In his determination to see the Affordable Care Act gone, one way or another, Donald Trump has threatened to “let it explode” by killing off payments for insurance companies.

But his administration has also resorted to a number of other tactics that may actually be illegal — and there may be some big guns trained on the administration as three separate actions challenge the administration’s efforts.

First, a report in the Washington Post says there’s a request by Democrats to the Government Accountability Office to investigate “whether the Trump administration has been violating the law by using government resources to promote the Republican replacement plan.”

The GAO has already announced its intention to examine the Department of Health and Human Services “for possible lawbreaking” after Senator Patty Murphy, D-WA, and three other Democrats requested in their own letter to the GAO and the U.S. inspector general that the GAO investigate whether HHS is engaging in a “pattern” of “using federal resources to advance partisan legislation.”

HHS has used its official Twitter account to denigrate the ACA and push Trumpcare, and may have used taxpayer funds to film videos that do the same, thus “engaging in covert propaganda,” according to the letter.

Then there’s a report in the Huffington Post that the U.S. Court of Appeals for the District of Columbia has ruled that attorneys general from 17 states and the District of Columbia “may pursue the Trump administration’s stalled appeal of a lawsuit alleging the federal government has been making [the aforementioned payments to health insurance companies] illegally.”

The lawsuit was filed by Congress against the Obama administration after Congress refused to explicitly authorize funding for those payments and the Obama administration paid them anyway. When Obama left office, that meant Trump’s administration became the defendant — and suddenly the government was not vigorously defending the payments against the Congressional lawsuit.

So the state attorneys general sued.

According to the report, the court agreed with state officials “that there’s reason to believe the Trump administration isn’t adequately acting on behalf of states.” Naturally, the Trump administration and House Republicans have opposed the states’ determination to rejuvenate that appeal.

Failing to make those payments would seriously destabilize the insurance markets, jeopardizing care for thousands who would no longer be able to afford coverage if insurers were not reimbursed for the money they lose by reducing out-of-pocket costs, deductibles and copayments for exchange customers with incomes up to 250 percent of the federal poverty level. Insurers have already pulled out of state exchanges over concerns that they will not be reimbursed.

Republicans are by no means united on the question of the payments, however. One group is pushing for the subsidies to be paid so that the market won’t further destabilize; the other more or less advocates holding them hostage as a means to compel changes to — or repeal of — the ACA.

And last but not least, according to a CBS report out of Sacramento, California’s State Insurance Commissioner Dave Jones is threatening to sue the Trump Administration over its handling of the Affordable Care Act.

In the report, Jones says that Covered California, the state’s exchange, had to release two different rates of increase for coverage on the exchange: 12.5 percent and 25 percent. According to Jones, the second rate will kick in if Trump continues to withhold payments in his efforts to take down the ACA. That money, according to Jones, is earmarked for insurance companies to help offset the cost of treating low-income California residents.

Jones says, “If President Trump continues to refuse to fund the cost sharing portion of the affordable care act, Californians can thank President Trump for an almost doubling of rates.” He adds that he will sue the Trump administration on behalf of the California consumer, alleging that Trump is not abiding by the Constitution.

“The Constitution is very clear: the president is charged to faithfully execute the laws of the United States,” Jones continues. “The Affordable Care Act is still law in the U.S. and cost sharing reduction payments are a part of that law.”

Jones says that if the administration doesn’t make the payments available by the end of August, that higher rate will be the one going into effect at the beginning of 2018 — and that he will also file that threatened lawsuit.

Instant Insights /

Court actions, investigations swirl around Trump and ACA

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