September 27, 2017

After insisting he had the votes to repeal the Affordable Care Act if only a Senator hadn't been in the hospital (?), Donald Trump distracted the press with a Shiny Thing called an Executive Order Doing A Thing Which Is Already Allowed To Be Done.

First, the claim that Grassidy would have passed if only a Senator hadn't been in the hospital. Which Senator? Apparently Thad Cochran has been out of Washington this week due to health issues, which at least validates that part of Trump's claim.

Still, he didn't have the votes. Are the sycophants surrounding him telling him he DID have the votes so he doesn't take after vulnerable Republicans on Twitter? Or is he just blowing smoke? Maybe it's a little bit of both.

Trump then went on to say it would be done in January, February or March of next year. I do not know why he spread out the promised terrorist threat over three months. Perhaps he is hoping for attrition amongst Republican Senators opposing his ramshackle repeal efforts and terrorist threats or something.

But wait! There's more.

He will also negotiate with Democrats! He wants to block grant Medicaid still and wants Republicans to do that alone but he will also negotiate with Democrats for something! We don't know what that is, but apparently he will negotiate A Thing With Democrats.

But wait! There's STILL more.

He was asked about the Great Tyrannical Executive Orders (at least they were tyrannical when Obama signed them, amirite?) and whether he would be signing any. He will be signing some. At least two, apparently.

"I am considering an executive order on associations and that will take care of a tremendous number of people with regard to health care," he answered.

It won't take care of a tremendous number of people at all but it will make Rand Paul dance for joy with a tingle up his leg so there's that.

"I'll probably be signing a very major executive order where people can go out, cross state lines, do lots of things and buy their own health care," he continued, "And that will be probably signed next week. It's being finished now. It's going to cover a lot of territory and a lot of people. Millions of people."

Well, actually, no. The Affordable Care Act HAS provisions for selling insurance across state lines, but insurers don't want to do it. It makes very little sense to do it, because the primary driver of health costs is local costs inside local networks.

The American Academy of Actuaries is less optimistic: “The ability to lower premiums by allowing cross-state sales of insurance is limited,” the organization says, “because a key driver of health insurance premiums is local costs of health care.” When the idea was floated last year at an industry conference, the “audience literally laughed,” one health care consultant noted.

As previously noted, the ACA has specific provisions for health care choice compacts across state lines. A handful of states allow them, but no insurer is implementing them.

The only purpose of an executive order would be to force states to accept out-of-state policies even if they don't meet state requirements for health insurance. That would seem to be an order which could be challenged in court easily enough, as a violation of the precious "states' rights" conservatives whine about constantly.

The bottom line here is that the "across state lines" argument has always been a canard and a race to the bottom. Insurers aren't going to do it, but there will be some scam companies which will form to relieve people of their hard-earned money before someone puts a stop to it.

Grifters gotta grift, and Donald Trump is the Grifter-in-Chief right now.

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