aside The President Is Causing The Ruin Of The ACA, The Affordable Care Act

The republicans are at it again. The republican President Donald Trump and his republican legislative cohorts are deliberately sabotaging the Affordable Care Act (ACA), so they can yell, “the ACA is a failure,” “it is on a death spiral.” “we have no choice but to rescue it. ”

And they foolishly think that the average Joe voter cannot see through the republicans’ deceptive strategies to kill Obamacare.

Here is the rest of the story…

On 5/20/17, Robert Pear of the New York Times penned the following post, Trump, Shouting ‘Death Spiral,’ Has Nudged Affordable Care Act Downward.

“When Aetna, the health insurance giant, announced this month that it was pulling out of the Affordable Care Act’s insurance exchange in Virginia in 2018, President Trump responded on Twitter:“Death spiral!”

“When Humana announced plans to leave all the health law’s marketplaces next year, the president chimed in, “Obamacare continues to fail.”

Left unremarked on was a big reason for the instability: The Trump administration and Congress are rattling the markets.

“The administration’s refusal to guarantee payment of subsidies to health insurance companies, the murky outlook for the Affordable Care Act in Congress and doubts about enforcement of the mandate for most people to have insurance are driving up insurance prices for 2018, insurers say in rate requests filed with state officials.”

“Opponents of President Barack Obama’s signature legislative achievement have made what may be a self-fulfilling prophecy: They repeatedly forecast the collapse of the health law, and then push it along.”

“Frustrated state officials have ideas for stabilizing the individual insurance market, but they say they cannot figure out where to make their case because they have been bounced from one agency to another in the Trump administration.”

“We have trouble discerning who has decision-making authority,” said Julie Mix McPeak, the Tennessee insurance commissioner and president-elect of the National Association of Insurance Commissioners, which represents state officials. “We reached out to the Department of Health and Human Services. They referred us to the Office of Management and Budget, which referred us to the Department of Justice. We reached out to the White House Office of Intergovernmental Affairs.”

The Trump administration has sent mixed signals, reflecting an internal debate about whether to stabilize insurance markets or let them deteriorate further. Mr. Trump has said he could cut off the subsidies at any time if he wanted to.

“The government may clarify its plans in a legal brief to be filed on Monday (5/15/17)  with the United States Court of Appeals for the District of Columbia Circuit. Or it could simply ask the court for a three-month extension, prolonging the uncertainty.”

“State insurance commissioners have joined insurers, hospitals and congressional Democrats in urging the administration to pay “cost-sharing” subsidies, and federal health officials initially indicated that they would do so. But Mr. Trump countermanded them, refusing to make any long-term commitment.”

“On Thursday (5/18/17), 15 Democratic state attorneys general, led by Xavier Becerra of California and Eric T. Schneiderman of New York, filed a motion to intervene in the case, demanding that the payments continue.”

“Unable to get an explicit appropriation from Congress, the Obama administration went ahead and paid the subsidies, in a way that a federal district judge later found to be unconstitutional. The ambivalence of the Trump administration has further spooked insurers.”

“The subsidies are paid to insurance companies so they can reduce deductibles and other out-of-pocket costs for low-income consumers — seven million people this year.”

“Continued payment of the subsidies is “critical to the viability and stability” of health insurance markets, the National Association of Insurance Commissioners said in a recent letter to congressional leaders.”

“As long as the court case, House v. Price, remains unresolved and federal funding is not assured, carriers will be forced to think twice about participating on the exchanges,” the letter said. “Even if they do decide to participate, state regulators have been informed that the uncertainty of this funding could add a 15 to 20 percent load to the rates.”

“Senate Republicans, well aware of the political risks, are seeking short-term solutions for 2018 and 2019, even as they consider big changes in a House-passed bill to repeal and replace major provisions of the Affordable Care Act.”

“In order to rescue Americans from collapsing Obamacare exchanges, Republicans are likely going to have to temporarily do some things we may not like, including looking at funding the cost-sharing payments,” said Senator Lamar Alexander, Republican of Tennessee and chairman of the Senate health committee.”

