WASHINGTON – There’s more than one way to kill the ACA, and the Republican Trump administration is trying it. Teachers President Randi Weingarten — among others — is trying to stop them.
And if Trump carries through on his threat, at least five million people could lose health insurance coverage and millions more would see their insurance premiums rise by 20 percent-25 percent, a non-partisan report warns.
Weingarten is urging people to sign petitions to HHS against Trump’s move. And congressional Democrats are protesting his planned scheme.
The GOP’s latest legislation to eliminate the 7-year-old Affordable Care Act, which it derisively calls Obamacare, died in late July when three Republican senators defied the party line and joined all the Democrats and independents to vote it down.
That didn’t stop the president and his Health and Human Services Secretary, Tom Price. Since they couldn’t kill the ACA in Congress, they’re scheming to destroy it administratively, by refusing to implement it, yanking money, and removing an enforcement weapon.
Their latest, and possibly most dangerous, threat is to end the ACA’s subsidies to insurers to help keep premiums affordable for low-income people who use the ACA’s exchanges to buy coverage.
Yanking the subsidies, the non-partisan Congressional Budget Office says, could lead insurers to drop millions of low-income clients. And withdrawal of the $7 billion-$10 billion in subsidies, called cost-sharing reductions (CSRs), could also force insurance premiums to rise sharply on plans available to remaining qualified low-income people, CBO reports.
Stan Dorn, health care analyst for FamiliesUSA, says without the CSR subsidies, insurers would have to pass the rising costs on to consumers. He calculates a single person earning $18,900 a year would have to pay 11 percent more than under current law for silver-level (average) health care coverage in 2026.
Weingarten is urging people to deluge Trump and HHS in opposition.
“From his first days in office, President Trump has worked to sabotage the Affordable Care Act. And now, if he doesn’t make cost-sharing payments, he could destabilize the whole insurance market,” she explained online. “The vote to repeal the ACA failed. Don’t let Trump ruin it to exact his political revenge.”
Weingarten said insurers face an end-of-August deadline to file ask state regulators for premium rate hikes. To protect themselves, insurers filed two sets of rate requests in at least one state, California. One assumes CSR subsidies remain. The other assumes they don’t.
California insurance officials have already said the uncertainty over Trump’s decision forced them to grant insurers a 12.5 percent rate hike.
“We can’t let Trump throw the market into chaos” with “his reckless endeavor that could cost lives and drive up costs for us all,” Weingarten adds.
Congressional Democrats also denounce Trump’s anti-CSR menace.
The threat “will cause premiums to rise 25 percent and explode the deficit by $194 billion over the next ten years,” said House Minority Whip Steny Hoyer, D-Md.
“Moreover, for Americans in some parts of the country, it would lead to there being no insurance options left on the individual market. This isn’t a partisan prediction; it is the careful analysis of the nonpartisan Congressional Budget Office, which I asked it to produce to show the American people the dangerous impact ending these payments would have.”
Rep. Dan Lipinski, D-Ill., used Trump’s threat to renew his push for a bipartisan ACA fix, crafted by the 43 lawmakers of the Problem Solvers Caucus, including himself. Their replacement has gone nowhere in Congress.
Their plan would — among other things — close the ACA loophole that lets Trump and Price cut off the CSR subsidies. That means the insurers would be paid next year, keeping premiums affordable, Lipinski said.
If the CSRs are not guaranteed for 2018, “Premiums for benchmark plans will go up an additional 20 percent next year and 25 percent in 2020. That’s on top of other increases caused by rising healthcare costs,” he added.
After the Senate GOP’s ACA repeal bill died, Senate Democratic Leaders Charles Schumer of New York, Dick Durbin of Illinois and Patty Murray of Washington state wrote to Majority Leader Mitch McConnell, R-Ky., saying now is the time for a bipartisan fix to the 7-year-old health care law, including enshrining the subsidies in the legislation.
“Such reforms would have an immediate effect in stabilizing the market while lowering premiums,” they said. They touted three Democratic bills to close ACA holes. McConnell has yet to reply.
Before the threat to the subsidies, Trump and Price instituted other administrative threats to the ACA and its coverage. The first, early this year, was a Trump decree to the Internal Revenue Service not to collect the $700 fee, deducted from tax refunds or added to taxes, from people who forgo health coverage. The $700 is an enforcement tool designed to prod people into obtaining coverage.
Price tried to dampen ACA demand by stopping advertising its availability during the most recent sign-up period. And the Kaiser Family Foundation reports at least a dozen states seek ACA “waivers” to let them throw hundreds of thousands of people off Medicaid.
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