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First Executive Order – Obamacare repeal foreplay

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Executive order on PPACA - Click to enlarge
Executive order on PPACA

The devil will find work for tiny hands to do.

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  • wjts

    And I’m feeling very sick and ill today.

    • Denverite

      But I’m still fond of you

  • howard

    i was assured by the republican party that executive orders were no way to govern, an anathema to freedom-loving people.

    surely they weren’t lying about such a core matter of principle? this is just a joke document floating around, right?

    • MNmiracle

      Correct. They were not lying. This is just a joke document. No reason to be concerned. /s.

  • Harry Hardrada

    Another thing the Trump administration is violating on day one: the ADA, by removing Spanish/accessibility options from the White House website.

    https://twitter.com/AndrewPaulJoyce/status/822535305139994627

    • ProgressiveLiberal

      LOL I am shocked, shocked that they don’t give a shit about anyone who isn’t fully able and white.

      Any and all laws are subject to being ignored. What is anyone going to do about it?

      • postmodulator

        No, no, Just_Dropping_By assures us that Trump will be bound by all the veto points.

        • Just_Dropping_By

          My point was in regard to things like people claiming that Trump was going to suspend the 2018 elections. Obviously any administration can choose to disregard a law in the short-run (see, e.g., every instance where the Supreme Court ultimately concluded that something the Obama administration did was unlawful/unconstitutional), regardless of whether their political party controls any other veto points. The question is what happens when the administration’s actions run into those other veto points. So, assuming that the presidential website is required to comply with the ADA and that removal of the link violated the ADA (which I don’t know one way or another), get back to me when (a) a court refuses to enforce the law or (b) a court orders the administration to correct the problem and the administration refuses.

    • patrick II

      I am surprised that they would do this, but I shouldn’t be. But I am absolutely amazed they thought it important enough to do on the first day.

  • randy khan

    You’ve got to love Section 2 – don’t impose burdens on anyone, not even considering that removing a burden from one party might impose a burden on another.

    • Nobdy

      It says don’t do anything that would cause a burden, not “do things that would reduce burden.” It is a command to inaction and decay.

      • randy khan

        Actually, no – it requires affirmative action to “exercise all authority and discretion available to them to waive, defer, grant exemptions from,” etc. any implementation of the ACA that would burden anyone.

        • Nobdy

          The point is there is no balancing test. The ratchet only goes one way. You delay or waive or whatever if any regulation would impose a burden on someone, but you don’t worry that waiving would impose a burden on someone else who was expecting to receive the benefit. There is no “don’t delay implementation if doing so would impose a burden.” You might be able to create one through framing but as written you are free to waive something if it would impose a burden, regardless of whether the waiver itself imposes a burden. There is no “do not waive if waiver would cause a burden” clause.

          It is like the concept of negative freedom vs positive. This looks only at negative, not balacing against positive.

          • randy khan

            In practice, I’m confident that any action that will benefit insurers will be treated as fine, regardless of the burdens it places on individuals (including, much to their surprise, doctors).

        • Colin Day

          Don’t the Republicans reject Affirmative Action? :-)

    • sigaba

      Its written in a manner meant to suggest that people will be making determinations and he’s giving them latitude, but it’s understood that everybody in the departments will be on the same page.

      It is sortof characteristic of the kinds of laws dictators pass by fiat- the actual operative language is a euphemism, “relieve the burden.” This, of course, doesn’t tell anybody what to do because the burdens are completely a matter of opinion, it’s understood that the blanks will be filled in by off-the-record directives and communication. Causing the insurance markets to death spiral is obviously a huge economic burden, a real law would give a clear decisionmaking process laying out what’s an acceptable burden and what isn’t, but that’s not what this is for.

      There will of course be a very complicated policy conversation going on about how the cabinet and health officials should do their job (or at least give the appearance of doing so) as long as the law is still on the books, but that’ll all be under the table, this order exists only to give the actions they eventually take the color of validity.

  • Nobdy

    What percentage of this document did Trump read before signing? What percentage did he understand?

