As Trump told Republican governors, they needed to let the law “be a disaster because we can blame that on the Democrats and President Obama.” Steve Bannon, former White House chief strategist, said, “Then you had ObamaCare. Not gonna make the [payments to insurers], gonna blow that thing up, gonna blow those [insurance] exchanges up, right?”

Trump’s former secretary of Health and Human Services, Tom Price, recently echoed this point, saying, “There are many, and I’m one of them, who believe that [repealing the individual mandate] actually 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.”

Now we’re in the second year of seeing the effects of these attacks on the market. Rates in Maryland, Virginia and Oregon are much higher because of destructive actions taken by Republican leadership in Washington. All told, experts believe that this sabotage will drive up premiums around 18 percent this year, costing people who buy their own insurance more than $1,000 on average. That’s on top of last year’s nearly $1,000 premium increase. This burden will be felt largely by the middle class, who do not receive tax credits to help with premium costs, and thus will bear the full burden of health care sabotage.

Faced with the reality of their actions, the administration is now trying to evade responsibility. They’re claiming that premium increases are due to the law itself, rather than their intentional efforts to undermine it. But the cause is clear. An exhaustive analysis of insurer financial data by the Kaiser Family Foundation found that, in the absence of sabotage, “Insurers would generally have required only modest premium increases in 2018.”

If Trump and Congress actually wanted to lower premiums, there are plenty of steps they could take. They could ban or limit junk plans, replace the individual mandate, expand financial assistance to make insurance more affordable, or create a reinsurance program. States can, and have, taken similar steps. But federal lawmakers have been more interested in empty gestures than actual policy solutions.

When politicians act in such bad faith, and with such harmful consequences for the American people, it’s important not to shy away from honestly naming what they’ve done. The administration and its congressional supporters took actions to increase premiums in order to undermine support for the Affordable Care Act. The word for this type of behavior is sabotage, and we should all feel comfortable using it.

Sam Berger is senior adviser at the Center for American Progress. He served as a senior adviser on the White House Domestic Policy Council, where he focused on the Affordable Care Act, from 2015 to 2017.