Category Archives: Obamacare

‘Breakthrough’ Reached On Short Term Health Care Fix

DENVER (CBS4) – Two key senators say they’ve reached a breakthrough deal on a short term health care fix. Republican Senator Lamar Alexander of Tennessee and Democratic Senator Patty Murray of Washington State hashed out the deal after weeks of hearings by the Senate Health Committee, that included plenty of input from Colorado.
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Senator Michael Bennet is a member of the committee and Governor Hickenlooper was among those asked to testify. They warned the president against cutting subsidies that help insurers cover low income Coloradans. The bi-partisan bill restores the subsidies for two years. “It’s important to understand this is a self-inflicted wound,” said Bennet, “This was not something that ‘Obamacare’ caused. This was caused by the president… and now we are in a bi-partisan way putting it back together again.”
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The goal of the bill is to stabilize the health insurance market. In Colorado, 14 counties have one insurer left on the exchange and premiums are expected to jump nearly 30% next year. Bennet says the bill also gives states more flexibility on some Obamacare mandates, “It creates less bureaucracy and gives states the opportunity to innovate without compromising the essential health benefits.”
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Republicans have been pushing for more state control but, so far, republican leadership has not indicated whether it will support the bill. Senator Alexander says, “The important thing is not that Senator Murray and I agree but that we find consensus with colleagues so we can enact it.” President Trump says he was involved in the compromise, but called it a short-term fix, saying Obamacare is dead, “It’s a concept that doesn’t work and we are very close. We feel we have the votes.” The bill also includes millions of dollars to help enroll people in Obamacare. What remains to be seen is whether the so-called Freedom Caucus in the House will get behind the bill. The ultra-conservative republicans have opposed the subsidies, calling them bailouts for insurers.  

Senators Propose Bipartisan Compromise To Restore Insurance Subsidies

President Trump recently announced that he was pulling the plug on $7 billion a year in federal cost-sharing subsidies to insurance companies selling individual policies to lower-income Americans, but today a pair of influential senators announced a bipartisan compromise that, if approved, would restore those payments for two years, while also giving states more flexibility with rules under the current law. These subsidies, which are paid out monthly by the federal government, are part of the 2010 Affordable Care Act and are intended to keep out-of-pocket expenses — like co-pays and deductibles — low, particularly for Americans making between 100% and 250% of the federal poverty line. Trump had ridiculed these payments as “bailouts” for the insurance industry, and had repeatedly threatened to cut them off, which insurers and other critics said would have the immediate effect of destabilizing the individual insurance market. On Oct. 12, only hours after he signed an executive order undermining other key aspects of the Affordable Care Act, the President released a one-paragraph statement directing that the payments come to a halt. If the payments were to end, it’s expected that many insurance companies would flee the individual marketplace in 2018 and that premiums would continue to soar. Rates for 2018, which were recently locked in, had already been increased in expectation of the White House ending these subsidies. But this afternoon, Sen. Lamar Alexander (TN) and Sen. Patty Murray (WA) — the Republican and Democratic heads, respectively, of the Senate Health, Education, Labor, & Pensions Committee — announced they had ironed out a deal that would preserve the payments for two more years. The compromise also reportedly includes additional flexibility in what’s known as the Section 1332 waiver program, which allows states to apply for innovation wavers. Under a 1332 waiver, any tweaks a state makes to its insurance requirements must result in insurance that is just as comprehensive and as affordable as what would be available without the waiver; in other words, it can’t be used to make insurance worse in a state. Alexander told reporters this afternoon that the proposed change to the 1332 waivers would both speed up the review process for each waiver request and loosen the threshold to “comparable affordability,” meaning a waiver could open the door to insurance that is more expensive than what would be purchased without the waiver. The senators claim that the change to the waiver program will not — as was proposed by GOP lawmakers multiple times during the failed repeal and replace legislative efforts — allow states to opt of requiring that insurance carriers cover the ACA’s list of mandatory Essential Health Benefits. In an apparent effort to make insurance more affordable for some, the bill proposes letting Americans over the age of 30 buy catastrophic insurance plans — aka “copper” plans — that cost less but also provide less coverage for general health maintenance. Politico reports that the bill adds $106 million back into support for ACA enrollment. The Trump administration recently gutted funding for the upcoming enrollment period, which has also been cut in half. The Alexander-Murray legislation has not been finalized, but Murray told reporters this afternoon that the final details are being ironed out and that she’s “very optimistic” that it will move forward. If the compromise does make it to the Senate floor, it would be first bipartisan piece of health insurance reform to do so. Unlike the unsuccessful repeal bills, this legislation could pass without full support from either party. Right now, some GOP lawmakers are being cautiously supportive of the proposed compromise. Sen. John Thune (SD) said today that, from what he’s seen of the bill, it “is something I think will attract a good number of votes for people who want to see a near-term solution that ensures stability in the markets and enables and sets up a debate down the road.” While some more hardline conservatives are already opposing the proposal, claiming that they won’t stand for anything other than full repeal of the ACA. “The GOP should focus on repealing & replacing Obamacare, not trying to save it,” Tweeted Rep. Mark Walker (NC), head of the conservative Republican Study caucus. “This bailout is unacceptable.” One big question that remains to be answered is whether Senate leadership will make time for this bill to be considered in the coming weeks, or if it will be delayed until after Congress has dealt with other matters, like tax reform. While legislators move forward with this possible compromise, several states are currently suing the Trump administration in the hope of restoring the subsidies. They argue that the President doesn’t have the authority to cut off these payments on a whim, and that he is violating the Take Care clause of the Constitution by not faithfully executing the laws of the country.