    I would guess he read 15% or so and understood 5% (his name, the date, and “for immediate release”)

    • ProgressiveLiberal

      0%. They just tell him they have something for him to sign and give him a synopsis. He signs it.

      Welcome to our long national nightmare.

      • efgoldman

        0%. They just tell him they have something for him to sign

        He read the word “order” at the top and his name at the bottom. All he needed to know.

        Anyway, I remain pretty sure he can’t read it – that he is functionally illiterate.

        • bender

          He wouldn’t be able to tweet if he were functionally illiterate.

          I think he has a reading disability such as dyslexia. Reading is an effort for him; that’s why he can’t get through an entire written speech without drifting into adlibs.

          • rm

            People mean a variety of things when they say “illiterate.” He obviously can read and write printed words. But he does not read challenging or technical or difficult texts, whether the cause of that is a reading/learning disability, an attention disorder, or his narcissistic personality disorder (why give concentrated attention to anything other than myself). When he talks the diction and sentence structure are extremely basic. When someone like Reagan or W talked real simple, you knew they were intentionally pandering. I don’t think this fool is capable of better..

          • farin

            He dictates his tweets.

          • delazeur

            He wouldn’t be able to tweet if he were functionally illiterate.

            For a while, Slate (I think) was actively looking for photo or video evidence that Trump has ever actually used a computer keyboard or smartphone keypad, and came up dry. There were a few pictures of him talking into a smartphone (but none of him dialing) and some obviously posed shots with laptops, but nothing definitive. The closest they came was a picture of his office with a laptop sitting on one of the side tables.

    • David Chop

      That document? How about what percentage of the document he just swore an oath to preserve protect and defend has he read, much less understood?

  • vic rattlehead

    But this doesn’t do anything? Does it? It’s typical Trump. All gesture no detail.

    Thus far it’s just saying “hey let’s gum up the works until we repeal it” Which they were gonna do anyway.

    I am feeling very sick. I feel like my mom dropped me off at kindergarten. Where is obama? I want my Obammy back. :(

    • sherm

      Not sure about that. For example, who is responsible for enforcing the mandate? Can the mandate and taxes now be ignored without consequences?

    • Nobdy

      It provides cover for others to do bad things. States can close help centers and sign up drives. Maybe Healthcare.gov goes down and they don’t fix it for awhile. Language options get cut. Medical devices are re-classified outside the tax category.

      Imagine a thousand Kim Davises out there ready and waiting to do their jobs badly or not at all and the president of the United States just said “go sick!”

    • TopsyJane

      Where is obama? I want my Obammy back.

      I wonder if your Obammy is wondering if he should have taken all those shots at Trump at that fatal correspondent’s dinner. The Donald is not mocked.

  • Lasker

    So, can anyone ELI5 what this actually means?

    At minimum, I’m thinking it suggests that the DOJ will no longer defend the ACA against challenges from the states.

    I’m going to call this ruin/repeal/replace and optimistically hope that this is an effectively meaningless CYA move because they are no longer confident they have the votes to repeal.

    I wish I really believed that.

    • Denverite

      No mandate enforcement (business or individual) plus states are going to get a lot of waiver flexibility incl prob block grants

      • Lasker

        Thanks. Makes sense about the waivers.

        But how would the changes to the mandate enoforcement work?

        Is it: update your tax software not to include the penalty for being uninsured? Or is it still there but payment is not enforced? And if it is the latter, how does that work? the IRS sends you a bill for unpaid taxes and you write a little note that says “ah yes, the difference is the no-longer-enforced individual mandate, kindly forgive it”?

        • efgoldman

          the IRS sends you a bill for unpaid taxes and you write a little note that says “ah yes, the difference is the no-longer-enforced individual mandate, kindly forgive it”?

          The way things are going, they probably plan to have nobody at the IRS to check returns and send letters.

          • Lasker

            Trump (further) de-funding the IRS would be perfectly in character.

