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Jenny Starrs

President Trump has seemed clueless about health care before — but perhaps never so much as over the last 24 hours.

Early Tuesday, Trump decided upon a justification for his controversial decision to <a href="https://www.washingtonpost.com/news/the-fix/wp/2017/10/16/steve-bannon-just-totally-contradicted-trumps-claim-about-canceling-obamacare-payments/?utm_term=.3826d59faa3b">cancel Obamacare payments to insurers that subsidized policies for low-income Americans</a>: The insurance companies are getting rich off this stuff, he claimed.

His argument was dubious at best; insurance companies are making lots of money, but not on Obamacare plans. And not only that, but Trump then suggested at a news conference that he actually supported <a href="https://www.washingtonpost.com/powerpost/key-senators-reach-bipartisan-health-care-subsidy-deal-and-trump-expresses-support/2017/10/17/72be5b04-b355-11e7-a908-a3470754bbb9_story.html?utm_term=.c43f2f395941&amp;wpisrc=al_alert-COMBO-politics%252Bnation&amp;wpmk=1">a newly struck deal that would restore the payments</a> that he had said were lining insurance-company pockets.

And then <a href="https://www.washingtonpost.com/powerpost/key-senators-reach-bipartisan-health-care-subsidy-deal-and-trump-expresses-support/2017/10/17/72be5b04-b355-11e7-a908-a3470754bbb9_story.html?utm_term=.9b20ac5bba83&amp;wpisrc=al_alert-COMBO-politics%252Bnation&amp;wpmk=1">he did a 180</a>. He told the Heritage Foundation later Tuesday that “Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies.” Then he tweeted the same Wednesday morning.

Sen. Lamar Alexander (R-Tenn.) who spearheaded the deal with Democratic Sen. Patty Murray (D-Wash.), is now suggesting Trump pulled the rug out from underneath him.

It's a whole lot of self-inflicted confusion. Let's sort through it.

During an appearance Tuesday morning on Brian Kilmeade's Fox News Radio show, Trump pointed to soaring stock prices for the insurance companies, even bringing along visuals.

“Look at these insurance companies. This is since Obamacare started. Anthem, big company, 270 percent increase. 270 percent. And that’s since ACA, that’s Obamacare,” Trump said. “So since Obamacare, Humana, 420 percent increase. Aetna, 470 percent increase. Cigna, 480 percent increase.”

He added: “They got a great deal with Obamacare. The one beneficiary — the great beneficiaries for Obamacare is not the people.”

First things first: Trump is cherry-picking his data. He appears to be using numbers since Obamacare was passed — back in March 2010 — rather than when it was actually implemented and most of its provisions took effect in 2014. For example, Humana's stock price is up about 140 percent since the start of 2014, rather than the 420 percent since 2010, when the economy was still climbing out of the recession. Cigna is up about 220 percent over that shorter span since the law was put into effect.

And secondly, while it's certainly true that insurance companies' stock prices have spiked in recent years — even more than the thriving stock market as a whole — there is very little indication this owes much to Obamacare. In fact, it seems to be despite it, with insurers generally taking losses from their Affordable Care Act plans.

A <a href="http://money.cnn.com/2017/06/15/news/economy/health-insurers-profits-obamacare/index.html">report the rating company A.M. Best</a> released in June showed the health insurance industry made $13.1 billion in 2016, even as it lost nearly $900 million on its commercial business lines, which include Obamacare policies. The nation's top six insurers went on to make a combined $6 billion in the second quarter of this year, <a href="https://www.cnbc.com/2017/08/05/top-health-insurers-profit-surge-29-percent-to-6-billion-dollars.html" target="_blank">according to a CNBC report</a>, but the biggest insurers still lost money on Obamacare plans.

The fear among Obamacare proponents and <a href="https://bangordailynews.com/2017/10/15/news/susan-collins-says-trumps-move-to-end-obamacare-subsidies-hurts-vulnerable-people/">even many Republicans</a> is that losing these subsidies could tempt insurers who have already been pulling out of some Obamacare marketplaces to pull out even more and/or raise costs for low-income policyholders. In other words, they might continue to make massive profits, but if Obamacare is putting a dent in those profits, Trump's decision might still “blow up” Obamacare, <a href="https://www.washingtonpost.com/news/the-fix/wp/2017/10/16/steve-bannon-just-totally-contradicted-trumps-claim-about-canceling-obamacare-payments/?utm_term=.3826d59faa3b">as former top White House aide Stephen K. Bannon argued</a> it would.

At least by the end of the day, Trump wound up making a consistent argument for what he wants to see from the health-care deal: He doesn't support “bailouts” for insurance companies. But his characterization of those “bailouts” is highly misleading, at best.

Very little of it makes sense, and coming from a president who seemed to vacillate daily on what he wanted from an Obamacare replacement, it suggests Trump doesn't really have a game plan or understanding of how all of this works.

University of Minnesota

Aaron Blake is senior political reporter, writing for The Fix. A Minnesota native, he has also written about politics for the Minneapolis Star Tribune and The Hill newspaper.

Aaron Blake

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