Senators Reach Bipartisan Deal On Resuming Payments To Health Insures

WASHINGTON (AP) — Key senators reached a breakthrough deal Tuesday on resuming federal payments to health insurers that President Donald Trump has blocked. Insurers had warned that unless the money is quickly restored, premiums will go up. At the White House, the president spoke favorably about the bipartisan compromise, which is still likely to face opposition in Congress. The agreement would involve a two-year extension of federal payments to insurers that Trump halted last week, said Sen. Lamar Alexander, R-Tenn. Unless the money is quickly restored, insurers and others say that will result in higher premiums for people buying individual policies and in some carriers leaving unprofitable markets. Alexander and Sen. Patty Murray, D-Wash., have been working for weeks on health care legislation, separate from repeated and unsuccessful efforts by GOP leaders to dismantle Barack Obama’s Affordable Care Act. Emerging from a closed-door GOP luncheon on Tuesday, Alexander said, “Senator (Patty) Murray and I have an agreement,” and added that Trump has encouraged them and the “president likes this idea.” While the agreement is a breakthrough, they still need to secure the support of fellow Republicans and Democrats. Majority Leader Mitch McConnell, R-Ky., was noncommittal while Minority Leader Chuck Schumer, D-N.Y., welcomed the agreement as a step forward that will provide stability for insurance markets in the short-term. Murray hailed the bipartisan effort, saying “when Republicans and Democrats take the time … we can truly get things done” for the American people. In brief comments at the White House, Trump offered support. “It is a short-term solution so we don’t have this very dangerous little period,” the president said. Murray and Alexander began talks on extending the payments months ago, when Trump was frequently threatening to stop the subsidies. Both had said they were close to a deal, but GOP leaders shut the effort down in September when the Senate revisited the Republican drive to repeal Obama’s law. The repeal effort failed, as did an earlier GOP attempt to dismantle the law in July. Trump’s halt of the payments and worries about its impact have galvanized lawmakers in both parties to take action to prevent it. Even so, strong opposition by some conservatives means the congressional fate of a compromise would be uncertain. For their part, Democrats believe Republicans in control of Washington will be blamed by voters for future health care problems and are reluctant to bend too far toward GOP demands for opening loopholes in Obama’s law. Alexander said Trump has twice in recent days urged him to reach a deal with Murray. “He says he doesn’t want people to be hurt in this interim,” said Alexander, a reference to Trump’s desire to revisit the effort to scrap Obama’s statute next year. Trump repeated his gloomy assessment of a law that’s expanded health coverage to 20 million people and required insurers to cover specified services and limit costs, but has also seen premiums rise and limited competition in some regions. “Obamacare is virtually dead. At best you could say it’s in its final legs. The premiums are going through the roof. The deductibles are so high that people don’t get to use it. Obamacare is a disgrace to our nation and we are solving the problem of Obamacare,” he told reporters in the Oval Office. Senate Minority Leader Chuck Schumer, D-N.Y., said Trump’s stoppage of the payments “showed that he’s willing to take a wrecking ball to our nation’s health care for the sake of politics.” He said congressional support for an agreement between Alexander and Murray would show lawmakers have “no intention of going along with President Trump’s reckless sabotage of the nation’s health care law.” Under Obama’s 2010 overhaul, the government must pay insurers for reducing out-of-pocket expenses for lower-earning customers. A federal judge has ruled that Congress hadn’t legally approved the payments, but Obama — and initially Trump — continued them anyway. Trump halted them last week, even though by law insurers must continue reducing costs for lower-income consumers. Trump and some Republicans consider the payments to be bailouts to carriers. But Democrats and some Republicans say halting them would create chaos in insurance market places. The so-called cost-sharing reductions cost around $7 billion this year and lower expenses like co-payments and deductibles for more than 6 million people. © Copyright 2017 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.

