It's possible, just possible, that the never-ending Republican machinations on repealing and replacing Obamacare aren't really about either. At the very least, they're part of the very real sabotage popular vote loser Donald Trump is engineering on the law. Right now, insurance companies are determining whether they're going to continue in the law's exchanges in the 2018 plan year and what plans they'll offer. The ongoing discussions create a great deal of uncertainty, potentially leading more insurers to scrap the exchanges.
That's what's happened with the major insurer in Iowa.
Iowa’s dominant health insurance company has decided to quit selling individual policies because of tumult in the market stemming from the Affordable Care Act and Republicans’ failed effort to replace it.
Wellmark Blue Cross & Blue Shield’s decision means more than 21,000 Iowans who bought health insurance policies from the company in the past three years will need to find another carrier—and it's not clear all of those people will have another choice.
Wellmark President John Forsyth said his company's decision was painful but necessary, because the carrier had lost $90 million over three years covering that group of people.[…]
Two other carriers, Aetna and Medica, sell individual policies in much of the state. But they have not yet committed to doing so for 2018. Iowa Insurance Commissioner Doug Ommen said he is worried that consumers in some Iowa counties won’t have any options if they need to buy individual health insurance policies for next year. “We are very concerned about this development,” Ommen said of Wellmark’s announcement.
Here's what Forsyth said helped lead him to this decision: "Now, President Donald Trump's administration has decided not to enforce the Obamacare penalty for Americans who fail to obtain health insurance. That makes the situation even worse, Forsyth said."
Trump's regime have not made that explicit decision, but hinted that they would do it. That was the point of a vague executive order that Trump signed his first week in office. He didn't explicitly tell the IRS to stop enforcing the mandate, he told agencies to start looking at ways to unravel the law. The mandate is clearly a target, but it still exists.
Does Wellmark CEO Forsyth know that, and is just using it as a handy excuse figuring that people are going to let it slide, or has he been a victim of the confusion and chaos created by Republicans surrounding the Affordable Care Act? To the 21,000 Iowans who were on the company's plans, it doesn't make a whole lot of difference. They're might be out of luck.
Which is precisely what Republicans have been aiming for.