By Alaina Kennedy
With Congress giving up on repeal and replace the Affordable Care Act (ACA), for now, the Trump administration stepped in and created backdoor attempts to sabotage the ACA and destabilize the insurance market for people who buy their policies on their own rather than through their employers.
The Trump administration took two actions last week:
Executive Order
On Thursday, October 12, 2017, the Trump administration issued an Executive Order urging the Department of Labor and HHS to issue rules that will undermine the individual and small group health insurance markets, harming consumers across the country.
This executive order lets insurance companies sell junk – junk insurance that is – in the form of association health plans marketed to small companies and short-term insurance marketed to individuals.
The order lets “Association Health Plans” cherry-pick companies with younger and healthier workers, keeping costs down by skimping on covered benefits. Small companies with older or sicker workers would be left behind in their own risk pool, with higher and higher premiums as time goes by. Many companies would be forced to drop insurance entirely, leaving their employees uninsured.
Many people with preexisting conditions, such as those living with HIV, would once again be unable to obtain coverage that meets their needs, as routinely occurred before the ACA.
Cost Sharing Reduction
Last week the Trump administration also announced that it would end Cost Sharing Reduction (CSRs) for insurance marketplace plans.
Trumps decision to pull government funding for CSR payments means insurers are on the hook for these payments going forward.
Insurers must continue providing these CSRs’ who are eligible even though the federal government won’t pay the insurers. That is because the subsidies are a requirement of the ACA. Click here to learn more about CSRs.
Insurers in Illinois assumed CSRs would be cut in their 2018 proposed Marketplace rates (which is why they increased their silver level premiums so much this year), so we don’t think anything will change with those.
The Illinois Department of Insurance said, “‘DOI is committed to ensuring that consumers are prevented from incurring higher health insurance costs due to uncertainty in Washington,’ said DOI Director Jennifer Hammer. ‘Insurers have been advised to apply the CSR uncertainty cost, solely to silver plans.’ This change makes it important that consumers diligently shop for a plan this year. DOI reminds consumers that cost alone may not be the only factor to consider when selecting a plan. For example, consumers may want to also consider a plan’s provider network.”
Experts warned failure to make these payments would raise premiums by 20% or more and add nearly $200 billion to the national debt. Even Sen. Lamar Alexander (R-TN) warned, “Without payment of these cost-sharing reductions, Americans will be hurt.”
However, health care beyond 2019 is very unclear. The Congressional Budget Office (CBO) has said Trump ending subsidies increases premiums by 25% by 2020 and increase the deficit by $6 billion by 2018 and $21 billion by 2020.
To learn more about and stay involved on the Trump administration’s sabotage efforts visit the Protect Our Care and Stand Up To Sabotage website, a campaign to stop Trump’s repeated and ongoing efforts to blow up our health care.
