7 Ways President Trump Is Undercutting Obamacare

WASHINGTON, DC — "Repeal and replace Obamacare" was a Republican rallying cry for seven years, leading the party to take the White House and win majorities in the House and Senate. But after failing to fulfill the promise, the Trump administration has decided to chip away at the lw, even if they can't get rid of it entirely.

"ObamaCare is a broken mess," Trump tweeted Friday. "Piece by piece we will now begin the process of giving America the great HealthCare it deserves!"

While it may be satisfying for Republicans to weaken the Affordable Care Act and its provisions, the move brings political risks. There's a reason the GOP promised both "repeal" and "replace" — the party knows that if it doesn't make health insurance more affordable and accessible to people, the voters will not be happy. If people end up paying more for insurance or getting worse coverage, Republican voters may abandon their lawmakers in droves in 2018.

WATCH: This Activist Is Worried That Trump's Health Care Move Will Hurt Him

Here are seven ways the Trump administration is currently working to roll back Obamacare without passing any legislation at all:

1. Uncertainty

Since he was elected, one of the biggest impacts the president has had on the Obamacare insurance markets has been spreading uncertainty about the law's prospects. Both insurers and individuals who could purchase coverage under the law know he and the Republican Party would like to demolish the policy. (For more information on this and other political stories, subscribe to the White House Patch to receive daily newsletters and breaking news alerts.)

This makes insurers less confident about the future of the market and potential customers less likely to enroll. Louisville, Kentucky-based Humana, for instance, said its decision to leave the Obamacare markets was based on its uncertainty about the future of regulations under GOP leadership.

2. Short-term plans

Under a new executive order signed this week, Trump instructed his administration to loosen regulations on short-term health insurance plans. These plans are not subject to the same expansive Obamacare regulations that require coverage for essential health benefits and set caps on out-of-pocket spending.

Obamacare limited short-term plans to cover people for a maximum of three months. Trump's executive order will likely loosen this requirement and let customers buy short-term insurance that lasts for nearly a year.

3. Association plans

The order also paves the way to make association plans, which are also not subject to all of Obamacare's regulations, more common. These plans would have fewer benefits than insurance that complies with federal regulations, but it may be more affordable for some people.

Experts worry opening up both association plans and short-terms plans could split the market. Healthier, younger people will be more attracted to short-term plans and association health insurance, because they are less like to need medical care and the premiums will be lower.

But if healthier people leave the Obamacare markets, older, sicker people who need more comprehensive coverage could end up paying much more for their premiums.

4. Shorter enrollment period

Obamacare set up an enrollment period for health insurance. Since it is still the law of the land, the Trump administration is running the Obamacare enrollment period this time around — but it decided to make it much shorter.

Enrollment begins on Nov. 1 and lasts until Dec. 15. Under President Obama, enrollment was six weeks longer. And because the Department of Health and Human Services will be conducting maintenance on its website for 12 hours on nearly every Sunday during the enrollment period, people will have even less time to sign up.

With a truncated period to sign up for health insurance, it's almost certain that fewer people will sign up for a plan than they otherwise would.

5. Tax penalty

One of the central — and most controversial — parts of Obamacare is the tax penalty imposed on people who do not sign up for health insurance. While the administration has indicated that it will respect the law as it stands, it may increase the number of exemptions to the tax penalty it allows. Since the penalty encourages people to sign up, weakening the mandate, or even signaling that it might be less enthusiastically enforced, it could reduce the number of people who enroll in health plans.

6. Weakening the contraception mandate

Obamacare required nearly all companies to provide health insurance to their employees that covered a wide range of benefits, including contraception. While some religious organizations could exempt themselves from this rule, the Trump administration recently announced that it will let any company that has a "religious or moral" objection to this form of coverage opt out.

7. Cost-sharing reduction payment

Thursday night, the White House announced it would stop paying cost-sharing subsidies. These Obamacare subsidies provide additional funds to insurers to cover the cost of patients who incur extensive medical bills.

Without the subsidies, health insurers may pull out of the individual market and leave more states with less and less competition, which would lead to the higher premiums. However, for many people insured on the individual market, Obamacare's premium tax credits would absorb the additional costs. Only those people making over 400 percent of the federal poverty line, who receive no Obamacare tax credits, would pay the increase.

In addition to the effect on premiums, ending the payments will likely add to the deficit.

"Federal deficits would increase by $6 billion in 2018, $21 billion in 2020, and $26 billion in 2026," the Congressional Budget Office found in its analysis of the change.

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