Oct 13, 2017, 7:23 AM ET

The Note: Trump takes a chainsaw to health care



President Trump is once again the bull in the china shop, telling Congress, "I broke it, you buy it." Within 24 hours, he will make two statements that could wreak havoc on systems in place expecting lawmakers to pick up the pieces. First, the monumental decision to end subsidies the federal government pays to insurers to keep out-of-pocket health care costs down for lower-income Americans. The Department of Health of Human Services says the payments will stop immediately, and it is possible health insurance companies could pull out of certain markets by next year. The president seems to think the move will strong-arm Democrats to the table, but will they negotiate with a president who has arguably yanked the rug out from millions of Americans? Later today, the president is expected to essentially kick an international accord to Congress. His announcement on the Iran deal will most likely force lawmakers to decide whether or not to reinstitute sanctions. A vicious cycle seems to be emerging: the president dumping more on legislators, and then, frustrated they are not delivering, acting on his own.


There has perhaps been no more consistent thorn in President Trump's side than Maine Sen. Susan Collins. This morning, the moderate Republican is set to make a major announcement. Collins will say whether or not she will run for governor in 2018, a decision that could have major implications for the balance of power in the Senate. The four-term senator has a good read on the political temperature of her state, and has said that traveling back and forth to D.C. can at times be "difficult." Collins has wrestled with the decision for months, and the effects of her move are likely to reverberate nationally. A Collins departure from the Senate would set in motion a highly competitive, and costly, race for her seat in 2020, and could possibly open up an opportunity for Democrats to pick up a seat. Collins, one of the few GOP moderates still left in the Senate Republican caucus, has twice thwarted the president's attempt at health care reform, thrusting her into the national spotlight as a key vote on numerous big ticket policy items. Collins has her share of detractors in her own state, including the state's current Gov. Paul LePage, a staunch supporter of the president. LePage has previously said that Collins would not survive a Republican primary if she were to forgo the rest of her term and run for governor, and has also refused to deny that he may seek to challenge Maine's Independent Sen. Angus King in 2018.


  • President Trump delivers remarks at 12:45 p.m. on his Iran strategy. He is expected to decertify the Iran nuclear deal.
  • The White House announced Thursday night the government will end cost-sharing reduction payments - the Obamacare subsidy payments to insurers that bring down out-of-pocket health care costs for lower-income individuals.
  • Trump is weighing in on Twitter: "The Democrats ObamaCare is imploding. Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!"
  • President Trump will deliver remarks at the Values Voter Summit at 10:10 a.m. ET.
  • One day after Trump said FEMA can't stay in Puerto Rico "forever," House Speaker Paul Ryan leads a bipartisan delegation to the U.S. territory to assess the damage from Hurricane Maria and to get a briefing from officials.

    "Unless things change, I'm not quitting. I'm not getting fired, and I don't think I'll fire anyone tomorrow." --Chief of staff John Kelly


    The Powerhouse Roundtable debates the week in politics, with ABC News senior congressional correspondent Mary Bruce, editor and publisher of The Nation Katrina vanden Heuvel, author of the new book Beyond the Messy Truth Van Jones, American Conservative Union chair Matt Schlapp, and author of the new book How The Right Lost Its Mind Charlie Sykes. Check the "This Week" homepage for full guest listings.


    President Trump aims to strike down parts of Obamacare with new executive order. President Donald Trump signed an executive order Thursday at the White House that seeks to increase consumer options for health insurance, but could further destabilize Obamacare marketplaces. With the "power of the pen," Trump's executive order would unravel significant parts of insurance rules under the Affordable Care Act by directing federal agencies to consider new rules. The order, through a series of rule recommendations to be carried out by Health and Human Services, the Department of Labor and the Treasury Department, aims to get those agencies to expand association health plans, short-term limited duration plans and makes recommendations for changes to health reimbursement arrangements. http://abcn.ws/2gz2Fjt

    Iran nuclear deal: How Trump's plan to pressure Tehran could play out. After months of bashing the Iran nuclear accord while simultaneously keeping it alive, President Trump is expected to decertify the agreement in a speech Friday as part of his new policy toward Iran. But decertification is strictly a matter of U.S. law, a step the Trump administration hopes will give it greater leverage to renegotiate or build on the current agreement. It does not mean tearing up the agreement, and the other parties say the deal is not up for renegotiation –- two things Trump pledged to do as a candidate. Here are the administration's plans for the deal, what they hope will come next, and what else it may mean: http://abcn.ws/2kJufyR

    Chief of staff John Kelly: "I'm not quitting today." White House chief of staff John Kelly forcefully pushed back on rumors of discord between him and President Donald Trump on Thursday, telling reporters he has no plans to resign nor does be have a reason to believe he will be fired. "Although I read it all the time, pretty consistently, I'm not quitting today," Kelly said in his first public appearance at a White House press briefing. "I don't believe -- and I just talked to the president -- I don't think I'm being fired today. And I'm not so frustrated in this job that I'm thinking of leaving." He went on, "I will tell you, this is the hardest job I've ever had." http://abcn.ws/2xByhup

    Trump threatens to pull aid from Puerto Rico. President Donald Trump said Thursday the federal government cannot keep the Federal Emergency Management Agency in Puerto Rico "forever," even as the U.S. territory continues to reel from the devastation wrought by Hurricane Maria in September. http://abcn.ws/2xB87gf

    Trump to extend March 5 deadline to end DACA protections if Congress doesn't act, GOP senator says. The Washington Post

    Gillespie won't say he's 'happy' with Trump endorsement. WVEC

    Roger Stone faces subpoena threat over Assange contact. CNN

    The Note is a daily ABC News feature that highlights the key political moments of the day ahead. Please check back Monday for the latest.