Senators Reach Deal On Resuming Payments To Health Insurers

WASHINGTON (AP) — Key senators reached a breakthrough deal Tuesday on resuming federal payments to health insurers that President Donald Trump has blocked. Insurers had warned that unless the money is quickly restored, premiums will go up. At the White House, the president spoke favorably about the bipartisan compromise, which is still likely to face opposition in Congress. The agreement would involve a two-year extension of federal payments to insurers that Trump halted last week, said Sen. Lamar Alexander, R-Tenn. Unless the money is quickly restored, insurers and others say that will result in higher premiums for people buying individual policies and in some carriers leaving unprofitable markets. Alexander and Sen. Patty Murray, D-Wash., have been working for weeks on health care legislation, separate from repeated and unsuccessful efforts by GOP leaders to dismantle Barack Obama’s Affordable Care Act. Emerging from a closed-door GOP luncheon on Tuesday, Alexander said, “Senator (Patty) Murray and I have an agreement,” and added that Trump has encouraged them and the “president likes this idea.” While the agreement is a breakthrough, they still need to secure the support of fellow Republicans and Democrats. Majority Leader Mitch McConnell, R-Ky., was noncommittal while Minority Leader Chuck Schumer, D-N.Y., welcomed the agreement as a step forward that will provide stability for insurance markets in the short-term. Murray hailed the bipartisan effort, saying “when Republicans and Democrats take the time … we can truly get things done” for the American people.
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U.S. President Donald Trump (Photo by Alex Wong/Getty Images)

In brief comments at the White House, Trump offered support. “It is a short-term solution so we don’t have this very dangerous little period,” the president said. Murray and Alexander began talks on extending the payments months ago, when Trump was frequently threatening to stop the subsidies. Both had said they were close to a deal, but GOP leaders shut the effort down in September when the Senate revisited the Republican drive to repeal Obama’s law. The repeal effort failed, as did an earlier GOP attempt to dismantle the law in July. Trump’s halt of the payments and worries about its impact have galvanized lawmakers in both parties to take action to prevent it. Even so, strong opposition by some conservatives means the congressional fate of a compromise would be uncertain. For their part, Democrats believe Republicans in control of Washington will be blamed by voters for future health care problems and are reluctant to bend too far toward GOP demands for opening loopholes in Obama’s law. Alexander said Trump has twice in recent days urged him to reach a deal with Murray.
“He says he doesn’t want people to be hurt in this interim,” said Alexander, a reference to Trump’s desire to revisit the effort to scrap Obama’s statute next year. Trump repeated his gloomy assessment of a law that’s expanded health coverage to 20 million people and required insurers to cover specified services and limit costs, but has also seen premiums rise and limited competition in some regions. “Obamacare is virtually dead. At best you could say it’s in its final legs. The premiums are going through the roof. The deductibles are so high that people don’t get to use it. Obamacare is a disgrace to our nation and we are solving the problem of Obamacare,” he told reporters in the Oval Office. Senate Minority Leader Chuck Schumer, D-N.Y., said Trump’s stoppage of the payments “showed that he’s willing to take a wrecking ball to our nation’s health care for the sake of politics.” He said congressional support for an agreement between Alexander and Murray would show lawmakers have “no intention of going along with President Trump’s reckless sabotage of the nation’s health care law.” Under Obama’s 2010 overhaul, the government must pay insurers for reducing out-of-pocket expenses for lower-earning customers. A federal judge has ruled that Congress hadn’t legally approved the payments, but Obama — and initially Trump — continued them anyway. Trump halted them last week, even though by law insurers must continue reducing costs for lower-income consumers. Trump and some Republicans consider the payments to be bailouts to carriers. But Democrats and some Republicans say halting them will create chaos in insurance market places. The so-called cost-sharing reductions cost around $7 billion this year and lower expenses like co-payments and deductibles for more than 6 million people. By ALAN FRAM, Associated Press AP reporter Ken Thomas contributed. (© Copyright 2017 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

