Trump's Obamacare Death Threat Is Likely Just Bluster

In other words, it’s all up to the president and HHS Secretary Tom Price in the near term. If they want, they can send insurers scurrying away from the exchanges or force them to jack up rates in a way that will damage enrollment. By not enforcing the ACA’s individual mandate, killing cost-sharing subsidies and refusing to encourage new enrollment, the administration can dramatically disrupt the exchanges — no Congress needed.

But as much as President Trump might enjoy the fantasy in his head — one in which the ACA rapidly collapses and Democrats come to the negotiating table, begging to pass repeal-and-replace measures they’ve consistently opposed — letting the individual market devolve into chaos would be an unprecedented presidential act and a huge political risk.

Not only would this approach directly harm Americans and a sector that makes up a fifth of the economy, it would more likely enrage Democrats (and provide for potent political advertisements) than bring them to the table. The GOP would conclusively own the market failure heading into 2018′s midterm elections.

Price said on Friday that “HHS has taken numerous steps to provide relief to Americans who are reeling from the status quo, and this effort will continue.” That doesn’t sound like someone actively planning to destabilize the insurance market. The growing chorus of calls for a bipartisan ACA fix may not result in a bill any time soon, but nor does it suggest Congress would take kindly to deliberate sabotage.

The Trump administration quietly passed on the latest opportunity to stop paying cost-sharing subsidies, which would have caused exchanges to truly implode. Despite any threatening tweets that might emanate from the White House in the days ahead, expect the administration to keep avoiding that outcome.

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