            • Sentient AI from the Future

              Probably a good time to get involved in tax return fraud

              • Lasker

                No kidding. I am self-employed in a largely cash-based business and could easily report next to nothing. The injustice of our health system is such that if I had a chronic health condition I would feel no guilt whatsoever about “reducing” my income to the point where I qualified for Medicaid, but as a healthy socialist, to do otherwise than report honestly would be hypocritical.

                • ProgressiveLiberal

                  You can make a donation to the treasury for the amount you’d have owed. Just sayin…

                • alexceres

                  You’re not rich enough for the rules to not apply. I think the IRS will be auditing the plebs with vigor under this administration. That tax money could be redirected to a trump affiliate! Republican concern for small businesses is a facade

          • ProgressiveLiberal

            Something like this. Don’t enforce it on taxes. Maybe even auto refunds for anyone who paid the fine.

            The point is to kill the individual mandate to induce a death spiral to kill the market. Healthcare companies just threw up in their mouths. I’ll be shocked if more than just a handful nationwide even produce plans to give to insurance commissioners this spring for next years marketplace. This could be the nail in the coffin.

            As of today, its #TrumpCare. Fucking pussy democrats need to get on this now.

            • Origami Isopod

              Fucking pussy democrats

              Fuck you, you misogynist piece of shit. Especially on the day of the Women’s March.

  • LeeEsq

    Its going to be a long four years.

    • Denverite

      We wish

  • Bitter Scribe

    Just today I bought health insurance on the ACA exchange. I need it because I lost my job (Merry Christmas, you’re fired) and my company insurance is going to run out in three weeks.

    The ACA insurance will cost me $150 a month for medical and dental. COBRA coverage would cost me $650.

    I’m scared. And I’m angry. Does “make America great again” mean going back to the days when unemployed people were expected to shoulder the full cost of health insurance?

    • Nobdy

      Donald Trump cut off health care for his nephew’s disabled son over an inheritance dispute. That is the degree to which he gives a damn about other people (even his own relatives!)

      • AdamPShort

        at the risk of setting off the Godwin alarm, I am getting the feeling that the next four years is going to involve a lot of people making the face that the Nazis kept making in Untergang when they realized “holy shit this guy Hitler really has no humanity at all!” and you want to be like ‘yeah where have you been the past 25 years?’

      • wengler

        You gotta remember that one of Trump’s early mentors was Roy Cohn. Trump is going to plumb the depths of American villainy.

    • Does “make America great again” mean going back to the days when unemployed people were expected to shoulder the full cost of health insurance?

      Certainly not! They continue to have, as they used to, the option of going uninsured, getting sick, and bankrupting themselves if they don’t simply die quickly (and maybe their family even if they do)!! America doesn’t get greater than that!!!

    • Moondog von Superman

      Does “make America great again” mean going back to the days when unemployed people were expected to shoulder the full cost of health insurance?

      Only if they can actually get and keep health insurance. I mean, “insurance.”

      The individual market was a terrible place. Most people had zero awareness of this fact. (And most still don’t know.) Til they lost their job and their government-subsidized employer-provided insurance.

      • efgoldman

        Til they lost their job and their government-subsidized employer-provided insurance.

        Even then, the ex-employee could keep the insurance for eighteen months under COBRA, but had to pay the entire employer+employee premium. Typically coverage would go from ~$150 or so/month to nearly $700. Just what somebody who’s unemployed needs.

        • postmodulator

          Mine was something like $1100. By the time I might have needed it I had a start date three weeks in the future (with the same employer. My life is weird) and I just rolled the dice that my wife and I wouldn’t get the hantavirus or something in that window.

    • alexceres

      You’re not a real American, so your problems are just whining for socialist hand outs.

    • Barry_D

      “I’m scared. And I’m angry. Does “make America great again” mean going back to the days when unemployed people were expected to shoulder the full cost of health insurance?”

      Yes. And that health insurance won’t cover ‘pre-existing conditions’, where the insurance company defines that.

  • encephalopath

    This is exactly like the way Trump runs his business. It’s not an order or requisition to do something specific and defined.