Denver Teacher Sues President Trump Over New Contraceptives Rules

By Rick Sallinger DENVER (CBS4) – A school teacher in Denver is suing President Trump and members of his cabinet over contraceptives. Under the new rules made to the Affordable Care Act, employers and insurers can decline to provide birth control if it violates their religious beliefs or moral convictions. Jessica Campbell, a math teacher at Colorado Academy in Denver has now filed a lawsuit challenging that. Her attorney Alan Kennedy-Shaffer says the changes are unconstitutional.
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A lawsuit over new mandates on contraceptives lists President Donald Trump as a defendant. (credit: CBS)

“This gives employers a license to discriminate against women by taking away with their birth control,” Kennedy-Shaffer says. The suit names President Trump and members of his cabinet as defendants. It states Campbell uses contraception not just for birth control, but for “medically necessary health and safety reasons.” It cites statements made during the election campaign by Trump the suit calls “vulgar and derogatory about women.” On the other side, there are those who feel contraception is wrong. A prayer vigil took place outside Planned Parenthood in the Stapleton area of Denver y the group “40 Days for Life”, it was directed primarily against abortion, some of those present spoke about contraception with CBS4 regarding the changes to the Affordable Care Act, known as Obamacare. Nickie Tomaino said, “Obamacare is not going to pay for that and I am not going to pay for anyone else’s contraception,”
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A prayer vigil happens outside of a Denver Planned Parenthood. (credit: CBS)

Several attorneys general have already filed lawsuits by states against the government over the changes. The lawsuit by Jessica Campbell is believed to be the first in Colorado. Her employer, Colorado Academy issued a statement from Dr. Mike Davis, the head of the school saying, “Any questions about the lawsuit filed by Ms. Campbell should be directed to her attorney, Alan Kennedy-Shaffer. In choosing to file the lawsuit, she is acting independently from Colorado Academy. Ms. Her employer, Colorado Academy issued a statement from Dr. Mike Davis, the head of the school saying, “Any questions about the lawsuit filed by Ms. Campbell should be directed to her attorney, Alan Kennedy-Shaffer. In choosing to file the lawsuit, she is acting independently from Colorado Academy. Ms. Campbell continues to receive health insurance coverage as an employee of Colorado Academy and her benefits, which include coverage for contraception and contraceptive care, have not changed, and there are no plans to change those benefits.” Rocky Mountain Planned Parenthood’s Adrienne Mansanares issued a statement that read, “Planned Parenthood of the Rocky Mountains proudly stands by increasing access to reproductive health care, that includes access to birth control.  With this rule in place, a woman’s decision to access birth control is made for her by her boss. Placing barriers in front of health care that the vast majority of women will use in their lifetime is an insult to our fundamental rights and health. This administration is telling women in America they can’t be trusted to make their own health care decisions and must get permission from their employer first: it’s a dangerous intrusion in women’s ability to get the care they need.” The lawsuit by Jessica Campbell is asking for a temporary injunction to block the changes to the regulations that have already taken effect. CBS4’s Rick Sallinger is a Peabody award-winning reporter who has been with the station more than two decades doing hard news and investigative reporting. Follow him on Twitter @ricksallinger.

Duckworth: Ending ACA Subsidies Affect The Most Vulnerable

CHICAGO (CBS) — Illinois’ junior U.S. Senator is among those highly critical of President Donald Trump’s Executive Order ending federal payments to health insurance companies under the Affordable Care Act, also known as Obamacare. Senator Tammy Duckworth says President Trump’s order ending the subsidies for health insurance marketplaces is going to push many people out of being able to afford the healthcare they need. “The subsidies help keep the cost low so that we could actually afford the health plans that are out there,” said Duckworth. “What will happen is when the subsidies go away, the cost of the healthcare plans will go up and they will become unaffordable,” she said. Duckworth says the President should pay attention to the vast majority of Americans and consider their needs. She calls his actions shortsighted at best.

