President Donald Trump has pledged to slowly dismantle the Affordable Care Act until Democratic lawmakers agree to help repeal it.
Trump's comments arrived after he signed an executive order that relaxed key ACA regulations and repealed cost-sharing subsidies. Democrats have accused the president of working to sabotage the health care system for partisan gain.
On Oct. 13, Trump took to social media to announce that he had cut off cost-sharing reduction payments to insurers in the ACA markets.
"The Democrats ObamaCare is imploding," Trump tweeted. "Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!"
The president later added: "Piece by piece we will now begin the process of giving America the great Healthcare it deserves!"
Trump's statements arrived after he took two dramatic executive actions reshaping the ACA. Critics of the directives warn that Trump's moves could destabilize the health care market and disproportionately punish Americans with pre-existing conditions.
On Oct. 12, Trump signed an executive order directing the Department of Labor to explore ways to make it easier for small businesses and groups to join up into health associations to purchase insurance. The directive also would lift ACA restrictions on how long individuals can have short-term insurance policies that cost less and offer less comprehensive coverage, CNN Money reports.
GOP Sen. Rand Paul of Kentucky, who advocated for the ACA revisions, asserted that the executive action would offer patients more options for cheaper health plans. Health care experts have largely blasted the order, warning that it would raise premiums for people with pre-existing conditions.
"The clear intent of the executive order is to create a parallel insurance market exempt from many of the consumer protections in the Affordable Care Act," Senior Vice President Larry Levitt of the Kaiser Family Foundation told Vox. "This has the potential to siphon off healthy people with skinnier benefits and cheaper premiums, leaving behind a sicker pool of people under ACA plans."
Trump also scrapped the federal cost-sharing reduction payments to insurance companies in the ACA markets. These federal subsidies had reimbursed insurance companies that helped cover low-income patients' out-of-pocket medical expenses. Insurance companies have stated that ending these subsidies would prompt them to raise premiums for consumers, The New York Times reports.
Senate Minority Leader Chuck Schumer and House Minority Leader Nancy Pelosi released a joint statement blasting Trump's decision to discontinue the cost-sharing subsidies.
"It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America," the Democratic leaders said. "Make no mistake about it, Trump will try to blame the Affordable Care Act, but this will fall on his back and he will pay the price for it."
GOP Sen. Susan Collins of Maine also criticized Trump's two directives, asserting that they would adversely impact low-income Americans, The Hill reports.
"I will say that I am very concerned about the president's executive order that was issued yesterday and his decision to do away with an important subsidy that helps very low-income people," Collins said during an event in Maine.
Andrew Bremberg, the White House's domestic policy director, released a statement asserting that Trump's directives were steps toward dismantling the ACA until the GOP-majority Congress could outright repeal the health care law.
"The president still firmly believes that Congress must act to repeal and replace Obamacare, but before that can be done, this administration must act to provide relief," Bremberg said.