If he can’t kill it by vote, maybe he can starve it to death.

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That seems to be Donald Trump’s intensified approach to therepeal-replace efforts on the Affordable Care Act, with BuzzFeedreporting that the Department of Health andHuman Services will not be sending any regional directors to helpstates with planning for the upcoming open enrollment period thisyear.

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According to the report, this is the first time that regionaldirectors won’t be assisting states. Mississippi’s health careadvocates found out via an e-mail on Monday, confirming news from aBuzzFeed source that “all of the department’s 10 regional directorswere told to not to participate in state-based events promotingopen enrollment.”

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The e-mail confirmed news first reported by Vox that officials would be absent fromMississippi events, as well as informing advocates that thedepartment would “not be supporting marketplace efforts by beingout in the regions this year.”

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In a Wednesday statement, the report adds, departmentpress secretary Caitlin Oakley said, “Marketplace enrollment eventsare organized and implemented by outside groups with their ownagendas, not HHS. These events may continue regardless of HHSparticipation.” Oakley’s statement adds that, “As Obamacarecontinues to collapse, HHS is carefully evaluating how we can bestserve the American people who continue to be harmed by Obamacare’sfailures.”

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But any collapse appears engineered by the Trumpadministration after repeated declarations by the president that hewould “let Obamacare implode.” And this isn’t the first action theadministration has taken to steer the ACA toward that goal, norwill it be the last—actions that some are outright calling sabotage.

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Not only did HHS announce in August that it was cuttingits Obamacare enrollment advertising budget by 90 percent, from$100 million down to $10 million, but it’s also decided to shutdown healthcare.gov every Sunday from 12 a.m. to 12 p.m. throughoutthe open enrollment period—something else that’s far above the norm of past enrollment periods.And that’s after already cutting the enrollment period in halfcompared to earlier years, thus giving people far less time to signup.

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Trump has also refused to say that he will definitely authorize payment of the subsidies that enablethe system to function for the poorest and sickest—an action that’sdriving up premiums as nervous insurers try to anticipate how muchthey might be on the hook for if those subsidies aren’t paid.

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But wait, as the commercials say, there’s more—some of whichcomes from Trump’s love of executive orders. Not only did he signan executive order on his first day in officedirecting agencies to delay or waive provisions of Obamacare thatwould “impose a fiscal burden,” but the latest news, courtesy of aHuffington Post report is that he’s planning to sign anotherone—this time on associations.

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Executive action on association health plans, the report pointsout, could end up exempting association health plans from some ofthe ACA rules—those pesky things that made it possible for so manypeople to get broad health insurance coverage under the new lawdespite preexisting conditions and other former barriers.

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Says the report, “[A]ssociation health plans, also known asAHPs, might have more freedom to sell skimpier plans that, forhealthier beneficiaries, would be cheaper than plans they arebuying todayeither through HealthCare.gov or state-based exchanges,or directly from insurers. But the more healthy people flocked tothose plans, as individuals or part of small businesses, the morecarriers selling to everybody else would have to increase theirpremiums to reflect their new, sicker pool of enrollees.”

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“We don’t know exactly what the Trump administration is going todo on this front,” Kevin Lucia, a research professor at GeorgetownUniversity’s Center on Health Insurance Reforms, says in thereport. “But if they allow AHPs to bypass the ACA’s consumerprotections, like not covering maternity and other essential healthbenefits, it sets up an uneven playing field, destabilizes thestate individual and small group markets, and ultimately putsconsumers at risk.”

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