Trump is threatening to harm millions out of pure spite. Here’s what to watch for now.


Now that the Senate GOP health-care bill has collapsed, the chatter in Washington is all about whether Republicans and Democrats will — or even can — come together behind some kind of bipartisan deal to shore up the individual markets. Central to this question is the fact that President Trump is now threatening to sabotage those markets himself. He appeared to renew this with an early-morning tweet that was odder than usual, if you can believe that:

Senate Republicans are set to meet with Trump today to discuss what’s next, and Trump’s tweet appears to build on his vow yesterday to “let Obamacare fail” to force Democrats “to come to us” eager to support a compromise on his terms. This tweet helpfully illuminates his emotional grasp of the situation, which is drenched in grievance and spite. Letting Obamacare “die” will punish Democrats (they will “scream death”) for the collapse of his bill. Remember, he has raged at Democrats for not being willing to work with him as he tries to destroy Obamacare, apparently unaware of how absurd this stance is. Now he will make them “scream death.”

But how seriously should we take this threat? Very seriously, until we have proof that he doesn’t really mean it, or until Republicans take active steps to defuse it, which they can do if they choose to.

Trump can indeed do a great deal of damage. He can “let Obamacare fail” by refusing to renew the so-called cost-sharing reductions (a full explanation of the CSRs is here), which are paid to insurers to subsidize out-of-pocket costs to millions of lower-income people. If he did this, insurers would probably have to hike premiums by enormous amounts, and many might exit the markets, further destabilizing them, potentially causing many millions to have no access to coverage. We know Trump sees this threat as working in his favor: Back in April, he explicitly threatened not to continue the payments for the express purpose of forcing Dems to negotiate with him. The administration didn’t go through with it, and the payments have continued, but that doesn’t mean they won’t be ended this time.

An insurance industry official told me today that insurance companies have gotten no indications from the administration that these payments will not happen this month. This official also told me that the industry would probably have received an indication if they were going to cease. So that may well mean this threat turns out to be empty.

For now, anyway. The next big thing to watch is what happens in late August. That is when lawyers for the administration and the House of Representatives are due to reappear in court as part of the ongoing litigation around the CSRs. The House previously sued the Obama administration to block the payment of the subsidies, arguing that they are unconstitutional if they are not appropriated. President Barack Obama fought this, and the current administration now has to decide whether to continue to defend the CSRs against the House lawsuit. If it decides not to, and if it decides to stop the payments, the damage could be severe. We will know a lot more next month.

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As it is, the uncertainty around the payments has already done a good deal of damage. The American Academy of Actuaries recently noted that this uncertainty has already led insurers to price in the possibility of them disappearing as they set their premiums, and some insurers have openly blamed the Trump administration for their own premium hikes. At the same time, administration officials have dishonestly and reprehensively cited the partial results of their own sabotage — destabilized markets harming people — to make the case for the GOP health bill. Trump’s tweet today suggests he may continue with this, only with a different goal: Getting Democrats to “scream death.”

As it happens, congressional Republicans, if they chose, could put a stop to any such strategy by appropriating the money to cover the CSRs themselves, as the insurance industry has urged. At this point, there is no serious argument against doing this: Some Republicans have said it must happen, perhaps in part because they are mindful that they would likely be blamed for any serious chaos in the marketplaces that would result. Even Senate Majority Leader Mitch McConnell (R-Ky.) has said that if the GOP health-care bill failed, Republicans would have to negotiate with Democrats over ways to stabilize the markets. And as Jonathan Cohn explains, there actually is room for bipartisan talks around an array of reforms that could give Republicans, and even Trump himself, some of what they want, in both substantive and political terms:

Polls also show the public strongly supports bipartisan action ― and if Trump were to sign a bill, flanked by Democratic and Republican lawmakers, he’d get the kind of signing ceremony he so obviously craves. He’d even look like he was governing.

But first Trump would have to give up on the idea that if he “lets Obamacare fail,” he will be able to grind down Democrats to the point where they will “scream death” and give him everything he wants. It’s an absurd idea to begin with — polls have suggested the public will hold Trump and Republicans responsible for further Affordable Care Act problems on their watch, so Trump doesn’t have the leverage he thinks he does. But the key point is that Trump believes it is within his power to do this.