Trump To Issue Stop-Payment Order On Health Care Subsidies

WASHINGTON (AP) — In a brash move likely to roil insurance markets, President Donald Trump will “immediately” halt payments to insurers under the Obama-era health care law he has been trying to unravel for months. Before sunrise Friday morning, Trump went on Twitter to urge Democrats to make a deal: “The Democrats ObamaCare is imploding,” he wrote. “Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!” The Department of Health and Human Services had made the announcement in a statement late Thursday. “We will discontinue these payments immediately,” said acting HHS Secretary Eric Hargan and Medicare administrator Seema Verma. Sign-up season for subsidized private insurance starts Nov. 1, in less than three weeks, with about 9 million people currently covered. In a separate statement, the White House said the government cannot legally continue to pay the so-called cost-sharing subsidies because they lack a formal authorization by Congress. Officials said a legal opinion from the Justice Department supports that conclusion. However, the administration had been making the payments from month to month, even as Trump threatened to cut them off to force Democrats to negotiate over health care. The subsidies help lower copays and deductibles for people with modest incomes. Halting the payments would trigger a spike in premiums for next year, unless Trump reverses course or Congress authorizes the money. The next payments are due around Oct. 20. The top two Democrats in Congress sharply denounced the Trump plan in a joint statement. “It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America,” said House and Senate Democratic leaders Nancy Pelosi of California and Chuck Schumer of New York. “Make no mistake about it, Trump will try to blame the Affordable Care Act, but this will fall on his back and he will pay the price for it.” In a subsequent tweet, Trump asserted, “Obamacare is a broken mess. Piece by piece we will now begin the process of giving America the great HealthCare it deserves.” The president’s action is likely to trigger a lawsuit from state attorneys general, who contend the subsidies to insurers are fully authorized by federal law, and say the president’s position is reckless. “We are prepared to sue,” said California Attorney General Xavier Becerra. “We’ve taken the Trump Administration to court before and won.”
Word of Trump’s plan came on a day when the president had also signed an executive order directing government agencies to design insurance plans that would offer lower premiums outside the requirements of President Barack Obama’s Affordable Care Act. Frustrated over setbacks in Congress, Trump is wielding his executive powers to bring the “repeal and replace” debate to a head. He appears to be following through on his vow to punish Democrats and insurers after the failure of GOP health care legislation. On Twitter, Trump has termed the payments to insurers a “bailout,” but it’s unclear if the president will get Democrats to negotiate by stopping payment. Experts have warned that cutting off the money would lead to a double-digit spike in premiums, on top of increases insurers already planned for next year. That would deliver another blow to markets around the country already fragile from insurers exiting and costs rising. Insurers, hospitals, doctors’ groups, state officials and the U.S. Chamber of Commerce have urged the administration to keep paying. Leading GOP lawmakers have also called for continuing the payments to insurers, at least temporarily, so constituents maintain access to health insurance. Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander, R-Tenn., is working on such legislation with Democratic Sen. Patty Murray of Washington. The so-called “cost-sharing” subsidies defray copays and deductibles for people with low-to-modest incomes, and can reduce a deductible of $3,500 to a few hundred dollars. Assistance is available to consumers buying individual policies; people with employer coverage are unaffected by the dispute. Nearly 3 in 5 HealthCare.gov customers qualify for help, an estimated 6 million people or more. The annual cost to the government is currently about $7 billion. But the subsidies have been under a legal cloud because of a dispute over whether the Obama health care law properly approved them. Adding to the confusion, other parts of the Affordable Care Act clearly direct the government to reimburse the carriers. For example, the ACA requires insurers to help low-income consumers with their copays and deductibles. And the law also specifies that the government shall reimburse insurers for the cost-sharing assistance that they provide. But there’s disagreement over whether the law properly provided a congressional “appropriation,” similar to an instruction to pay. The Constitution says the government shall not spend money unless Congress appropriates it. House Republicans trying to thwart the ACA sued the Obama administration in federal court in Washington, arguing that the law lacked specific language appropriating the cost-sharing subsidies. A district court judge agreed with House Republicans, and the case has been on hold before the U.S. appeals court in Washington. Up to this point the Trump administration continued making the monthly payments, as the Obama administration had done. While the legal issue seems arcane, the impact on consumers would be real. The Congressional Budget Office estimated that premiums for a standard “silver” plan will increase by about 20 percent without the subsidies. Insurers can recover the cost-sharing money by raising premiums, since those are also subsidized by the ACA, and there’s no legal question about their appropriation. Consumers who receive tax credits under the ACA to pay their premiums would be shielded from those premium increases. But millions of others buy individual health care policies without any financial assistance from the government and could face prohibitive increases. Taxpayers would end up spending more to subsidize premiums. © Copyright 2017 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.