    It’s “do whatever I would do and make it classy. Oh and you don’t get paid if I don’t like the results of your mind reading.”

    It’s crap from a man who doesn’t understand what he wants policy wise or the steps necessary to get there. It’s just “make me some classy healthcare policy people. You know what to do.” (In the voice of Alec Baldwin)

  • Origami Isopod
    • ΧΤΠΔ

      Per Balloon Juice, we need to make the name Fuck the Fucking New York Times stick.

    • Lurking Canadian

      Oh my fucking God. Now? Today? “Oops! Sorry. Y’all, our bad!”

    • efgoldman

      O/T, but thanks for nothing, Liz.

      I was going to leave her a hearty “Hey, Liz, Fuck you” but you have to register and sign in, so never mind. Everyone here knows I have a good heart and true.

    • Lasker

      Shouldn’t that be “thanks for nothing, Dean?”

      Spayd’s comment is phrased (too) delicately but seems fairly damning.

      • Origami Isopod

        She went along with the charade willingly. Fuck her.

        • Lasker

          I guess she must have defended them in the past? I admit I haven’t followed this story so I’ll defer to you (and others). But hearing that Dean Baquet sees no problem with any of the decisions is alarming, no?

        • Moondog von Superman

          What do you mean by went along with it? As far as I can tell from her account, she was not part of the decision making.

          • efgoldman

            As far as I can tell from her account, she was not part of the decision making.

            She made plenty of risible excuses along the way.

          • ΧΤΠΔ

            It’s true that she may have been hired primarily as a bullet sponge, but issuing crayon-written defenses of BOFF SIDES chickenfucking tends to limit your sympathy. (About the best thing I can say about them is that that they weren’t as bad as POLITICO’s defenses, which were both idiotic and actively evil).

  • Lurking Canadian

    Can one of you legal types interpret what this EO means? Can insurance companies start refusing customers because of pre-existing conditions, or go back to recission and lifetime caps, now, on the grounds that to follow the law is a “burden”?

    • Lots of gas tanks out there. Sure would be a shame if we started pouring sugar in them.

    • vic rattlehead

      Fuck this. Fuck every single piece of shit who is against protecting people with pre-existing conditions (more people than you think-it could be you!), and for rescission and lifetime caps. For throwing us back to the barbarism we had before.

      God damn I’m so pissed off. I will probably lose my health insurance and I know that my smug dipshit doctor father will find some way to blame Obama. And me. It’ll be my fault for having had suspicious moles biopsied and therefore having a pre-existing condition. Or when our coverage drops because my wife is expensive to insure. Fucking dickhead voted for Johnson in Florida. I swear I will never speak to him again if he pulls any of that smug shit on me. Fuck my drunkass aunt for supporting Trump and saying Hillary was a criminal every time she called me up half in the bag. Fuck every loathesome subhuman piece of shit who actively worked for or even enabled the thug currently occupying the White House. All of them.

      I have never been more angry in my goddamn life.

      I only hope that some assholes out there who enabled the rise of Trump will be as immiserated as my wife and I and my friends will be. That is my sole consolation.

      And I will remain politically active and try to be constructive. But I will never stop being pissed.

      • Lasker

        From one ACA-dependent household to another, I salute you.

      • Chetsky

        Amen. As Brad Delong wrote: “If you voted for him, you are dead to me.”

      • ProgressiveLiberal

        Yep. That. Fuck them all.

      • DJ

        Had to delurk to say you have my sympathy. I’m in the same boat, with 20+ years of pre-existing conditions. I’m just as angry. But we have to find a way to channel that anger into something productive. Just a bunch of words from someone you don’t know, I know. I won’t go down without a fight though. And I hope you don’t either.

        • vic rattlehead

          I appreciate that. I just needed to vent. My wife (understandably) doesn’t want to talk about this stuff today and I needed to get it out.

          • DJ

            Haha, from my understanding, that’s what the Internet’s for.

            I’m angry about everything but I’m also a little scared. I’m afraid that, worst case scenario, I won’t hurry up and die. I’ll live for another 50+ years with my health failing by degrees every year.

