POLITICS
10/14/2017 04:19 pm ET Updated 8 hours ago

Trump’s Obamacare Sabotage Is Doing Real Damage To American Health Care

A series of blows is taking its toll.

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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
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