    News - The Note: Trump takes a chainsaw to health care

    RRelated Posts


    • Krimson

      "68 of the 70 counties [nationally] where these consumers would suffer the largest losses supported Trump in November" - LA Times, March 2017

    • ruelph

      In the latest poll conducted on 10/13/17, as reported, 'Americans really don’t want Trump to sabotage Obamacare, poll finds more than 7 in 10 think it’s his job to make the program work, not to drive it to fail.'

    • Gary Hudson

      trump has said all along that he wanted repeal and replace because he didn't want to own the failure that the ACA was going to end up being. Now that he decided to take matters into his own (tiny) hands, he is surely going to own it now. The calamity that is about to develop over health care is going to have his name all over it. Yet another poor choice by the man in charge. Has anyone noticed that that's all he does, is make poor choices? What a loser !

    • Bud Simpson

      If this genius Makes America any Greater, we'll officially be a 3rd World Country.

    • ruelph

      Trump thinks that by dismantling some of Obama’s legacy, he would be judged as the better president of the two. The exact opposite is happening, Obama is being judged as one of our best leader as president, and Trump is being judged as one of our worst-ever leader as president. Long after he is gone, Americans in the future are going to be reading about how bad Trump was as president.

    • Red Hawk

      What happens when these Trump voters find out their Health Insurance cost five times what they were paying?

    • quinLee

      Remember when republicans used to complain, moan and whine about executive orders. Wonder what has changed in the past few months.

    • b rubble

      Yeah, trump is looking out for the little people.
      He takes away school children lunch programs, better nutrition and loosens regulations. Better nutrition and education at an early age can help people be healthier and save in insurance costs. So how is growing up with bad nutrition habits where people get obese, get high cholesterol, high blood pressure, get diabetes etc. going to help and save people on insurance when their insurance costs go up and they need more health care when it could of been prevented? Oh wait, preexisting condition clause. Got it Donald. That's where insurance companies will save money and the rich pocket extra cash.

    • Jim W

      Damn!!! POTUS has effectively put thousands without any chance of medical insurance just by the stroke of a pen. Not including the burden to each state as they struggle to try and put them on state insurance programs like medicaid. And all those small businesses that rely on the help of money to keep their employees on some form of insurance! Gone! He is POTUS not...a dictator nor someone who can run a country like it is his own business. It is supposed to be for the good of the people and i see nothing good about this. Crying like a baby because you as President didn't get your way. Trump so far in less than 10 months has pushed this country to the brink of war, stirred a country into being undivided and not united, gone through more high level secretaries who have either resigned or got told to leave office. The list keeps growing as the more you open your mouth, the more hate you expel from it.
      Well the people will prevail as they always do in this country. How much more is too much for the people to handle before they react? In your words..." We will see what happens and it's going to be huge"

    • Bronx

      Putin wants to take down the US. Trump and Bannon are the tools of that destruction. Oh, Bannon says it nicely so you
      think he meant something else-- but 'deconstruction of the administrative state' is exactly the policy Trump has been following.

      Deconstruction really means dismantling and destruction and administrative state here means our government.

      It is obvious from EOs as the present one to the understaffing of State.

      We've been had.

    • ruelph

      Now that Trump is president, my premiums are increasing more than it ever did when Obama was president. I get my insurance through the FEHB (Blue Cross/Blue Shield).

    • Conservative_Democrat

      Once again .The dictator has spoken.

    • muomega0

      Takes a chainsaw to healthcare..only true journalists could describe the action so objectively and ironically is so few words.

    • Fred Mertz Pants

      Ya know, if the rest of us were as bad at our job as this clown is, would we still have a job?

      Would our bosses/coworkers remain silent as we ruined our work place, essentially destroying it?

    • Bronx

      Bannon's words, 'deconstruction of the administrative state' is the policy Trump is following. It comes from Putin, straight from Russia,
      as a means of harming the USA.

    • WhosVoice

      Trump destroyer of all creator of nothing but division. Taking health care away from millions while giving tax cuts to the 1% & the Cult of 45 still thinks he is a man of the people looking out for them. If you haven't woke to the fact that this man cares nothing of the American people, it is already too late.

    • Thomas

      Just as an aside, that photograph of Trump holding up the EO reminds me of the expression my 2 year old grand daughter made when she first was successful in writing her name.