“At the same time, he said, “Democrats will have to do some things they may not like, including allowing people to use their subsidies to buy insurance outside the Obamacare exchanges” and giving states more power to decide what types of insurance can be sold.”

Image result for cartoons trump ACA“Federal health officials say they want to stabilize insurance markets, and they issued a “market stabilization” rule last month. But the administration has also taken steps that destabilize the market, by creating doubts about subsidy payments to insurers and enforcement of the requirement for people to have insurance under the Affordable Care Act.”

“Anthem, one of the nation’s largest insurers, has sought rate increases of 24 percent to 38 percent in Connecticut, based on the assumption that the Trump administration will continue paying the subsidies through 2018. If that assumption is wrong, the company said, rate increases could be much higher.”

“With so much uncertainty, Anthem said, it expects to serve a smaller, sicker group of people next year.”

“We are forecasting that the individual market will continue to shrink and that those individuals with greater health care needs will be the most likely to purchase and retain their coverage,” while “healthy members are more likely to drop coverage,” Anthem said in its Connecticut rate request.”

“But the cost-sharing payments are only part of the problem. Insurers said the Trump administration was also destabilizing insurance markets by indicating that it would loosen enforcement of the mandate for people to have coverage or pay a penalty.”

“In seeking rate increases that average more than 50 percent in Maryland, CareFirst, the state’s largest insurer, said, “We have assumed that the coverage mandate introduced by A.C.A. will not be enforced in 2018 and that this will have the same impact as repeal.”

“Failure to enforce the individual mandate makes it far more likely that healthier, younger individuals will drop coverage and drive up the cost for everyone else,” said Chet Burrell, the chief executive of CareFirst.”

“The bill passed by the House this month to repeal the Affordable Care Act would eliminate the cost-sharing subsidies in 2020. The outlook is unclear in the Senate, which is developing its own version of the legislation.”

“Democrats sought money for cost-sharing subsidies in the omnibus spending bill that Mr. Trump signed on May 5. But the White House refused to go along, sowing doubts about future payments.”

“The Trump administration is paying the subsidies, but is trickling them out one month at a time,” as part of a “very cunning’’ strategy to undermine the health care law, said Senator Christopher S. Murphy, Democrat of Connecticut.”

“In an interview with The Wall Street Journal last month, Mr. Trump threatened to withhold subsidy payments from insurers as a way to induce Democrats to negotiate with him on a replacement for the Affordable Care Act.”

“If those payments are not made, Mr. Trump said, “Obamacare is gone, just gone.”

3 comments

  1. Gronda, as we have often discussed, the ACA is imperfect and needs improvement, but what far too many fail to realize the significant role Republicans have played in making premiums higher for people than they would have otherwise been and now doing further damage under this President to hasten more problems.

    As a retired actuary, benefits consultant and manager, premiums are higher due to adverse selection, but the Republican Congress has defunded risk corridors driving some carriers out of the market. Trump wants to do his part to harm the ACA. As you have noted, Trump is continuing the role played by Republicans to screw Americans to win an argument they are gaming. The AHCA is just one example.

    I have written about this for four years – look at the data and improve the ACA, don’t kill it. Keith

  2. Dear Keith,

    The question is, why isn’t this point being driven home by the cable news networks. You certainly are an expert who has been sounding the alarms for years. So have others like Wendell Potter.

    “We the people” are tired of being scammed and then thrown under the bus to grant huge tax cuts for those in the 1% wealth category. Over the past decade, these folks have made out like bandits.

    I am in favor of cutting corporate taxes to as low as 25% with caveats.

    Ciao, Gronda

    • Gronda, I read Mitch McConnell say today he is having trouble getting the votes for a Senate ACA repeal and replace. He also says he does not want to work with Democrats. Note to McConnell – the majority of the American people say to keep, but improve the ACA. Work with the Democrats and focus on people and data! To do otherwise is poor stewardship. Keith

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