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Trump Signs Executive Order Undermining Health Care Rules

Donald Trump signed an executive order today undermining rules insurance companies were required to follow by law.

President Trump signed an executive order on Thursday intended to allow small businesses and potentially individuals to buy a long-disputed type of health insurance that skirts state regulations and Affordable Care Act protections.

[More...]

The order represents Trump’s biggest step to carry out a broad but ill-defined directive he issued his first night in office for agencies to lessen ACA regulations from the Obama administration.

Critics, who include state insurance commissioners, most of the health-insurance industry and mainstream policy specialists, predict that a proliferation of such health plans will have damaging ripple effects: driving up costs for consumers with serious medical conditions and prompting more insurers to flee the law’s marketplaces.

Who benefits under his rules? The young and healthy. Who suffers? Older people with significant health histories.

How you know Trump's action is bad for individuals: Business groups support it, consumer groups oppose it.

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  • Display: Sort:
    If something is collapsing, or imploding, (5.00 / 2) (#5)
    by Anne on Fri Oct 13, 2017 at 09:22:06 AM EST
    why would Trump need to do anything but stand back and watch it happen?

    Jonathan Chait at New York magazine makes the same point:

    The exchanges in 2017 had stabilized financially, as insurers found a profitable price point. The Republican Party has, as a matter of theological principle, refused to accept the possibility that Obamacare might succeed at its stated ends. If Obamacare were truly collapsing, sabotage would not be necessary. It is the law's success, not its failure, that has made Trump so determined to wreck it. The White House has released a statement confirming its intention to end the payments, written in the pidgin English indicating the president's own authorial hand.

    I'm pretty sure Trump not only doesn't understand how insurance works, he has even less understanding of what the cost-sharing reduction payments are (this is, after all, the man who thinks the gains in the stock market are erasing the deficit).

    For those who don't know:

    The ACA requires insurers to offer plans with reduced patient cost-sharing (e.g., deductibles and copays) to marketplace enrollees with incomes 100-250% of the poverty level. The reduced cost-sharing is only available in silver-level plans, and the premiums are the same as standard silver plans.

    To compensate for the added cost to insurers of the reduced cost-sharing, the federal governments makes payments directly to insurance companies. The Congressional Budget Office (CBO) estimates the cost of these payments at $7 billion in fiscal year 2017, rising to $10 billion in 2018 and $16 billion by 2027.

    Not to mention that ending the cost sharing subsidies will likely cause premiums to rise.  As premiums rise, the tax credits will have to rise, as well:

    Any systematic increase in premiums for silver marketplace plans (including the benchmark plan) would increase the size of premium tax credits. The increased tax credits would completely cover the increased premium for subsidized enrollees covered through the benchmark plan and cushion the effect for enrollees signed up for more expensive silver plans. Enrollees who apply their tax credits to other tiers of plans (i.e., bronze, gold, and platinum) would also receive increased premium tax credits even though they do not qualify for reduced cost-sharing and the underlying premiums in their plans might not increase at all.

    We estimate that the increased cost to the federal government of higher premium tax credits would actually be 23% more than the savings from eliminating cost-sharing reduction payments. For fiscal year 2018, that would result in a net increase in federal costs of $2.3 billion. Extrapolating to the 10-year budget window (2018-2027) using CBO's projection of CSR payments, the federal government would end up spending $31 billion more if the payments end.

    Here is another article that explains more about cost-sharing subsidies and their effect on co-pays and deductibles.

    Millions of people are going to suffer for this, and that blood is on Trump's hands now.  Not that he cares.

    Leapin' Lizards! (2.00 / 3) (#1)
    by Abdul Abulbul Amir on Fri Oct 13, 2017 at 08:12:35 AM EST

    Affordable coverage that people actually want to buy as opposed to mandated to buy. The horror.

    AKA - Barebones, catastrophic policies ... (5.00 / 4) (#2)
    by Yman on Fri Oct 13, 2017 at 08:21:32 AM EST
    ... for those healthy/young people willing to gamble, with soaring premiums and collapsing markets for everyone else.

    Poisoning the well usually results dead lizards.

    Parent

    You must (5.00 / 6) (#3)
    by Ga6thDem on Fri Oct 13, 2017 at 08:24:22 AM EST
    be completely ignorant of insurance to make a comment like that.

    And millions are going to lose their insurance due to people like you. Embrace the suffering because the GOP sure likes to mete it out to Americans.

    Parent

    Insurance that doesn't cover much (5.00 / 1) (#8)
    by Chuck0 on Fri Oct 13, 2017 at 11:04:11 AM EST
    is worthless. I understand the value of comprehensive health insurance as I type this from my hospital bed.

    Parent
    hospital bed? (5.00 / 2) (#10)
    by NYShooter on Fri Oct 13, 2017 at 12:40:19 PM EST
    Chuck0, I'm sorry to hear this. Whatever the reason, here's wishing for a speedy and total recovery.

    Keep us posted, kid......(at my age, everyone's a "kid.")

    Parent

    Had to go to ER Tuesday. (none / 0) (#11)
    by Chuck0 on Fri Oct 13, 2017 at 12:58:06 PM EST
    Breathng problems. Turns out I have a chest full of blood clots.

    It sucks cause I have tickets to see Jim Jeffries at the Hippodrome in Baltimore tonight.