Reprinted with permission from DailyKos

Because he just can't help himself, on the Sunday before the election Donald Trump squeezed in one more act of sabotage against Obamacare, one that will create major headaches for the people of Georgia. Sunday marked the beginning of the 2021 open enrollment period for the Affordable Care Act, and this year the marketplace again promises to be more stable and to offer more coverage options and more affordable plans. (That is, if the Supreme Court doesn't decide early next year to nuke the whole thing.)

The same day enrollment opened, Trump announced a waiver for Georgia allowing it to scrap the use of the Healthcare.gov website—the marketplace for plans—in the state. No, the state hasn't developed its own online marketplace, like a handful of states have done since the law was passed. It just doesn't want any more people signing up on Obamacare plans, so it will be direct people who need insurance to go through brokers or do their own work on private websites.

Center for Medicaid and Medicare Services Director Seema Verma said in a statement Sunday that "The Obamacare Exchanges have not worked for Georgians, leaving them with fewer options and skyrocketing premiums. […] Today's approval of the states waiver will usher in a groundswell of healthcare innovation that will deliver lower costs, better care, and more choice to Georgians in the individual market." Which is ,of course, not true. Georgia's uninsured rate is 13.7 percent as of now—the state didn't expand Medicaid—fully 5 points lower than it was in 2013, before the law took effect.

The Center for Budget and Policy Priorities estimate tens of thousands of Georgians will lose coverage because of this. They'll have to "navigate the type of fragmented insurance system of brokers and insurers the ACA was intended to remedy," CBPP predicts. They won't have the simple apples-to-apples experience provided by Healthcare.gov, and will be more susceptible to being duped by Trump's substandard plans that don't provide comprehensive coverage. This doesn't expand choice for Georgians in any way, it just makes it a lot harder for them to find the information they need to make an informed choice. It will probably keep people who would qualify for Medicaid out of the program, as brokers are going to be a lot less likely to inform them that they're eligible for that when they can steer them into a private plan, for which they're probably getting a commission.

Sen. Ron Wyden, who authored the provision in the ACA allowing for these waivers, said the administration and Georgia Republicans "are using a perverted and illegal interpretation of the law I wrote to push junk insurance." Wyden's provision explicitly says that states using these waivers have to cover as many people as the ACA, with the same quality and affordability as offered through the Obamacare exchange. "Any state—including Georgia—that tries to make health care worse using this waiver is consciously breaking the law and recklessly endangering American families, all to sabotage the Affordable Care Act," Wyden said. "Distorting black-letter law to suit a political crusade has consequences."

The consequences are likely to be another court challenge, like the states that have fought back against the efforts of the administration to impose work requirements on Medicaid, along with other elements of Obamacare sabotage.