The Trump administration released limited fixes Thursday for shaky health insurance markets, even as it reaffirmed its goal of dismantling the Obama-era healthcare law that created them and that covers millions of Americans.
Republicans contend that the Affordable Care Act — also called the ACA or Obamacare — is beyond repair, but their “repeal and replace” slogan hasn’t been easy to put into practice, nor politically popular. So the administration is taking steps to keep the existing system going even as it pursues its ambition of a total remake.
Many of the changes announced Thursday follow recommendations from insurers, which wanted the government to address shortcomings with HealthCare.gov markets, including complaints that some people are gaming the system by signing up only when they get sick and then dropping out after being treated.
President Trump and congressional Republicans finally goaded the health insurance industry into defending the Affordable Care Act this week — sort of. But these companies’ pusillanimous response to the GOP’s direct threat to Obamacare’s survival is a reminder that the industry, which collectively has made hundreds of millions of dollars from the law, has in many ways been its worst enemy.
The health insurers’ rare outspoken defense of the law came via separate letters from the industry’s lobbying arms, America’s Health Insurance Plans and the BlueCross BlueShield Assn., to Trump and to congressional leaders. The letters warn that the Republican determination to undermine the ACA threatens to drive more insurers out of the individual market, push up premiums and other costs, and burden hospitals with more unpaid bills.
Seven vulnerable Republican lawmakers are being targeted with $1 million in television spots by a liberal group backed by labor and progressive interests. The ads generally focus on the lawmakers’ apparent support for the American Health Care Act (AHCA), the failed House bill that was designed to replace the Affordable Care Act, a.k.a. Obamacare. The ad tries to capitalize on the interesting shift in public sentiment about Obamacare, suddenly more popular as it has come under legislative assault by the Trump administration.
The Trump administration is sending mixed messages on billions of dollars in federal payments that make deductibles affordable for millions of Americans and are a top priority for health insurers considering whether to sell Affordable Care Act health plans next year.
The administration said it will continue making the payments while a lawsuit that challenged whether they are legal is ongoing. But a spokeswoman stressed Tuesday that no final decisions have been made about the long-term future of the payments or the lawsuit.
“The administration is currently deciding its position on this matter,” Alleigh Marré, a spokeswoman for the Department of Health and Human Services said in an e-mail. “No decisions have been made about how the administration will proceed.”
The Affordable Care Act’s worst enemies are now in charge of the vast range of health coverage the law created. They’re also discussing changes that could affect a wider net of employment-based policies and Medicare coverage for seniors.
Although Republicans failed last month in their first attempt to repeal and replace the ACA, President Donald Trump vows the effort will continue. And even if Congress does nothing, Trump has suggested he might sit by and “let Obamacare explode.”
Health insurance for the 20 million who benefited from the ACA’s expanded coverage is especially at risk. But they’re not the only ones potentially affected. Here’s how what’s going on in Washington might touch you.
Of all the shibboleths used to denigrate the Affordable Care Act, perhaps the most persistent is to label it a “job-killer.”
The label was strong on the wing during the presidential campaign, when one could hear it uttered by Sen. Ted Cruz (R-Texas), who called it “the biggest job-killer in this country,” and Donald Trump, who said repealing the law would save “2 million American jobs.” The notion had a long history: In January 2011, only a few months after the law had been passed and three years before its major provisions went into effect, the newly Republican House was trying to pass a measure entitled the “Repealing the Job-Killing Health Care Law Act.”
The failure of the GOP health care plan in Congress and the ongoing uncertainty surrounding the Trump administration’s next moves have left insurers skittish about participating in the Obamacare exchanges next year. And this could leave hundreds of thousands of Americans without an option for subsidized coverage.
Republicans are trying to bring back Obamacare repeal. And the emerging deal would make a mockery of those promises ― by forcing people with medical problems to pay more for their health care, and in many cases leaving them unable to get insurance at all.
It would be a breach of faith, but also a revealing window into what Republicans who support this measure think the world should look like.
The whole point of health insurance is to protect people from financial ruin just because they happen to be injured or sick. Living with diabetes, battling cancer, recovering from serious injury ― these things are hard enough without having to worry that paying the medical bills will drive you into bankruptcy.
The Affordable Care Act was an effort, however imperfect and incomplete, to protect people from those problems. This Republican proposal would expose them all over again.
Last year, residents in Pinal County, Arizona, came close to facing a unique dilemma when they headed to Healthcare.gov to sign up for insurance. The county was the only place in the country where there would be no tax-subsidized insurance plans for customers to buy, meaning those without an employer-provided plan would have to foot the bill on their own, go uninsured or look for an alternative arrangement lacking the extensive coverage required under President Barack Obama’s health care law.
The lack of subsidized plans came after a string of marketplace exits by insurers that left a third of U.S. counties – most of them rural – with only one health insurer in the area. To make matters worse, rates for midlevel plans under Obamacare would be rising on average by more than 20 percent.
As House Republicans struggle to find a way to repeal ObamaCare, the two GOP senators from Tennessee are looking to temporarily fix an issue that may strike the health insurance exchanges next year.
A bill introduced by Sens. Lamar Alexander and Bob Corker would allow people to use their ObamaCare subsidies to purchase any state-approved plan on the private market if there are no insurers selling policies on the federal exchange in their county.