The White House Reduced Poor Americans' Health Care To A Bargaining Chip

Mark Wilson/Getty Images News/Getty Images

As more and more information is revealed about the Senate's health care bill, concern over the future of the country's most vulnerable people is at an all-time high. In order to put additional pressure on Congress to pass the health care bill on Friday, Press Secretary Sean Spicer threatened that the White House is willing to withdraw support for cost-sharing reduction payments.

Those payments, subsidized by the federal government, reimburse insurers for providing discounted out-of-pocket costs to low-income people and help more than 7 million Americans afford insurance. Despite reports from April that Trump intended to continue supporting CSRs, Spicer told reporters on Friday that the Trump administration is prepared to only commit to making these payments on a month-by-month basis, but added that passing a healthcare bill "changes the dynamic."

Trump has previously stated that he could "blow up" Obamacare by ceasing support for CSR payments, but Spicer's statements highlight the political strategy behind such threats:

If the President were to hypothetically say that he's going to make the payments in perpetuity or for a year, I think that continues to prop up a failed system. It continues to do wrong by the American taxpayer. And it also doesn't lend itself to the expediency that I think we want to — help get a new healthcare system in place.

In other words, the end goal is passing the Senate's health care bill.

In an interview with The Economist in May, Trump had few reservations about pulling the plug on the payments:

[T]here is no Obamacare, it's dead. Plus we're subsidizing it and we don't have to subsidize it. You know if I ever stop wanting to pay the subsidies, which I will. ... Anytime I want...

Trump echoed a similar sentiment — and a willingness to let Obamacare "crash & burn!" — on Twitter Monday morning, after criticizing opposition to the Republican health care bill from Democrats.

For Trump, the "crash and burn" narrative contributes to his over-all claims (that have been called "misleading") that the Affordable Care Act is failing or, in his words, is "absolutely dead."

Further, experts have stated that the uncertainty surrounding the future of these CSR payments has already made premiums go up. However, outside the political chess match, the reality of those "crash and burn" threats could be devastating for low-income Americans. According to estimates from the Henry J. Kaiser Family Foundation, premiums would have to increase by percentages in the double digits to make up for the loss of those payments.