Fresh off his Republican Party's 941st embarrassing failure of an attempt to repeal the Affordable Care Act—this number is technically approximate, but spiritually accurate—Donald Trump has elected to wreck as much of it as he can without having to rely on Mitch McConnell and Paul Ryan, the dueling twins of utter legislative ineptitude. On Thursday, the White House announced that it would end the payment of federal subsidies to health insurance companies that make insurance affordable for millions of low-income Americans. A press release bafflingly called the subsidies "bailouts," an absurd descriptor that previously earned the Washington Post's coveted Four Pinocchios rating.

“The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system,” a statement from the White House said. “Congress needs to repeal and replace the disastrous Obamacare law and provide real relief to the American people.”

These aren't bailouts. They are cost-sharing reduction payments, or CSRs, that enable private insurers to offer means-tested coverage to lower-income Americans. CSRs split the cost of providing health care between private companies and the federal government and functionally limit the individual's out-of-pocket expenses based on how much they're able to pay. The payments have been the subject of litigation for several years now, because due to a drafting error in the ACA, the text of the legislation arguably authorizes the payment of funds without Congressional appropriation—which is required anytime the government is going to spend money. (This is, in retrospect, a profoundly unfortunate typo.) Now, rather than wait for the court system to sort this out, the administration has elected to render the issue moot.

For poor people who were available to afford health care for the first time thanks to Obamacare, this development is unfathomably cruel. From NPR:

Ending the payments could cause premiums to spike, push insurers out of the marketplace, and even cost the government $2.3 billion more in 2018 than it would otherwise spend, according to one analysis.

Obamacare is not "imploding," as President Trump so often likes to claim without evidence, but this new directive might actually cause that process to begin in earnest. Withholding CSR payments is not governance. It is sabotage. Insurance companies have been urging for weeks that this decision would throw the market into chaos, since it allows companies who intended to offer low-cost insurance in 2018 to scrap their plans to do so altogether.

What they fail to realize when issuing such warnings is that for Donald Trump, chaos qualifies a feature, not a bug. While this president has crafted nothing resembling a coherent policy agenda on any issue of substance, he remains as obsessed as ever with undoing anything that has Barack Obama's name attached to it, no matter how good that thing may be, by any objective measure, for the American people whose interests he claims to represent. Despite its opposition to the Affordable Care Act, this administration has nonetheless continued making CSR payments for nearly a year, and there is no principled reason for it to suddenly stop doing so right now. This happened because Donald Trump is tired of meeting humiliating defeats at every turn, and if the price of eking out a half-measure of a win in an imaginary fight with his predecessor is making health care unaffordable for millions of his most vulnerable constituents, so be it.

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