President Trump called a federal Obamacare director in August to tell her to reject an application from Iowa officials to improve the state’s Affordable Care Act individual marketplace after reading a newspaper article about it, the Washington Post reported Thursday.
Officials in GOP-held Iowa had applied for a Section 1332 waiver, which allows states to make changes to how they provide Obamacare services as long as they don’t reduce coverage or make it more expensive. The officials, including state insurance commissioner Doug Ommen, wanted to implement a “stopgap measure” to make the marketplace more competitive in an effort to lower costs — a plan other states were keeping an eye on to gauge its effectiveness. In September, Ommen argued that, without the waiver, “over 20,000 middle class farmers, early retirees and self-employed Iowans will likely either go uninsured or leave Iowa.”
Trump reportedly read about Ommen’s efforts in a Wall Street Journal article, then tried to contact then-Health and Human Services Secretary Tom Price (who resigned amid a chartered flight scandal last week) by phone but was unable to reach him because he was on a trip in Asia. So Trump instead contacted Seema Verma, administrator of the Centers for Medicare and Medicaid Service, the agency that reviews the Section 1332 waivers and “had been working closely with Iowa as it fine-tuned its submission.” Verma is seen as less likely than Price was to attempt to sabotage Obamacare.
Iowa officials planned to get rid of the state’s Obamacare exchange and replace subsidies with tax credits in an effort to expand insurance options, but even that was deemed unacceptable by Trump, whose administration is attempting to dismantle Obamacare after repeated failed efforts by congressional Republicans to repeal the law. The state’s waiver application is reportedly complete and currently under review, and some administration officials disagree with Trump that it should be rejected.
“Supporters of the Affordable Care Act see the president’s opposition even to changes sought by conservative states as part of a broader campaign by his administration to undermine the 2010 health-care law,” the Post reported. “In addition to trying to cut funding for the ACA, the Trump administration also is hampering state efforts to control premiums. In the case of Iowa, that involved a highly unusual intervention by the president himself.”