In a recent speech to the World Health Care Congress, CMS Administrator Seema Verma reportedly said “I take exception to those out there who have made claims that we have tried to sabotage the health care of the American people, particularly when it comes to the health-care exchanges. Obamacare was failing long before Donald Trump became president and I became CMS administrator…” In light of this statement, after consulting a thesaurus, we highlight how the administration has attempted to obstruct, impair and undermine healthcare.   

Here are just some of the ways the administration has sabotaged negatively impacted health care:

• President Trump is quoted as saying “Let Obamacare fail; it'll be a lot easier.”
• HHS created a website which describes the Affordable Care Act (ACA) as having “done damage to this market and created great burdens for many Americans.”
• President Trump is quoted as saying “I’ve been saying for the last year and a half that the best thing we can do politically speaking is to let Obamacare explode…”.”
• The administration refused to pay Cost Sharing Reductions (CSRs) to help lower-income consumers afford coverage.
• The U.S. Department of Health and Human Services (HHS) decided to not participate in events with advocates to educate consumers about open enrollment and their plan options.
• HHS cut the open enrollment outreach and advertising budget by 90%.
• HHS cut funding for many “navigator” organizations that help people enroll by almost 50%.
• Healthcare.gov was shut down during critical times during the open enrollment season. On the first day of open enrollment, the site was shut down overnight.
• HHS canceled contracts to provide enrollment assistance in various cities around the country.
• In 2017, HHS cut the time in half for consumers to enroll in an ACA Marketplace plan.
• President Trump included a proposal in his budget to slash millions in spending for healthcare.gov  
• The LA Times reported that Seema Verma suggested to insurers that “The administration would fund the CSRs if insurers supported the House Republican bill to repeal the Affordable Care Act.”
• President Trump touted and signed a bill that gave tax cuts to wealthy individuals and repealed the ACA’s individual mandate. Even former HHS Secretary Tom Price said this will cause “individuals who are younger and healthier not participating in that market, and consequently, that drives up the cost for other folks within that market.”
• President Trump signed an executive order directing the administration to seek the expansion of Association Health Plans and Short-Term, Limited-Duration Plans. These plans do not meet basic benefit criteria and offer little real coverage.  The executive order also contained a provision that will allow, according to the Center for American Progress, “employers to use health reimbursement accounts to move their less healthy employees into the individual insurance market, increasing premium costs in that market.”
• President Trump is quoted as saying “Obamacare is finished. It’s dead. It’s gone…You shouldn’t even mention it. There is no such thing as Obamacare anymore.”
• HHS used tax payer funds to create and post videos on its YouTube channel of people who described being “burdened” by the ACA. An HHS spokesperson called these “educational” videos.
• Former HHS Secretary Price, while Secretary, sent a series of anti-ACA infographics describing the ACA as “a losing hand for Nevada, the wrong horse for Kentucky, and leaving Alaska out in the cold.”
• HHS released its draft FY 2018- 2022 Strategic Plan that made virtually no reference to implementing the ACA.
• It was reported that the administration would auto-enroll millions of Americans into plans without conducting sufficient outreach to encourage them to shop around for a better deal.
• The administration issued a proposed rule to allow more Association Health Plans that could be treated like large employer plans, which don’t have to play by the same ACA coverage rules for the individual or small group market.
• Senator Bob Casey released the “sabotage document” that detailed a secret plan to undermine the ACA through executive actions. Senator Casey said in Politico that “The primary problem here is government officials, government agencies, were taking steps that would lead to fewer people having coverage and erecting barriers to people having coverage. In addition to that, you have kind of a closed-door, back-room slimy deal here that should trouble anyone.”        
• The president’s fiscal year 2019 budget sought to repeal the ACA and replace it with something similar to the failed Graham-Cassidy-Heller-Johnson plan. The HHS budget summary called for implementing this plan “as soon as possible.”
• The states of New York and Minnesota sued the administration for cutting funding for state-based programs that provide health coverage for low-income people. The states received "abrupt" notice that funding for their ACA authorized programs would be cut. A New York state official is quoted as calling the cuts “a cruel and reckless assault…”
• It was reported that the administration conditioned its support of legislation to stabilize the Marketplace on it including proposals that would expand the sale of junk plans and raise premiums for older people – up to five times as much as what younger people pay.
• The administration released the Protecting Statutory Conscience Rights in Health Care Proposed Rule. This amounted to a discriminatory attack on health care rights, allowing providers to refuse to provide care based on their individual concerns.
• The Sunlight Foundation’s Web Integrity Project issued a report showing that information about ACA coverage of mammograms had been removed from WomensHealth.gov.
• HHS issued the Notice of Benefit and Payment Parameters for 2019 Final Rule which would lower the threshold of covered essential ACA health services and leave many consumers without access to the care they need. In addition to undermining essential services, the rule also negatively impacts network adequacy, rate review, navigators and the Medical Loss Ratio, which requires insurance companies to use a set, minimum amount of premiums to pay for health care. 
• The administration issued the Short-Term, Limited-Duration Insurance Proposed Rule which would allow the sale of fake insurance. These plans will do nothing but undermine benefits, erode coverage protections, and inflate costs for people who are older or have pre-existing conditions.
• The administration is reportedly examining weakening the ACA’s non-discrimination protections. Specifically, there are potential changes to Section 1557, which prohibits discrimination in health care.
• HHS issued a Request for Information, Promoting Healthcare Choice and Competition Across the United States, which negatively referred to the ACA as “expensive” and “mandate laden.”
• Vice President Pence is quoted as saying “Obamacare has failed and Obamacare must go.”

These actions by the Administration have obstructed, impaired, and undermined access to quality coverage and health care.

It is health care sabotage.

May 10, 2018 – B. Belton