New Orleans  For all the pluses and minuses of any debate on the Boy Scouts, they taught me one life lesson that I wish President Trump had also learned: don’t play with knives! Looking at the way he is trying to mindlessly hack away and butcher the Affordable Care Act, there is little doubt that this is a guy without a clue or a care about the damage that cutting can do.

In the last week unable to bend Congress to his whim or will, he’s signed one executive order after another in an attempt to gut coverage for millions. Recently one order will allow low-balling, bottom of the barrel policies without the Obamacare minimum standards to be sold. Now he’s also signing one that would cutback on support for lower income participants on subsidies and payments to insurance companies through cost sharing participation. Earlier, he drove a hole through the requirement that coverage for contraception be included if institutions offer the flimsiest objection. He has also effectively defunded outreach and navigation for people enrolling with the next open window only weeks away.

Admittedly, the President could care less about the consequences of these decisions. None of them will hurt anyone he knows or likely has ever known his entire privileged life. Seven million people, including many in red states like Mississippi and Alabama that are part of his hardcore support, will be hurt badly by these orders. Working with his political advisers, rather than any voices from public health sectors, he has probably made two calculations on the impact. First, that many of these people in the red states who are going to be hurt are lower income African-Americans and Latinos, who are less and less likely to ever cast a vote for him any day in the future. Hey, that’s the whole point of voter suppression programs by the Republicans anyway. Secondly, he probably sees – correctly – no prospect of a competitive alternative emerging to him in the Republican primary, given the knee jerk opposition there has been to Obamacare for years anyway. He’s sitting in the White House, essentially saying, “What me worry?

Reports indicate that there is some rumbling among Republican officeholders in Congress who might actually have to pay a price for Trump’s butchering of the Act. Trump, as always, takes no responsibility for his own actions, claiming he is hoping some of his hacking will force the Democrats to beg him to negotiate on the Affordable Care Act. As long as he insists on bargaining in bad faith where the only open door is repeal-and-replace, that’s not going to happen. The Democrats are clear all this pain and suffering is now on his shoes, so I’m not holding my breath.

One way or another he has once again forced the Act into the middle of every mess coming forward on the calendar. The lesson on playing with knives is that you can seriously hurt yourself. This may be a lesson Trump is going to have to be forced to finally learn, if we have folks willing to school him both at home and at the Capitol.