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.


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.

< Those Santa Ana Winds | AG Sessions Seeks to Tighten Asylum Rules >
  • The Online Magazine with Liberal coverage of crime-related political and injustice news

  • Contribute To TalkLeft

  • 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.


    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.


    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.

    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.")


    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.


    So sorry, (5.00 / 3) (#12)
    by Zorba on Fri Oct 13, 2017 at 01:02:53 PM EST
    Chuck0.  Sending healing thoughts your way, and hoping for a speedy recovery.

    Speedy recovry, ChuckO (5.00 / 2) (#13)
    by KeysDan on Fri Oct 13, 2017 at 01:05:47 PM EST
    Get ready for the next Jim Jeffries.

    Oh, Chuck, so sorry you are (5.00 / 2) (#14)
    by caseyOR on Fri Oct 13, 2017 at 01:07:30 PM EST
    in the hospital. Thankfully, the blood clots have been discovered and you are getting treatment. Hope you are out soon.

    Get well (5.00 / 2) (#15)
    by Ga6thDem on Fri Oct 13, 2017 at 01:22:30 PM EST

    Hope it clears quickly and you get back home (5.00 / 3) (#16)
    by Anne on Fri Oct 13, 2017 at 01:48:35 PM EST
    soon; hospitals aren't much fun, and we won't even talk about the food.

    Feel better!


    Pulmonary embolisms? (5.00 / 1) (#18)
    by Peter G on Fri Oct 13, 2017 at 03:14:11 PM EST
    If so, definitely no fun. But glad it was caught before causing a heart attack or stroke. Will have you slowed down for months, if your case is like my friend's who had the same thing happen to her in July.

    Yes sir (none / 0) (#19)
    by Chuck0 on Fri Oct 13, 2017 at 04:09:22 PM EST
    That's it. Large in number.

    Thank you all for your kind words and thoughts.


    No fun. (none / 0) (#20)
    by MileHi Hawkeye on Fri Oct 13, 2017 at 04:16:44 PM EST
    Hope they get you fixed up soon!

    thinkin good thoughts (none / 0) (#27)
    by CaptHowdy on Sun Oct 15, 2017 at 03:19:04 PM EST
    Oh Dear (none / 0) (#28)
    by Militarytracy on Mon Oct 16, 2017 at 07:08:38 AM EST
    Feel better soon Chuck.

    oh ChuckO (none / 0) (#17)
    by leap on Fri Oct 13, 2017 at 02:13:09 PM EST
    That does not sound like fun. Ugh. Hope you don't have to stay there too long. These days they actually try to boot you out the door as soon as possible, as long as you can eat and drink...oh, and breathe. Ya don't want to pick up some awful bacterium or virus while there.

    Rest up and get well (none / 0) (#23)
    by McBain on Sat Oct 14, 2017 at 11:00:06 AM EST
    Best wishes

    re: `Affordable coverage" (none / 0) (#21)
    by linea on Fri Oct 13, 2017 at 07:49:16 PM EST
    i would have purchased an inexpensive catastrophic insurance plan last year had it been an option. instead, i went a year without medical coverage and paid the tax penalty.

    i don't understand why it's a good thing that taxpayers are giving medical insurance companies an additional 7 billion dollars in profit and letting them set prices without some governmental oversight and a limit on the profit margin. also, i don't understand why at 60k people are paying the full inflated high profit-margin price. how is that reasonable?


    linea, I don't think you understand (5.00 / 1) (#22)
    by Anne on Fri Oct 13, 2017 at 08:33:21 PM EST
    what the cost-sharing payment is all about:

    To compensate for the added cost to insurers of the reduced cost-sharing,

    It costs the insurance companies to issue policies with lower co-pays and deductibles; the cost-sharing payments compensate them for this - it isn't "profit."

    But, see, Trump doesn't understand much about this, either.  He thinks the cost-sharing payments are a "bailout" for insurance companies, and he doesn't understand the consequences of ending the payments.  He doesn't understand that ending the payments will likely result in higher premiums.  For those who qualify, the tax credits will have to increase.  The government will end up shelling out more money as a result.

    But this isn't about saving the government money, it's about trying to deal a death blow to a a law that has Obama's name on it.  And it for sure isn't about creating the conditions where people can get better coverage for less money, either.

    All you need to understand is that Trump doesn't care about health insurance or health care, he doesn't understand how any of it works, and he's not interested in improving the lives of average Americans.  He cares about getting even and getting over.  That's it.


    When someone with one of these junk policies (none / 0) (#24)
    by Militarytracy on Sun Oct 15, 2017 at 09:34:57 AM EST
    Develops cancer, and it isn't covered and they cannot afford to pay for their treatment out of pocket, what happens to them then?

    They die. Or they turn - as so many have - (5.00 / 1) (#25)
    by Anne on Sun Oct 15, 2017 at 10:18:32 AM EST
    to GoFundMe, and hope people aren't already tapped out from giving to all the other GoFundMe accounts.

    When you have members of Congress saying that maybe we should roll back the mandate that hospital ERs must treat people who don't have insurance (at least until they are stabilized), I think you have a pretty good idea where this is heading.

    However bad the system was before the ACA, Republicans seem hell-bent on making it exponentially worse, and just flat-out lying to the people about how great it's going to be.

    It's a nightmare.


    They don't (5.00 / 1) (#26)
    by Ga6thDem on Sun Oct 15, 2017 at 01:13:39 PM EST
    even have to develop cancer. Even normal routine stuff is not going to be covered. What the GOP wants people to buy is a cheesy health discount plan. You pay for health care out of pocket but you pay every month to get a discounted price.

    a whole lot (none / 0) (#4)
    by CaptHowdy on Fri Oct 13, 2017 at 08:43:26 AM EST
    of Trumps 32% are going to be hit hardest by this.

    even they are not stupid enough to blame anyone but Trump for it.  

    lets see how much they love him when they cant afford insulin or get a cancer diagnosis.

    I'm (5.00 / 3) (#6)
    by FlJoe on Fri Oct 13, 2017 at 10:16:02 AM EST
    not believing the "not stupid enough" part until proven otherwise.

    My thinking is he could kill their health care in broad daylight on Fifth Avenue and still not lose them.


    i totally accept (none / 0) (#7)
    by CaptHowdy on Fri Oct 13, 2017 at 10:52:22 AM EST
    the possible truth of that.

    we will see.


    What makes me pessimistic (none / 0) (#9)
    by KeysDan on Fri Oct 13, 2017 at 12:30:08 PM EST
    is that decisions have already been made against their economic interests so long as those people don't get free stuff. But, as you note, we will see. And, I hope you are right.

    I really do think they (none / 0) (#30)
    by Militarytracy on Mon Oct 16, 2017 at 09:22:46 AM EST
    Believed him though when he said everyone was getting health care and it was going to be affordable. I think he even campaigned on the word cheap in a few stump speeches.

    I know, this is really going to clobber them (none / 0) (#29)
    by Militarytracy on Mon Oct 16, 2017 at 09:18:24 AM EST
    It will finish off the administration in a way. I think Democrats will take both House and Senate back just because someone must stop Trump and Republicans aren't going to do it.

    A lot of damage will be done though