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Donald Trump, saddled with a Congress that couldn’t repeal Obamacare, finally took matters into his own tiny hands yesterday. Unable to toss out the Affordable Care Act outright, Trump has instead opted to sabotage it.

After signing an executive order Thursday morning that cripples Obamacare by loosening regulations on health plans, later that same afternoon, Trump dealt another blow to Americans seeking affordable, adequate care: cutting Obamacare subsidies for the poor.

The cost-sharing reduction payments Trump trashed are designed to help low-income Americans get health care. As NPR reports, without them, health insurance exchanges could spiral into chaos.

From NPR:

That money particularly helps people earning between 100 percent and 250 percent of the poverty level pay for the insurance and health care that they get through the exchanges set up by the Affordable Care Act, also known as Obamacare.

Ending the payments could cause premiums to spike, push insurers out of the marketplace, and even cost the government $2.3 billion more in 2018 than it would otherwise spend, according to one analysis.


The only way out now is for Congress—a group that has gotten perilously little done this year—to push through legislation that would fund the subsidies.

For now, the White House’s actions go beyond denying poor people health care, which Republicans have signaled for a long time they are happy to do. The executive order and the elimination of the subsidies are effectively a torpedo into the heart of Obamacare—one that could sabotage the health care exchanges for good and drain billions of dollars of taxpayer money along the way.

As one health care policy expert told Splinter, the timing of this is deliberate, especially with ACA enrollment set to begin in two weeks. Chad Bolt, policy manager for health care at the activist organization Indivisible, told the news outlet, “Trump is intentionally trying to create confusion so that people don’t know what to do.


“People don’t know if the ACA still exists, if they can still sign up,” Bolt added.

The Trump administration has already slashed funding for ACA advertising and “navigators”—organizations that help Americans enroll in exchange health plans. Trump also shortened the enrollment period to just six weeks (it was originally 12), which includes planned shutdowns on all but one Sunday. The sum of these actions is clear: to make it as difficult as possible for Americans to get the health care they need.

The confusion the White House has sown guarantees that Americans looking for Obamacare will face high premiums and less choice—the very things Trump hammered the ACA for doing.


Make no mistake: Pricing Americans out of health care and reducing their options (it’s possible that no ACA options will be available in some marketplaces) will cost lives. And Trump is so intent on undoing every piece of Obama’s legacy that he will sacrifice the blood of his own base, literally. As CNBC reports, the lion’s share of health care subsidies Trump cut on Thursday go to people in states that voted for him.

Read more at NPR and CNBC.