Trump Administration Details Health-Law Waivers for States

The Trump administration on Thursday outlined ways states will be allowed to waive parts of the Affordable Care Act, a move that has been welcomed by conservatives, spurred rebukes from Democrats and risks legal action.

The Centers for Medicare and Medicaid Services, which implements the health law, released four templates detailing how states may use waivers. States will get significantly more leeway to change the way they distribute and structure ACA premium subsidies that now go to almost nine million people.

“The specific examples laid out today show how state governments can work with HHS to create more choices and greater flexibility in their health insurance markets, helping to bring down costs and expand access to care,” said Health and Human Services Secretary Alex Azar.

The flexibility being offered to states marks a fundamental shift in approach, health analysts say. The Obama administration sought to make sure people had a minimum level of coverage, while the waivers show the focus now is on making sure people have access to some kind of coverage.

ACA supporters say that amounts to giving states and insurers a license to provide inadequate coverage. It undermines the ACA’s intent of providing eligible consumers with financial help to purchase plans that provide certain standards.

“These new templates are nothing more than a how-to guide for health-care sabotage,” Sen. Patty Murray (D., Wash.) said Thursday. “The Trump administration is brazenly warping a tool meant to help states innovate and lower prices so it can further gut protections for people with pre-existing conditions and drive up health-care costs.”

Under the new approach, states can let consumers use their premium subsidies under the ACA to buy cheaper health plans that don’t comply with the law or offer some benefits such as maternity care.

It goes deeper than that. Once in congress it seems Republicans think being a statesman means getting along with Democrats. They are passive and desire to get along even when the Democrats are doing their seriousness of the charges shtick and proverbially stabbing them in the back.

The RNC is useless. They’re still better than the DNC, which is actively dangerous, but better doesn’t mean worth a damn.

I think the root of the problem is that when all is said and done since they’re no less sold out for FDR’s high handed lawlessness it’s difficult for passionless compromisers to do more than tepidly resist those who are sold out for lawlessness and who seek to advance it always.

What the administration needs to impose on all parts of Obamacare that are still functioning is that thing that Obama first promised as he was preparing to enter office - transparency.

In all of the last 15 years until 2017 I was covered by a policy from my wife’s employer, a large national corporation with over 12k employees. She was provided with a health insurance package, and could ensure me for ~$300 additional per month. Then she turned 65 in mid 2017 and was covered by Medicare, and I had to go out onto Obamacare - and it was shocking. The first 6 months (the second half of 2017) covering myself only (age 60 at that time, healthy) with a Silver plan through Blue Cross Blue Shield of FL was $880/month. No subsidy due to our household income. In January 2018 the same policy was going to be $1440/month. I elected not to buy insurance and joined one of the “medi-share” type programs that were grandfathered in at the inception of Obamacare. Costs less than $300/month, and appears to have the same deductible profile as the BCBS plans that cost $1140 more each month.

When I am asked to pay $1440/month for something that is not tangible, I spend time analyzing it. The problem here is that the price is all you get - no breakdown of what goes into a premium that high.

The information that I expect to get in a quote would be a breakdown that would tell me what part of the $1440 is a payment to purchase my insurance and what part is a payment to subsidize other policies for other people.

Since the information i not available, I have to guess, and might guess that $500 is the premium to cover my insurance and $940 is a subsidy to buy down the cot of other’s premiums.

I could be way off the mark with that guess, but cannot be faulted because...the government, which must know the information in order to construct the program - doesn’t disclose the information to the public. They are not being in the slightest bit transparent.

Let’s say for the sake of argument that I am correct that the premium breaks down to $500 for my premium and $940 for the subsidy to others. If that was the case, and those numbers were disclosed to me, I could choose to accept it or object to it. And I would object to it and could make my representatives aware of how I felt.

I think that the primary accomplishment of Obamacare was in obscuring from the public the magnitude of the subsidies that are flowing from this group to that in this program.

Make it fully transparent, let every voter/taxpayer know what they are paying for and this will be dismantled in a hurry.

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