Here’s how Trump could sabotage Obamacare

I’ve got a new op-ed under that headline in the L.A. Times. Here’s an excerpt:

The private insurance market is much more vulnerable. And the biggest problem may not be what the Trump administration does. It may be what it doesn’t do. The exchanges depend on complicated information technology, and maintaining them requires competent day-to-day management. What if Trump doesn’t bother?

The problem is most acute for the 38 states that rely on HealthCare.gov, the federally administered exchange. But it’s also a concern for the states, including California, that run their own exchanges. To calculate a customer’s subsidized premiums, for example, the state exchanges need to know that customer’s income — which requires rapid communication with databases at the Internal Revenue Service. If that communication channel goes down and no one repairs it, the state exchanges can’t work.

For Obamacare to falter, in other words, Trump doesn’t need to burn down the exchanges. He just needs to let their gears turn to rust.

This sort of malign neglect would violate the president’s constitutional duty to “take Care that the Laws be faithfully executed.” But don’t expect the courts to save the day. Courts are pretty good at stopping presidents from doing unlawful things, but they can’t thwart a campaign of mismanagement.

Read the whole thing!  Also, if you’re very curious, Adrianna and I have compiled a longer list of the executive actions that the Trump administration might consider in connection with the ACA.

@nicholas_bagley

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