Congress Can’t Let Mr. Trump Kill Obamacare on His Own

Let’s start with short-term health policies. The Obama administration put in place rules that the policies could last 90 days and were not renewable. They’re currently meant for people between jobs. Mr. Trump is directing his aides to extend these plans and make them renewable, arguing that because these policies tend to be cheaper, this change could benefit millions of people. Short-term plans indeed cost less than yearlong policies, but that is because they are not as comprehensive. For example, many do not cover maternity care, cancer treatment or prescription drugs. And short-term policies often do not pay for treatment for pre-existing conditions, a signature requirement of Obamacare policies.

Mr. Trump also wants to expand the use of association health plans, which have been around for years but have a terrible track record. These plans typically work by insuring the employees of small and medium-size businesses that have something in common. A national plumbers association, say, might offer a plan to all of its members and their employees. These plans are lightly regulated by the federal government and often face little oversight by states because their beneficiaries are spread out across the country.

A 1992 General Accounting Office report found such plans had left nearly 400,000 members and their beneficiaries with $123 million in unpaid medical claims between 1988 and 1991. The Trump administration says it will require these plans to meet some of the requirements of the A.C.A., like protections for people with pre-existing conditions, but it has provided few details.

The combined effect of cutting off the insurance payments and the executive order will be to destabilize the A.C.A.’s individual market, which is used by nine million people to buy health insurance. Younger and healthier people will be tempted to buy a skimpy short-term policy with low premiums and switch to a policy that complies with the A.C.A. only when they need…

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