That may one day be the title of the unauthorized account of the Trump presidency. And, of course, President Trump would likely sue the author.
As you may have guessed, I’m not feeling very “glass half-full” at the moment. The day started off fine with a decent night’s sleep, a relaxing morning and attendance at the peaceful and spirited Women’s March on Lansing (Michigan). I even had a good idea for a post shortly after I awoke and was eager to write it when I got the chance.
That post I started this morning is entitled, “Well, That’s Clear as Mud” and had to do with the vagueness of the President’s executive order entitled “MINIMIZING THE ECONOMIC BURDEN OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT PENDING REPEAL.” The post was to touch on how I expected to finally know the President’s plans once he took office and began governing, but that first executive order told us nothing. Or so I thought – I now believes it tells us a lot and it is insidious.
Helping me reach this conclusion:
- I thoroughly read the executive order.
- White House Prests Secretary Sean Spicer berated the press for spreading fake news when it was accurate news and an error, later corrected, and he used fake facts in his attack. He also had previously accepted an apology for the error last night, but today, it was all vitriol from Spicer.
- President Trump grossly overestimated the crowd on inauguration day at 1 – 1.5 million.
You can read the executive order by clicking on the link in 1. above, but here are some portions that disturb me. The leaders of all executive departments and agencies which have control over any part of the healthcare law exercise all authority and discretion available to them:
- “to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.”
- “to provide greater flexibility to States and cooperate with them in implementing healthcare programs.”
This executive order is so vague and so broad that while we can guess at the possible actions, we really have no idea what will be done behind closed doors in the executive branch of government. They don’t have to tell us! Perhaps the IRS will no longer enforce the tax penalty for those without insurance. Maybe health insurers will again deny coverage to those with preexisting conditions because, while there’s still a law forbidding this, they have nothing to fear if the law will not be enforced. Many of those people covered by the Medicare expansion portion of the ACA may lose coverage if the 5-10% of the costs picked up by the states is deemed a fiscal burden, and the Attorney General will not pursue legal action against the states that drop people out of the program because of this executive order.
It is also so broad and vague that it the executive branches can pick the winners. Reducing regulation on business – i.e., “purchasers of insurance” – will almost certainly raise prices or reduce coverage for the insured – “recipients of healthcare service.” You can’t help one without hurting the other. There are plenty of other pairs of winners and losers in that list, but we simply don’t know and can’t know from this executive order what is going to happen.
The shorter section noted above about greater flexibility to States with respect to implementing healthcare programs is also worrisome. Some states make decisions based solely on monetary calculations. An excellent example is Texas. The Texas Education Agency (TEA) caps special education enrollment at 8.5%, which is the lowest in the country; the U.S. average is 13.0%. Since 2004, TEA has reportedly threatened to crack down on school districts that exceed 8.5% special education enrollment, and the state has reportedly saved billions of dollars by denying special education services to tens of thousands of children who meet the federal criteria. The Texas state average used to be 11 or 12% according to Mike Moses who ran the TEA from 1995-1999, and the number of low-birth-weight babies, teen pregnancies and kids in poverty has only grown.
Do we really want to give states total control over healthcare systems for their residents? I am certain that some states will make it very difficult for many of their residents to obtain health insurance, and potentially, healthcare. Texas prides itself on being a low tax environment for business, but it seems to be these kinds of restrictions on social safety net programs which help provide for that low tax system. We can debate the pros and cons, but for this post I feel confident in proclaiming that millions of people will lose coverage under exclusively state run healthcare systems.
So what can we do? We have this executive order which says that any portion of the Affordable Care Act may be subject to non-enforcement and that they don’t have to tell us what they are actually going to do. In popular books and movies, hackers evade detection by mapping a route full of dead ends called red herrings. When the hackees, or the white hats they hire, try to find out who hacked them, they hit these dead ends, take a step back and try another route. It makes for an exciting book or movie, but this executive order is full of red herrings and I find it much more troubling than exciting.
The American people need our own white hats. The only way we are going to find out which portions of the ACA are being enforced and which are not is through investigative journalism. These men and women will form relationships, probe systems, and ask the important questions on our behalf. They will ferret out the truth – hopefully before it is too late. This executive order allows the foundations of the healthcare system for tens of millions of Americans to be secretly undermined, and we need these investigative journalists to figure it out for us.
- Subscribe to a news organization with a strong investigative journalism department (New York Times and Washington Post, for example, but also your local newspaper which may be the first to discover something fishy going on in your community), and
- When the news comes out of threats to healthcare coverage for tens of millions of Americans, be active. Contact the White House (whitehouse.gov), your Senators, and your Representative and tell them that you want it to stop.
There was a sign at the Lansing March today which read, “Your Silence = Your Consent.” I didn’t much care for the sign because of its unintended implication toward sexual assault, but with respect to news of executive branch wrongdoing, it’s spot on. Don’t be silent when the news comes out. Be active and stay active. Your country needs you.