Posted on 10/12/2017 8:05:12 PM PDT by NRx
President Trump is throwing a bomb into the insurance marketplaces created under the Affordable Care Act, choosing to end critical payments to health insurers that help millions of lower-income Americans afford coverage. The decision follows an executive order on Thursday to allow alternative health plans that skirt the law’s requirements.
The White House confirmed late Thursday that it would halt federal payments for cost-sharing reductions, although a statement did not specify when. According to two people briefed on the decision, the cutoff will be as of November. The subsidies total about $7 billion this year.
Trump has threatened for months to stop the payments, which help eligible consumers afford their deductibles and other out-of-pocket expenses, but held off while other administration officials warned him that such a move would cause an implosion of the ACA marketplaces that could be blamed on Republicans.
Health insurers and state regulators have been in a state of high anxiety over the prospect of the marketplaces cratering because of such White House action. The fifth year’s open-enrollment season for consumers to buy coverage through ACA exchanges will open in less than three weeks, and insurers have said that stopping the cost-sharing payments would be the single greatest step the Trump administration could take to harm the marketplaces — and the law.
Ending the payments is grounds for any insurer to back out of its federal contract to sell health plans for 2018.
(Excerpt) Read more at washingtonpost.com ...
The house did sue to stop Obama’s payments as they were not provided in the original law and the R’s didn’t have the guts to stop it legislatively. Tried to hide behind the courts. It failed in court because of the fear of the effects it would have on the poor. Legal basis not used in the decision.
The “marketplaces” are already collapsing.
Amy Goldstein of the Washington Compost. Love child of Helen Thomas and Carrot Top.
You go to Church?
My Association is going to be the “Shoppers of Walmart.” Put up a booth for health insurance at all Walmart’s and have people sign up.
Obamacare is UnConstitutional.
So now even the headlines contain biased analysis.
If I understand correctly the payments are part of the law but funding for the payments was not passed by congress
If that is the case the insurance companies may be able to sue the government for breach of contract.
Someone with knowledge of the facts needs to clarify what the actual situation is.
Yes and no.
The US Government via Obamacare WAS on the hook to subsidize losses by the insurance companies due to being on the exchanges up til 2018.
But the losses were far, far worse than expected that it was even affecting their core businesses that weren’t covered by the law. So Obama diverted funds and bribed... er... supported the industries because he decided that was the “intent” of the law.
The court said no it wasn’t.
My memory is hazy but I think the republican congress never increased the payouts from the original numbers.
That the insurance companies were complicit in ramroding thisnlegislation through I think they deserve all of this.
Most people have no clue how Medicaid works. I was an eligibility worker for MediCal in California. They have what is called a share of cost and their share of cost depends on income. It can be anywhere from $0 to thousands a month. Their share of cost must be paid before Medicaid covers the rest. The share of cost is monthly.
Example: X has a share of cost of $100 per month. If x goes to the doctor and the cost is $150 then X pays the first hundred and Medicaid pays the $50. If X goes to the doctor twice in the same month the 2nd visit will be paid 100% since the share of cost was paid on the first visit. On the first of the next month the share of cost again goes back to $150 and they start again.
There are no ‘monthly premiums’ for Medicaid but there may be a share of cost dependent on income. If the share of cost is $0 then the person pays nothing and Medicaid covers 100%.
That's why I always call it "medical welfare"...but the lying RATs insist on calling it "insurance".
There are no ‘monthly premiums’ for Medicaid but there may be a share of cost dependent on income.
But there should be, and it should be based on a sliding scale (ability to pay) all the way down to full subsidy for the truly needy.
Anybody should be able to "buy in" to unsubsidized MediCaid, but I don't know why they would, if an available private insurance plan is cheaper, and has better benefits.
If the share of cost is $0 then the person pays nothing and Medicaid covers 100%.
>>then the person pays nothing and the taxpayers cover 100%.
Thanks to Obama, healthcare is now a political football that will continually be retooled and tweaked every presidential election cycle in an attempt to buy votes.
And too many so-called republican leaders are happy to play the game.
and it should be based on a sliding scale (ability to pay)
Apparently you didn’t read my post all the way through. A sliding scale based on income is exactly the way Medicaid works.
I want to see claw-backs! Bankrupt them and start anew.
The money has to be appropriated by Congress. It was not.
Two years ago, House Republicans sued Obama under then-Speaker John Boehner and claimed the president had violated the law by delaying enforcement of several provisions of the Affordable Care Act.
But lawyers later focused on the reimbursements for health insurers that had received little attention before. They said these payments would come to $175 billion over a decade.
The healthcare law says insurers who enroll eligible, low-income Americans shall cover the costs of their deductibles and co-payments, but promises the federal government “shall make periodic and timely payments” to cover those costs.
The law is not entirely clear on where this money will come from, however.
At first, the administration asked Congress for an appropriation to cover these costs.
But when that request went nowhere in Congress, officials at the Department of Health and Human Services said they could continue to pay these required reimbursements.
They said payments were like “other appropriate entitlements like Medicaid” that are covered by permanent federal funds and not subject to an annual appropriation.
Judge Collyer called that claim a “most curious and convoluted argument whose mother was undoubtedly necessity.”
Collyer, an appointee of President George W. Bush, said she would block “any further reimbursements…until a valid appropriation is in place,” but then put her order on hold while the administration appeals.
Trump dropped the appeal.
And apparently you didn’t read my post. I said they should pay premiums (based on a sliding scale) and anyone could "buy into" it.
Additionally, in fact, it should be privatized, with eligibility and the subsidized premium being the only government involvement. Premiums are cheaper than claims.
That way, the providers would receive compensation at market rates instead of pennies on the dollar. All carriers should be required to participate.
ok, thanks for the clarification.
I am SO amazed at Trump’s courage. Our courts and Congress are spineless. We only have ONE man representing us!
“Despite working hard, making a decent (but certainly not “great”) middle-class income, living frugally, and in general saving, investing, and managing my $$ fairly well, I think... odds are I will be destitute at age 70 — because of our health care system.”
At 70? At 65, you can get Medicare. The costs are very low to the consumer, compared to the real costs of the healthcare.
If only 8 million are still insured by Obamacare, how will 25 million be affected and possibly die by this move?
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