Fight Synthetic Repeal, the Latest GOP Attempt to Kill Obamacare, Oct 19 Update

Fight Synthetic Repeal, the latest attempt by the GOP to kill the Affordable Care Act (ACA), aka Obamacare.

Because Synthetic Repeal is basically Trojan Horse Trumpcare, we at OTYCD will be devoting posts to it every weekday until it is derailed. Subscribers will receive these as new posts though the text will at least partially earlier posts. Apologies in advance for this.

Having failed flagrantly and publicly to kill the ACA via legislation, the GOP and the Trump administration are–big surprise–turning to broader but sneakier tactics.

One gambit is to tuck Medicaid cuts in the tax bill now under discussion. We at OTYCD have devoted, and will continue to devote, separate posts to the tax reform bill.

Last week, Trump took aim at the Affordable Care Act by signing an Executive Order (EO)   that ends cost-sharing reduction (CSR) payments that are key to making the health care system function. He also signed a second EO that allows for cheaper plans that don’t actually offer much true coverage. These plans weaken the market by tempting healthy people to leave the insurance pool.

Read more here:




Several state Attorneys General announced they would sue the federal government over the EO that ends CSRs. As of Friday October 13, a total of 17 state AGs plus Washington, D.C., had joined the suit. Read more here:



Here is a list of the states whose AGs have joined the suit as of October 13, 2017:







North Carolina


New York



Rhode Island



New Mexico



The District of Columbia

…is your state on this list? Then you need to call your AG and thank him or her. If it’s not, you need to call your AG and ask him or her to join the suit.

Find your state AG by plugging your address into this search engine:


Clicking the plus sign at the right of the AG’s name will give you the person’s office phone number and other relevant contact information.


Sample call for asking your AG to join the lawsuit: “Dear State Attorney General (Name,) I am (Firstname Lastname from town, zip code). I am calling to ask you to join your colleagues from Iowa, New Mexico, Kentucky, North Carolina, and about a dozen other states in suing the federal government over its refusing to honor the cost-sharing reduction payments that it is supposed to provide. Withholding the CSRs is a blatant, direct attempt by the Trump administration to kill the Affordable Care Act, and it will, and already is, throwing our health care system into chaos. Please do what you can to fight back and protect the vulnerable in our state. Thank you.”


Know also that Republicans and Democrats alike have spoken out against Trump’s latest actions.



Here’s a Vox article that covers the damage Trump is likely to cause with these EOs–it’s not just going to hurt sick people, it will cost taxpayers more as well. Yes, really, we’d spend more to cover one million fewer:



Here also is an opinion piece from the Washington Post on the same topic:




Andy Slavitt, who ran that program as well as Medicare and ACA under Obama, first picked up on the Synthetic Repeal effort. He’s been describing it and providing ideas for fighting back.


If you’re not following Slavitt on Twitter already, please do:


Also start checking the #SyntheticRepeal hashtag on Twitter for updates.


In addition, please follow Ben Wikler, Topher Spiro, and Celeste Pewter if you aren’t already. They’re on the case 24/7 and will have updates and specifics on how to fight back:





Synthetic Repeal is a multi-pronged effort that needs to be fought on several fronts.

The Trump administration is actively sabotaging the ACA by denying state waivers, cutting the annual enrollment period for the ACA, scheduling system maintenance during that already short enrollment period, slashing the marketing budget for ads that tell people when the enrollment period happens, understaffing ACA call centers, and now refusing to honor CSR payments.

Slavitt has several suggestions for how we can fight back. Many of them are things you’re already doing, and things that have been covered higher up in this post–calling your MoCs and state AGs.

Another is to be a health care voter–someone who pays attention to how your senators and your house rep votes on Trumpcare, CHIP, and other bills that affect our health care system. You need to vote for those who support the bipartisan Murray-Alexander bill to stabilize the ACA, and vote for those who are trying to reauthorize CHIP, the program that covers sick kids, and which expired on September 30, 2017 and has yet to be reauthorized.

We devoted a post to calling about reauthorizing CHIP:



You should also call to ask your senators to pass the Murray-Alexander bill that would stabilize the ACA. Senator Patty Murray is a Democrat from Washington and Senator Lamar Alexander is a Republican from Tennessee. Both have been at work on the bill for a while now. Senator Mitch McConnell told them to stop in September in hopes of getting Graham-Cassidy (aka Trumpcare 3.0) through the Senate. After that effort failed, Murray and Alexander took up their bill again.

According to stories in the Washington Post and Politico that quoted Mick Mulvaney, the president is not interested in passing a ‘clean’ Murray-Alexander bill:




But as weary watchers of Trump know too well, he says a lot of stuff and walks back a lot of stuff. And what he really wants is a win. It doesn’t matter what form the win takes so long as it looks like a win. If we can portray passing a clean Murray-Alexander bill as a win, maybe we have a shot here.


Sample script for calling your senators: “Dear Senator (Lastname,) I am (Firstname Lastname, from town, zip code). I am calling to express my support for passing the Murray-Alexander bill, which would stabilize the Affordable Care Act. We need to fix the law, and we sure as heck should not undermine it, as the president is doing with his Executive Orders. Thank you.”



Still another way to fight synthetic repeal is by helping a new org called Get America Covered. It intends to pick up the slack that the government has ostentatiously dropped with regard to enrolling people in ACA plans for 2018. It intends to spread the word about the enrollment period and help as many people gain coverage as possible.


See the Get America Covered website:



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Follow its cofounders, Lori Lodes and Joshua Peck, on Twitter:




Donate to Get America Covered: