Trump considers provocative new hostage strategy on health care
In an effort to appease insurance companies and attract more to rejoin the exchange, the Trump administration issued changes on Thursday that make it harder for people to drop in and out of the insurance marketplace.
While calling it a step in the right direction, the industry is looking for a guarantee that the government will also keep paying billions in "cost-sharing" subsidies. Far from forcing Democrats to the table to help him pass the Obamacare repeal-and-replace legislation he can not get with Republican votes alone, he has emboldened them to fight back. So Thursday's action was meant to keep the existing system going even as Republicans pursue a total remake.
The White House will continue to provide these cost-sharing subsidies, although Trump signaled that he might cancel the reimbursements to force Democrats to sign a deal on health care reform. They're separate from the better-known premium subsidies that customers receive.
"There is still too much instability and uncertainty in this market", Marilyn Tavenner, president of America's Health Insurance Plans and the industry's top lobbyist, said in a statement. The conservative group Judicial Watch, which has been tracking the cost of presidential travel for several years, estimates that President Trump's frequent visits to his Palm Beach resort Mar-a-Lago probably cost the government around $1 million each.
In an interview with The Wall Street Journal on Wednesday, Trump suggested he is willing to cut the federal funding for cost sharing reductions (CSRs), which House Republicans have challenged in a lawsuit. But the president also said he hasn't made up his mind, and said he doesn't want people to get hurt.
In fact, Democrats are so united on this one that they're willing to threaten Trump back with a government shutdown over these payments.
The Obama administration was sued in 2014 by House Republicans, who argued that the federal government was making these cost-sharing payments without authorization from Congress.
-A shortened sign-up window of 45 days, starting with coverage for 2018. "Those improvements include tightening up rules for special enrollment periods, greater flexibility in product and benefit design, and simplified administrative processes".
"There has to be an awareness that it costs money to go down there, and they should justify the cost or explain to the American people why it's necessary", he says. Insurers will now be allowed to use any payments for the subsequent year to go toward debt on the previous year premiums, meaning people will not be covered for the new year until they are fully paid up to date.
Medica spokesman Greg Bury offered a slightly more optimistic statement from the Minnesota-based insurer that sells plans on the Affordable Care Act exchange in Kansas.
"I think insurers needed a clear signal yesterday", said Larry Levitt, a senior vice president at the Kaiser Family Foundation. Major insurance companies panicked and major participants like Humana Inc. and Aetna, have left or announced their intention to leave the Obamacare exchanges, citing multi-million-dollar losses and patient populations that are far costlier and sicker than they expected.
Consumers likely won't know for certain what sort of choices they will have until late summer or early fall, a couple of months before open enrollment begins.
There are now 20 million Americans, many of them low income, who have health care for the first time because of Obamacare.
Most communities will have competing insurers on the public marketplace next year, but a growing number will be down to one, and some areas may face having none.