* DEMS TAKE BIG LEAD IN GENERIC BALLOT MATCH-UP: A new Post/ABC News poll finds that Democrats now lead in the generic congressional ballot match-up by 14 points, 52-38. But there’s this caveat:

Republicans actually hold the advantage in enthusiasm at this early point in the campaign cycle. A 65 percent majority of Republicans and GOP-leaning independents say they are certain they will vote next year, versus 57 percent of Democrats and Democratic-leaning independents.

Recent midterm elections have shown a big drop-off in Democratic voting. You’d think the Trump presidency would help change that, but …

The Senate GOP’s effort to overhaul the health-care system collapsed this week when multiple Republican senators came out against both the revamped bill and the idea of repealing Obamacare and letting the markets “fail” before replacing it. (Jenny Starrs/The Washington Post)

* TRUMP WAS ‘BORED’ BY HEALTH-CARE BILL FIGHT: The New York Times has a deep dive into why Trumpcare failed, which includes this nugget:

The Senate bill … was ultimately defeated by deep divisions within the party, a lack of a viable health care alternative and a president who, one staff member said, was growing bored in selling the bill and often undermined the best-laid plans of his aides with a quip or a tweet.

The real shock there is the notion that he “grew” bored. Was there ever a time when the specifics interested him in the least?

* HOUSE DEM TRIES AUDACIOUS MOVE ON RUSSIA PROBE: CNN reports that Democratic Rep. Seth Moulton of Massachusetts is issuing a challenge to his GOP colleagues on the Russia probe:

Moulton plans to offer an amendment that puts the House on record supporting Special Counsel Robert Mueller’s probe and committing that it will provide any resources it needs for the team of lawyers at the Justice Department. The proposal would be attached to the House GOP crafted budget resolution.

The House Dems’ campaign arm also formally asked their GOP counterparts to show a united front against Russian sabotage of the 2018 elections, with no luck.

* TRUMP’S VOTE SUPPRESSION COMMISSION MEETS TODAY: The president’s commission on “election integrity” is set to meet for the first time, and The Post’s curtain-raiser doesn’t inspire confidence:

[The commission] includes the publisher of “Alien Invasion II,” a report on undocumented immigrants who mysteriously showed up on the voter rolls in Virginia … Another championed some of the strictest voter identification laws in the country during her days in the Indiana legislature. And yet another warned nearly a decade ago of the “possibility for voter fraud on a scale never seen before in this country.”

Let’s not forget that one reason this commission exists is to validate Trump’s lie that he would have won the popular vote if not for millions of illegal votes.

* REPUBLICANS ARE VERY SERIOUS ABOUT THE RUSSIAN THREAT: The Atlantic talked to a lot of congressional Republicans to see whether there is any point at which they might break with Trump. The answers are not encouraging:

On one point, at least, there seems to be widespread consensus: All of them believe they’re already doing everything they can within reason to hold the president accountable — and they fiercely reject any argument to the contrary. One senior GOP aide, for example, described the outrage over Russia’s election meddling … as “a lot of partisan noise” generated by opportunistic Democrats. “Is there a cybersecurity issue here that needs to be taken more seriously? Absolutely. But,” he added with a scoff, “democracy is not dying in darkness.”

The phrase “within reason” is doing a lot of work here. Why aren’t more Republicans calling on the Trump administration to do more about Russian meddling in 2018?

* A LESSON IN WASHINGTON CHICANERY: Glenn Kessler notes that Trump and the White House have been claiming that under their bill, Medicaid spending would go up. But that’s actually a standard D.C. trick:

Defenders of the law tried to claim that Medicaid spending could to go up over that 10-year period, just at a slower rate of growth. That’s because the raw dollars would increase from $393 billion in 2017 to $464 billion in 2026. But that claim ignores that CBO estimated that, with the lower funding, 15 million fewer people would be enrolled in Medicaid. By 2026, funding for Medicaid would be $160 billion lower than under current law.

But Trump is an outsider who’s bringing a fresh businessman’s eye to governing! He’d never resort to typically sordid tactics used by swamp-dwelling politicians, would he?

* AND AN OHIO FATHER IS DEPORTED: ABC News has the emotional story of an Ohio father of four who never had a criminal record and worked at a packaging plant who has been deported. Note this, from former acting Immigration and Customs Enforcement chief John Sandweg:

“Cases like this are an incredible waste of ICE resources that only make it harder for the agency to identify and remove dangerous criminals… the [Trump] administration’s focus on the low-hanging fruit of the enforcement system only allows the bad guys to remain at large, weakening our public safety.”

Beyond the humanitarian argument, this is a matter of resource allocation. Is this really a good use of limited enforcement resources?