Trump order likely to bring higher premiums, skimpier coverage, and failure to provide essential benefits

Developments on Day 264 of the Trump Administration:

Trump Promises Executive Order “FAST” to Replace ObamaCare

After repeated failures to obtain passage of a bill in Congress, Donald Trump says he will issue an executive order to replace the Affordable Care Act:

Trump used a photo opportunity with former Secretary of State Henry Kissinger to amplify that he will “be signing something, probably this week, which is going to go a long way to take care of many of the people that have been so badly hurt on health care”.

He told Forbes in an interview, published on Tuesday:

It’s a total mess. What we’re doing is trying to keep it afloat, because it’s failing. I mean the insurance companies are fleeing and have fled. They fled before I got here. But with that being said, no, Obamacare is Obama’s fault. It’s nobody else’s fault.

On Saturday a “senior administration official” said Trump’s order will authorizing the sale of insurance plans across state lines and roll back regulations on association health plans, where small businesses group together to cover employees.

The changes will allow insurers to charge higher premiums to sicker patients or refuse to cover essential benefits and conditions.

A scheme in Tennessee, using a loophole, has allowed skimpier coverage for tens of thousands of people. The outcome has been that Tennessee has the sickest enrollees and some of the highest premiums in the US, and a diminishing number of health plans.

The Administration has already carried out Trump’s pledge to undermine ObamaCare by pursuing measure to limit new enrollments. Last week it cited “religious freedom” to declare that employers do not have to provide birth control in plans.

See TrumpWatch, Day 260: Trump Administration Limits Birth Control in Healthcare Plans

The Labor Department has already met with business trade groups about reinterpreting federal regulations under the anticipated executive order, according to “two sources familiar with the matter”.

Two sources said the Trump administration is looking into easing rules on short-term insurance policies, allowing them as competition for Obamacare plans with fuller coverage.

Cori Uccello, a senior health fellow at the American Academy of Actuaries, summarized the effect of the measures, “[They] would deteriorate the risk pool, lead to increased premiums, more instability and potentially make insurers have to make decisions on whether they’re going to continue to participate.”

A “F****** Moron”: Trump Wanted 1000% Increase in US Nuclear Weapons

Donald Trump called for an increase of almost ten times in the US nuclear arsenal during a meeting on July 20 of high ranking national security advisors, according to “three officials who were in the room”.

Trump responded to a briefing slide that charted the steady reduction of US nuclear weapons since the late 1960s, surprising the Joint Chiefs of Staff and Secretary of State Rex Tillerson. Officials explained the legal and practical impediments to a nuclear buildup and how the current military posture, despite the reduction in the arsenal, is stronger than it was at the height of the buildup.

Trump also asked for additional US troops and military equipment.

The sources for the story say no expansion is planned.

Soon after the lengthy and sometimes tense review of US forces and operations around the world, Tillerson reportedly said that Trump is a “f***** moron”.

The sources in the meeting said some participants were shaken by Trump’s lack of understanding of national security issues from the Korean Peninsula to Iraq and Afghanistan.

A day earlier, in the White House Situation Room, Trump unsettled his national security team’s meeting on Afghanistan by requesting the dismissal of the commander of US forces in the country. He compared his advisors’ recommendations to that of a New York restaurant consultant whose poor judgment cost a business valuable time and money.

“Two people familiar with the discussion” said the Situation Room meeting was so unproductive that the advisors decided to continue the discussion at the Pentagon the next day in a smaller setting, where Trump might be more focused.

One person “familiar with the discussion” said the thinking was “maybe we need to slow down a little and explain the whole world” to Trump.

Puerto Rico: Trump’s “Success” — Death Toll Rising, 82% Without Power, Many Cut Off

CBS News posts video of the situation in Puerto Rico, three weeks after Hurricane Maria, defying Donald Trump’s promotion of his personal success over the crisis.

Asked “What do you want from the government?”, a police officer replies, “Just to show up”:

See While San Juan Mayor Pleads for Help, Trump Brags, “I’ve Done So Much for Puerto Rico”

Government Office: Trump Transition Refused to Cooperate Over Ethics

The Government Accountability Office has found that the Trump transition refused to cooperate with it, and that it did not ask the Office of Government Ethics to provide assistance to Donald Trump on how to resolve his conflicts of interest or to give input on his ethics executive order after he became President.

The GAO concluded in a 48-page report that there was a lack of attention to ethics and that precedents from previous Administrations were frequently broken – with little recourse from Congress:

We contacted the Office of the Vice President because Vice President Pence also served as the Chairman of the Trump-Pence Transition Team. The Office of the Vice President did not respond to our request to discuss this work….[We] contacted the Executive Director and Chief Financial Officer of the Trump-Pence Transition Team [but they# declined our request for an interview.

While the Trump transition established an “ethical code of conduct”, it did not designate a transition official to enforce it so staff were not strictly required to follow the ethics pledge.

The OGE gave specific recommendations for the hiring of a government ethics expert, but the Trump team ignored this until after the inauguration.