What is going to happen when people with pre-existing conditions start dying and their relatives accuse the president of the murder of their relatives? He likely couldn't be convicted of murder (or remain president after that either).
What I'm saying here is they cannot blame Congress of murder because of this executive order only the president. The people of all political parties would hold him liable for these murders for a variety of reasons and he could not actually survive as president likely after this too. So, I agree with Bannon and many others: "He has a less than 30% chance of remaining president the rest of his term.
What I'm saying here is they cannot blame Congress of murder because of this executive order only the president. The people of all political parties would hold him liable for these murders for a variety of reasons and he could not actually survive as president likely after this too. So, I agree with Bannon and many others: "He has a less than 30% chance of remaining president the rest of his term.
begin quote from:
The damage is not catastrophic. But it is real and it will linger. That was the …
Trump’s Obamacare Sabotage Is Doing Real Damage To American Health Care
A series of blows is taking its toll.
The damage is not catastrophic. But it is real and it will linger.
That
was the conclusion many health care industry officials and analysts had
reached by week’s end, following a pair of blows that President Donald Trump delivered to the Affordable Care Act ― and, indirectly, to the millions of people who buy private health insurance on their own.
The first blow came on Thursday, in the form of an executive order
designed to undermine the new rules that “Obamacare” has placed on
insurers. The 2010 health care law famously prohibits carriers from
denying coverage to people with pre-existing conditions. It also
requires that all plans cover a set of “essential” health benefits
including mental health and maternity care.
With
the executive order, Trump instructed three federal agencies to carve
out some exceptions to those rules. The result could be a parallel
market full of plans that don’t have all of the essential benefits and,
in some cases, that are available to people only in relatively good
health.
At
an Oval Office ceremony to sign the order, Trump boasted that the new
plans would offer cheap alternatives to the millions of consumers
struggling with high premiums today. And that is true. But, as experts
have warned, anybody buying one of these plans would be rolling the
dice, because the plans wouldn’t necessarily cover the costs of a
serious injury or medical problem. At the same time, these skimpy plans
would draw the youngest and healthy customers away from the
comprehensive policies, making it ever more difficult for insurers to
sustain those plans financially.
But
Thursday’s order turned out to be a prelude to something bigger.
Literally hours after the president signed it, the administration
announced that it was carrying out a threat Trump had made for months.
The federal government would be cutting off a set of monthly payments to health insurers operating through HealthCare.gov
or one of the state-run marketplaces. The change was effective
immediately, the administration later confirmed, meaning the payments
that these insurers got in September could turn out to be their last.
This
is not how the architects of the Affordable Care had intended the
program to work. The law promises these payments to insurers, so that
insurers can, in turn, reduce deductibles and copayments for some of
their lowest income customers. (The payments are thus not a “bailout,”
though Trump describes them that way.) But Congress never formally
appropriated the money, creating a legal dispute that is still winding
its way through the courts ― and leaving payment, in the interim, to the
discretion of the president.
Former
President Barack Obama had kept the payments going, which, perhaps,
makes it surprising that Trump waited nine whole months to stop them.
Advisers warned him against taking this steps, according to a Washington Post
report, but in the end they couldn’t stop him ― perhaps because Trump
has become so frustrated with his party’s failure to get repeal
legislation through Congress.
“This is confirmation that the Trump administration has no interest in making anything on the individual market work,” David Anderson, research associate at Duke University’s Margolis Center for Health Policy, said on Friday.
How Insurers Are Reacting To Trump’s Latest Moves
Once
Trump pulled the trigger, a frenzy of crisscrossing emails and phone
calls ensued, as industry officials, analysts, and public officials
(and, yes, journalists too) tried to figure out exactly what would
happen next. Even now nobody seems quite certain of the answers,
although at the moment it looks like most insurers had already prepared for the possibility Trump would cut off those payments.
Either
on their own or at the behest of their regulators, those insurers filed
rates for 2018 assuming the insurer payments might stop. And in the states
where insurers expected the payments to continue ― Sean Mullin, senior
director at Leavitt Partners, told HuffPost he thinks it’s about a dozen
total ― insurers and regulators are now hastily making plans for last-minute revisions.
Whether
insurers made the plans previously or whether they are making them now,
the gist of the response is the same: The carriers are raising premiums
to make up for the money they’re no longer getting from Washington ―
and to account for any other steps the Trump administration might take
to depress enrollment or otherwise weaken the program. Charles Gaba, the
Michigan-based data nerd who runs the well-respected website ACAsignsups.net, has estimated that insurer anxiety over Trump’s management account for about two-thirds of next year’s premium increases.
