- - Tuesday, November 7, 2017


In October, the Trump administration announced it plans to halt illegal federal subsidies paid to health insurers. Predictably, Democrats and liberal pundits alleged the move is reckless and will further undermine the Obamacare health insurance exchanges.

President Trump has “apparently decided to punish the American people for his inability to improve our health care system,” Sen. Chuck Schumer of New York and Rep. Nancy Pelosi of California said in a statement reacting to the announcement.

“It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America,” they added.

The Washington Post’s Amy Goldstein and Juliet Eilperin said Mr. Trump “is throwing a bomb into the insurance marketplaces created under the Affordable Care Act, choosing to end critical payments to health insurers that help millions of lower-income Americans afford coverage.”

A more accurate statement would be Mr. Trump is refusing to violate the Constitution, which he promised to defend at his inauguration. The cost-sharing reduction subsidies Mr. Trump is halting are payments made to health insurers to offset losses they have incurred for reducing deductibles and copayments for their customers who make less than 250 percent of the federal poverty line. Insurance companies are required by the Affordable Care Act to provide these cost reductions, and these subsidies are applied in addition to the federal subsidies given to those who purchase health insurance in an Obamacare exchange who have an income up to 400 percent of the federal poverty line.

Because health insurers must pay for the cost-sharing reductions upfront, the payments they receive from the federal government after the fact are essentially reimbursements, and by 2026, the payments could amount to as much as $130 billion, according to Reason’s Peter Suderman.

During the Obama administration, after Republicans seized control of Congress, federal lawmakers decided not to appropriate funds to pay for the cost-sharing reductions, a power Congress has been granted by the Constitution, which plainly states, “No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law.”

The executive branch doesn’t make law, so it can’t lawfully appropriate money, regardless of whether it thinks that’s the right decision. But that didn’t stop President Obama from doing just that as part of his effort to keep his signature program afloat. Republicans in Congress agreed not to appropriate money, Mr. Obama paid the money to insurers anyway, and the Republican-led House of Representatives sued, reasonably arguing Mr. Obama violated the Constitution.

In 2016, the U.S. District Court for the District of Columbia ruled in favor of the House of Representatives, saying the Affordable Care Act mandates the cost-sharing subsidies must be appropriated by Congress, but that the payments could still be made while the federal government appealed the case, which happened soon thereafter. Mr. Trump won the election, which disrupted the case’s trajectory, and a higher court has never ruled on the matter further.

It seems like a pretty open-and-shut case, so why are Democrats so angry the Trump administration has decided to stop making these obviously illegal payments? According to Mrs. Pelosi, the move “is designed to force families across America to pay the most when they can afford it the least.”

“The American people overwhelmingly rejected Trumpcare, but President Trump is still spitefully trying to sabotage their health care, drive up their costs and gut their coverage,” Mrs. Pelosi added.

“Sabotage”? A deliberate attempt “to force families to pay the most”? If these attacks on the president sound desperate, it’s because they are, in addition to missing the point entirely. Mr. Trump is ending an illegal practice. If stopping the payments will hurt people, then that’s something Congress needs to address, not the president, and that’s precisely what Mr. Trump is hoping his move will do. After months of trying and failing to get Congress to pass health care reform, Mr. Trump has finally said, “Enough is enough,” and he should be applauded for it, not demonized.

We are a nation of laws, but as usual, Mrs. Pelosi and her power-obsessed allies in Congress and the media don’t care. What matters is that their agenda moves forward — legally or illegally. What more should we expect from a group of people who have so willingly accepted a political ideology that long ago embraced an “ends justify the means” mentality?

• Justin Haskins ([email protected]) is executive editor and a research fellow at the Heartland Institute.

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