            I was politically active when I was ideological & younger. Then I got complacent. Now I’m ready again to put myself on the front line.

            ETA: why does spellcheck capitalize “internet?”

            • postmodulator

              There’s one of them. It’s a proper noun.

              • DJ

                Ah, that makes sense.

      • Lurking Canadian

        I’m more than a little drunk right now, so I don’t know how to interpret your post, but just in case: I think the Trump administration ‘s likely actions on the ACA are monstrous. I wish I could do something to put a stop to it.

  • Little Chak

    Fucking hell. People in my neighborhood are setting off fireworks right now. (I live in a terrible neighborhood that includes one house with a Confederate flag and a noose hanging from a tree, and one “colored” family.)

    Stay classy, people.

    • ΧΤΠΔ

      Made plans to move yet? (Also, from & to where?)

      • Little Chak

        Can’t at the moment, financially…I’m in Florida, in a county that is wealthy, overall, but extremely segregated. I once came home from elementary school asking my mom why they called my Jewish friend a god-killer.

        I do like that I’m in a large purple state and can make more of a difference because of it. But god, sometimes…

        Also, I recently buried my dog in the backyard, and I’m not quite ready to leave her behind; and my dad has serious complications from cancer, and my parents might see their premiums go from 600/mo to 2000/mo…
        so there’s that, too. But they’re hard-working blue-collar folks, so I’m sure Trump has a plan for them…

        • ProgressiveLiberal

          I own a house in Palm Beach County and assholes in the neighborhood already have their Gadsden flags back up. And this is a pretty wealthy neighborhood, upper middle class, not a bunch of dumb hicks. Basically the worst type of racists.

          • efgoldman

            not a bunch of dumb hicks.

            DEFINITELY asserts facts contrary to evidence. Money doesn’t make them any less racist mouth breathing flying monkey fuckheads.

            • ΧΤΠΔ

              Golf club-wielding savages.

            • ProgressiveLiberal

              Dumb, racist, yes, but I used to live in PA….so definitely not hicks. I knows a hick when I see one.

              Favorite story from rural PA: getting a car towed “back to the city.” Tow truck driver asks me, seriously, I can’t make this shit up, “how can you stand to live around all those n******s?” Cause, you know, I’m white, so I must be a racist too.

              That’s a hick. A dumb, racist hick.

              • MobiusKlein

                My story from growing up in Oakland CA is telling a kid in 6th grade which elementary school I went to, and him saying “you go there? There are so many black kids who go there.”

                Dumb hicks are everywhere.

        • ΧΤΠΔ

          I actually live in a sub-rural area just outside of Palm Bay, where I’ve lived most of my life), and I’ve never experienced anything that bad or on a regular basis – although wingnuttery is common and I see the odd Confederate flag now and then (I’m AA, for context). Where is this, exactly?

          • Little Chak

            Sarasota. Home of Joe Gruters, who bet his political career on Trump and won bigly.

            I learned everything I needed to know about my county in 2nd grade. One of the few things I remember from that year was an AA classmate stealing my hotdog during lunch; the other thing I remember was dropping a Lifesavers Christmas booklet (I think about 30-40 Lifesavers) into his bag at the Christmas party, because my hyper-racist 2nd-grade teacher (who adored me and sent me birthday cards for the next decade) shamed him in front of the whole class for not bringing a present to the gift exchange.

            This was early 1990s, but I don’t think things have changed as much as people like to think they have.

            ETA: Lol, I didn’t even realize Palm Bay was Siesta Key.

            • ΧΤΠΔ

              Oh, actually there is a fair bit of racism if you know where to look for it, but at least below 30 it’s not usually malicious, and otherwise they take pains to hide it (although in the ’90s the Space Coast was apparently much worse). I dread to think bout race relations in the Panhandle and especially the Redneck Riviera.

            • I suspect we are very nearly neighbours. No asshats setting off fireworks in my neighbourhood though.

