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Trump is destroying Obamacare without actually repealing it

Trumpcare may still have a pulse, thanks to Trump.

Frustrated by congressional Republicans’ inability to repeal and replace Obamacare, President Trump is taking matters into his own hands and unilaterally changing — Democrats say sabotaging — President Obama’s signature legislative accomplishment, which candidate Trump promised to kill.

The latest in a series of executive actions designed to strip Obamacare’s gears will come Thursday, via an executive order that will lift some of Obamacare’s insurance rules for people and small businesses who group together to buy “association health plans.”


Trump previewed the move in a tweet on Tuesday:

The planned executive order earned praise from Republican Sen. Rand Paul of Kentucky, who hasn’t supported many of the attempts to repeal Obamacare because he felt the reforms didn’t go far enough.

The association health plans would be exempt from some Obamacare regulations such as requiring all insurance plans to cover procedures the government has deemed to be “essential health benefits,” according to the Wall Street Journal — things like maternity care, mental health care, and prescription drugs. Republicans argue that these rules unnecessarily inflate the cost of insurance, while Democrats insist they’re necessary consumer protections.

READ: Why the House put off its vote on Trumpcare

The legislative attempts to repeal and replace Obamacare took aim at those same essential health benefits. But with those bills stymied, Trump is doing what he can within the confines of the federal bureaucracy.

Other actions to hinder Obamacare include:

—Trump last week undid an Obamacare mandate for employers to cover birth control in company-sponsored healthcare plans.

—In September, the Department of Health and Human Services announced it was slashing the budget for Obamacare enrollment by 72 percent. The advertising budget of $100 million was cut to $10 million and the in-person outreach efforts were cut from $62.5 million to $36 million. “People are aware of Obamacare and the exchanges; they are aware they can sign up,” an HHS spokesperson said at the time.

—Trump has repeatedly threatened to shut off the Cost Sharing Reduction payments, which help keep people’s out-of-pocket insurance costs down and prop up the Obamacare marketplace.

But some of Obamacare’s chief architects are confident that Trump has limited ability to get rid of the healthcare law. “Will Obamacare survive? Absolutely,” said Massachusetts Institute of Technology economist Jonathan Gruber, who was a consultant for the Obama administration’s healthcare push. “These actions don’t delete the law; it just makes it less successful.”