It raises doubts about whether you want to partner with the federal government going forward Chet Burrell, CEO of CareFirst Blue Cross Blue Shield
Gaba’s
conclusion is consistent with what insurers have reported individually.
Blue Cross and Blue Shield of Montana, for example, is requesting an
average increase of 23.1 percent for its individual health plans next
year, company spokesman John Doran told HuffPost on Friday. About
three-quarters of that, he said, represented uncertainty over the Trump
cutoff.
As usual, the majority of people who buy coverage through HealthCare.gov
or one of the state exchanges won’t feel the impact of these increases,
at least not right away. That’s because the Affordable Care Act uses
tax credits to put a ceiling on premiums for consumers with incomes
below 400 percent of the poverty line, or $98,400 for a family of four.
No matter how high premiums go, they won’t pay more. Some insurers have
gone a step farther, and structured their premium increase for next year
in ways that shield even wealthier people from the impact of the cuts.
Because of the formula the federal government uses to calculate financial assistance, some people will be able to get better plans
for less money. Of course, the federal government will be picking up
the extra costs, which is one of the many ironies of Trump’s action
Thursday: The likely result will be more government spending, not less.
But
some upper-income consumers are going to pay more ― in some cases, a
lot more. It so happens that these are also the people who frequently
struggle the most with premiums today, because their incomes are just a
little too high to qualify for the tax credits, but they don’t have
money to spare and are basically paying one-fifth of their income on health insurance premiums.
Presumably
some of them will simply stop getting insurance altogether, and
presumably it will be people who feel like they can take that risk
because of their relatively good health ― thereby making the system’s
risk pool problems, already pretty severe in some parts of the country,
even worse.
Why The Real Story May Be What Happens After Next Year
By
itself, that won’t cause health insurance markets to
implode. Implementation of Thursday’s executive order won’t have that
effect either. But this week’s actions are merely the latest steps in a
campaign to undermine the Affordable Care Act that began on literally
the first day of the Trump presidency, when he made a big show of
signing a symbolic executive order instructing agencies to “waive,
defer, grant exemptions from, or delay the implementation” of the law’s
rules and regulations.
Since that time Trump has slashed the program’s advertising budget, cut funding for so-called navigators who help people enroll, used government funding to finance anti-Obamacare propaganda, announced unexpected downtime for HealthCare.gov, and delayed a planned step-up in enforcement of the individual mandate.
On a conference call Friday, Chet Burrell,
president and CEO of CareFirst Blue Cross Blue Shield, noted the
cumulative impact of these steps ― not just on enrollment, which the
Affordable Care Act needs to survive, but also on the psyche of insurer
companies like his, which is among the dominant carriers in Maryland and
Virginia.
The
Affordable Care Act has been a fragile program from the beginning,
Burrell noted, and it has serious flaws that still need fixing. But the
program has also insured millions, he explained, and it has the
opportunity to strengthen with support from Washington ― only now that
support is gone. “We’re worried,” he said. “It raises doubts about whether you want to partner with the federal government going forward.”
Maryland
is among the states where carriers are hurriedly preparing new rate
requests, because they had assumed insurer payments would keep flowing.
Burrell said he was working closely with state and federal officials and
was optimistic they would find a way to get it done, although he said
there’s already talk of pushing back Maryland’s open enrollment, now
scheduled to start on Nov. 1, by at least a few days to give it a bit
more time.
Around the country, insurers were expressing similar sentiments
― to stick with the program, at least through this year and most likely
next as well, even though the cutoff of those funds means some serious
financial losses for some of
them. That commitment to stay with the program is no small thing,
because their contracts would appear to allow them to withdraw if the
federal government pulls back on planned payments.
But
the issue is really more about what happens after next year. Insurers
will have to begin planning for 2019 this coming spring and, after what
is likely to be a rocky open enrollment period, the decision whether to
participate could be a difficult one.
The
insurers who stuck it out this long, despite all of the Affordable Care
Act’s problems, did so in part because they knew they were dealing with
president committed to making the program work. Today they are dealing
with a president bent on making it fail ― in many cases, by seeking out
the weakest parts of its edifice and attaching a stick of dynamite.
Of
course, Trump continues to promise that once Obamacare is gone the
American people will be better off ― that they will have “great, great”
health care, as he put it once again this week. Burrell, in his
conference call, was among the many leaders working in health care who
have come to the opposite conclusion. “If you wanted to have a great
health plan for the American people,” he said, “you wouldn’t be doing
this.”
CORRECTION:
An earlier version of this article said that insurers will have to
begin planning for 2018 in the spring. They will be planning for 2019.
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