Friday, October 13, 2017

Trump delivers one-two punch to affordable health care

No more subterfuge. No more subtlety. Trump is waging all out war on American health care.

Overnight multiple sources anticipated that Trump would scrap cost-reduction subsidies. And then he did it. Here’s the round-up on that starting with an updated item in this morning’s FiveThirtyEight Significant Digits email.

$7 billion
POLITICO is reporting that President Trump intends to did end the subsidy payments to private insurers that lower medical costs for 5.9 million Americans who otherwise would not be able to afford health insurance coverage. If that holds, premiums will rise and the deficit will increase, according to the nonpartisan Congressional Budget Office. [POLITICO, The New York Times]

Politico reported that Trump will scrap critical Obamacare subsidies.
Cutting off the payments to insurers, which could happen almost immediately, is likely to provide another jolt to Obamacare markets.

The New York Times predicted Trump to Scrap Critical Health Care Subsidies, Hitting Obamacare Again, and also predicted consequences for the federal budget noting that If Trump Stops Funding Key Health Care Subsidies, the Federal Government Will Actually Pay More.

It should not be surprising to learn that individual insurance premiums will spike as insurers make adjustments to counter the loss of the subsidies.

Here in Arizona the Daily Star carried the AP report on its front page: Trump orders end to subsidies as he dismantles ‘Obamacare’

In a brash move likely to roil insurance markets, President Donald Trump will “immediately” halt payments to insurers under the Obama-era health care law he has been trying to unravel for months.

Before sunrise Friday morning, Trump went on Twitter to urge Democrats to make a deal: “The Democrats ObamaCare is imploding,” he wrote. “Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!”

In another tweet later Friday morning, Trump said: “ObamaCare is a broken mess. Piece by piece we will now begin the process of giving America the great HealthCare it deserves!

The Department of Health and Human Services had made the announcement in a statement late Thursday. “We will discontinue these payments immediately,” said acting HHS Secretary Eric Hargan and Medicare administrator Seema Verma. Sign-up season for subsidized private insurance starts Nov. 1, in less than three weeks, with about 9 million people currently covered.

Halting the payments would trigger a spike in premiums for next year, unless Trump reverses course or Congress authorizes the money. The next payments are due around Oct. 20.

Democrats were quick to respond.

”It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America,” said House and Senate Democratic leaders Nancy Pelosi of California and Chuck Schumer of New York. “Make no mistake about it, Trump will try to blame the Affordable Care Act, but this will fall on his back and he will pay the price for it.”

The president’s action is likely to trigger a lawsuit from state attorneys general, who contend the subsidies to insurers are fully authorized by federal law, and say the president’s position is reckless.

I wonder if our state AG will join that suit. (Just kidding. Why would he?)

All this came on top of Trump’s first punch, a deregulation move that would enable cheap insurance policies but ones that would offer fewer benefits and less protection to the insured. The LA Times reported that Trump issues order to deregulate health insurance, promising relief from Obamacare. But that “relief” rhetoric is nonsense and health care providers know it. Medical groups angry after Trump loosens insurance rules reports the Washington Examiner.

President Trump’s effort to loosen federal rules to expand use of cheap, lower-quality health plans is drawing complaints from several major medical groups who fear the move will hurt the implementation of Obamacare.

The American Hospital Association and a collection of 18 groups — including the American Heart Association, March of Dimes and the American Cancer Society’s lobbying arm— opposed the executive order that Trump signed Thursday. Behind the criticism is a fear that the order’s embrace of short-term and association health plans could destabilize Obamacare’s marketplaces and endanger protections for people with pre-existing conditions like cancer.

For years, the GOP sought to destroy the Affordable Care Act. Just in the first months after Trump’s election the Republicans in Congress trotted out bill after bill - all being significantly worse along every dimension than whatever faults might be charged to ACA. Neither Congress nor Trump could swing it, in the end, thanks to our Senator John McCain. The bottom line now is that what Trump could not get done legislatively, he is now doing by royal decree - with the result that all players in American health care system will pay more and get less.

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