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‘Willful neglect’ of Obamacare is unsafe and unacceptable


President Donald Trump is trying to let Obamacare disintegrate on its own

In my younger days as a newspaper reporter, my beat was a busy city with a historic district. Every month, there was a new developer who wanted to demolish an old building, but couldn’t do so because of the structure’s location within the district. So, more times than not, the developer simply let the building deteriorate to the point that it crumbled to the ground or became otherwise unsafe due to lack of attention, leaving the developer free to rebuild.


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The term was “willful neglect,” a tool that delighted developers and rankled citizens who had no recourse.

President Donald Trump is trying to let Obamacare disintegrate through a similar mechanism. He is willing to turn his back and walk away from insurance subsidies, promoting open enrollment and other means to simply watch the foundation crumble.

But unlike the historic structures, Obamacare encompasses millions of Americans who will suffer, as well as their physicians, when access to care ends. His actions-or lack thereof-will cause rates to skyrocket for those who rely on marketplace plans for care. Current payer participants in the marketplace have already been fleeing, and the president’s pledge to let “Obamacare implode” surely won’t improve the situation.


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The president already signed an executive order in January, to “minimize the unwarranted economic and regulatory burdens” of the Affordable Care Act, taking aim at the individual mandate (allowing more to claim exemptions) and instead gave states more leeway to claim harm due to the act (via Medicaid programs).

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Following the Senate’s failure to repeal or replace the law of the land on healthcare, the president chided some in his party for not fulfilling a Republican campaign promise repeated over the last seven years. He also made it clear that he was in no way open to improving Obamacare, finding its good parts and fixing those in need of repair. He instead used 140 characters or less to essentially let millions know that their healthcare coverage would suffer instead.


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Just like the developer who can’t compromise to keep one small part of the past to move forward, the president instead plans to sit back, take in a few rounds of golf and wait for the marketplaces to fail, causing panic for both patient and physician.

There is growing bipartisan support to make needed repairs, and keep the foundation of the law in place, however.

One can only hope that the president takes stock of his “willful neglect” of Obamacare. I’m not asking him to endorse the entire legislation, which absolutely needs some work. I’m simply asking him to be a good Samaritan and not walk away. 


Keith L. Martin is editorial director of Medical Economics. How do you feel about President Trump’s approach to Obamacare?
Tell us at medec@ubm.com.

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