          • Little Chak

            Oh, wait…there’s a Palm Bay, Melbourne, FL, which makes more sense with “sub-rural”. I’m dumb. But yeah, my point was that 7-year-olds don’t need to be taught about racism to understand it when they see it. Hatred isn’t natural; it has to be taught.

            Also, I completely agree with efgoldman that rich and middle-class white people can be even more racist than “dumb hicks”, and frequently are.

        • alexceres

          If by “plan” you mean fisting their wallets and retirements, then yes, there’s a plan for all the hard working blue collar folks suckerd into believing Both Parties Do It by the media

  • Lasker

    This explainer from one of Vox’s more reliable contributors is helpful:

    http://www.vox.com/2017/1/20/14343332/trump-obamacare-executive-order

    • ProgressiveLiberal

      Yeah, but all those clowns assume things like “laws” and “norms” mean shit to these people.

      Again, who’s gonna stop them? He gonna get impeached? LOL.

      It’s a lawless free for all.

  • wengler

    Damn. He didn’t even bother re-imposing the international gag rule on abortions first?

    • ema

      Just you wait until Sunday.

  • MDrew

    I wonder if they’re going to look at ways to keep the mandate (penalty) in place while eliminating the subsidies (and regulations).

    The individual mandate (penalty) is a grotesquely regressive tax that falls on lots of very nearly poor people, if not many outright poor people. (I don’t recall where the income cutoff for the mandate s in comparison the FPL.)

    The thing that really gives these people their jollies is cutting taxes on the rich while raising them on the poor.

  • MacK

    CONSIDER THE POSSIBILITY THaT THIS IS A MAJOR POLITICAL MISTATE

    Let me explain. Right now part of what the Republicans are up to is trying to destabilise the ACA – Obamacare – by repealing or threatening to repeal bits without a replacement. Then they’ll yell “death spiral” and look,
    “Obamacare was a bad plan….” But what this Executive Order does, with the Congessional Republicans looking on is take ownership of every bad thing that happens to Obamacare from this point always – Democrats (truthfully or not) can point to this as having triggered any problems – any “death spiral” – and blame Trump and the Republicans.

    • Thrax

      Unfortunately, I think this is the right move politically, or at least hints at the right move. If they want to pressure Democrats to sign onto repeal-and-replace-with-something-crappy, which they do, they need the ACA to stop working. They can do that by ending the subsidies via a reconciliation bill, but that generates a lot of screaming “Republicans Gut ACA” headlines, and Democrats would feel no obligation to sign onto a strategy that they’ve already opposed when they voted against the elimination of the subsidies. The Rs’ fingerprints are already on the ACA sabotage. The smarter play is for Congress to do nothing and have Price quietly sabotage the ACA in as many ways as possible: refuse to enforce the mandate, grant waivers that allow red states to water down coverage, etc., thereby driving down enrollment (and driving up costs when young, healthy enrollees drop out). After a year of “ACA Cratering” headlines, there’d be some real pressure on Democrats to sign onto something.

      They may not take the smart approach because Trump’s attention span is pretty short–he’s going to want to do this right now. And if this year’s budget doesn’t defund the ACA, the base will probably freak. But they do, unfortunately, have a good option.

      • TopsyJane

        The Rs’ fingerprints are already on the ACA sabotage.

        True, but they weren’t in the power position they are now. This will make it easier for Democrats to pin the blame on them, which was harder to do when they were (mostly) just refusing to fix things.

        The danger, as you say, is that they stop the flow of signups and make it harder and harder in small ways for the law to function.

    • AdamPShort

      There’s also the possibility that this fits the principle “people who are actually doing things often don’t make threats. ” i wonder if Trump would bother with this if he were planning to sign a repeal bill anytime soon.

      Seems too optimistic but I’m clinging to it.

      • MacK

        Still, to take a page from the Republican playbook, blame everything that goes wrong with Obamacare on Trump and cite the executive order. From now on it’s their fault …..

        • Thrax

          Oh, sure. It’s just a harder play when the sabotage is done behind the scenes. I’m hoping the Democrats can hold the caucus together in that event.

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