Calling the move Trump’s “biggest assault to the ACA, American families, and the law” yet, Andy Slavitt, who oversaw the Centers for Medicare and Medicaid Services during the Obama administration, noted that while “2017 Trump aimed for a vote to repeal the ACA,” which failed multiple times, “2018 Trump is just skipping the voting part and ignoring the law.”

Slavitt also outlined some of the likely consequences should the rule take effect, emphasizing that “all of this is by design.”

Others pointed out that the Trump administration’s ability to continuously undermine the ACA partly demonstrates why there is growing support for overhauling the nation’s healthcare system and implementing a “Medicare for All” single-payer system that would make medical care a guaranteed right for all Americans.

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