by Max Brantley
The one-page order, which Mr. Trump signed in a hastily arranged Oval Office ceremony shortly before departing for the inaugural balls, gave no specifics about which aspects of the law it was targeting. But its broad language gave federal agencies wide latitude to change, delay or waive provisions of the law that they deemed overly costly for insurers, drug makers, doctors, patients or states, suggesting that it could have wide-ranging impact, and essentially allowing the dismantling of the law to begin even before Congress moves to repeal it.Already last night speculation arose that this could bring the end of penalties for those who don't get health insurance. If that's so, it will put a seismic crack by which a variety of fees help pay for the program as well as encourage the broad participation that holds down premiums.
While the Obama administration allowed “hardship exemptions” to the mandate, the Trump administration could conceivably interpret the requirement in a more lenient way, so that more people would not be penalized.Frog in water. With enough changes over time, hundreds of thousands will be bereft of health coverage and perhaps dead. And maybe a politically insignificant number — or type of voter — will notice.
Likewise, federal officials could be more receptive to state requests for waivers under Medicaid, the federal-state program that covers more than 70 million low-income people. A number of Republican governors and state legislators would like to charge higher premiums or co-payments than are now allowed. Some states want to provide a less generous, less expensive package of benefits, or require some able-bodied adults to engage in work activities as a condition of receiving Medicaid.