Trump To Halt Health Insurer Subsidies In New Blow To Obamacare

WASHINGTON (AP) — In a brash move likely to roil insurance markets, President Donald Trump plans to halt payments to insurers under the Obama-era health care law he has been trying to unravel for months. RELATED ARTICLE: Trump Signs Executive Order To Begin Dismantling Obamacare Two people familiar with the decision described the plan late Thursday night, seeking anonymity because they were not authorized to speak publicly. The White House said in a statement that the government cannot legally continue to pay the so-called cost-sharing subsidies because they lack a formal authorization by Congress. However, the administration had been making the payments from month to month, even as Trump threated to cut them off to force Democrats to negotiate over health care. The president’s action is likely to trigger a lawsuit from state attorneys general, who contend the subsidies to insurers are fully authorized by federal law, and say the president’s position is reckless. Among the likely consequences: a spike in premiums for next year. The top two Democrats in Congress sharply denounced the Trump plan in a joint statement. “It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America,” said House and Senate Democratic leaders Nancy Pelosi of California and Chuck Schumer of New York. “Make no mistake about it, Trump will try to blame the Affordable Care Act, but this will fall on his back and he will pay the price for it.” Word of Trump’s plan came on a day when the president had also signed an executive order directing government agencies to design insurance plans that would offer lower premiums outside the requirements of President Barack Obama’s Affordable Care Act. Frustrated over setbacks in Congress, Trump is wielding his executive powers to bring the “repeal and replace” debate to a head. He appears to be following through on his vow to punish Democrats and insurers after the failure of GOP health care legislation. On Twitter, Trump has termed the payments to insurers a “bailout,” but it’s unclear if the president will get Democrats to negotiate by stopping payment. Experts have warned that cutting off the money would lead to a double-digit spike in premiums, on top of increases insurers already planned for next year. That would deliver another blow to markets around the country already fragile from insurers exiting and costs rising. Insurers, hospitals, doctors’ groups, state officials and the U.S. Chamber of Commerce have urged the administration to keep paying. Leading GOP lawmakers have also called for continuing the payments to insurers, at least temporarily, so constituents maintain access to health insurance. Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander, R-Tenn., is working on such legislation with Democratic Sen. Patty Murray of Washington. The so-called “cost-sharing” subsidies defray out-of-pocket expenses for people with low-to-modest incomes, and can reduce a deductible of $3,500 to a few hundred dollars. Assistance is available to consumers buying individual policies; people with employer coverage are unaffected by the dispute. Nearly 3 in 5 HealthCare.gov customers qualify for help, an estimated 6 million people or more. The annual cost to the government is currently about $7 billion. But the subsidies have been under a legal cloud because of a dispute over whether the Obama health care law properly approved the payments to insurers. Adding to the confusion, other parts of the Affordable Care Act clearly direct the government to reimburse the carriers. For example, the ACA requires insurers to help low-income consumers with their copays and deductibles. And the law also specifies that the government shall reimburse insurers for the cost-sharing assistance that they provide. But there’s disagreement over whether the law properly provided a congressional “appropriation,” similar to an instruction to pay. The Constitution says the government shall not spend money unless Congress appropriates it. House Republicans trying to thwart the ACA sued the Obama administration in federal court in Washington, arguing that the law lacked specific language appropriating the cost-sharing subsidies. A district court judge agreed with House Republicans, and the case has been on hold before the U.S. appeals court in Washington. Up to this point the Trump administration continued making the monthly payments, as the Obama administration had done. The round of payments would be due around Oct. 20. A panel of appellate judges recently ruled that a group of states can defend the legality of the subsidies if the Trump administration decides to stop paying. While the legal issue seems arcane, the impact on consumers would be real. The Congressional Budget Office estimated that premiums for a standard “silver” plan will increase by about 20 percent without the subsidies. Insurers can recover the cost-sharing money by raising premiums, since those are also subsidized by the ACA, and there’s no legal question about their appropriation. Consumers who receive tax credits under the ACA to pay their premiums would be shielded from those premium increases. But millions of others buy individual health care policies without any financial assistance from the government and could face prohibitive increases. It’s also estimated that taxpayers would end up spending more to subsidize premiums. Earlier Thursday, Trump had directed government agencies to design a legal framework for groups of employers to band together and offer health insurance plans across state lines, a longstanding goal for the president. © Copyright 2017 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed

Trump Cuts Off Billions Of Dollars In Cost-Sharing Payments To Insurers, Putting Obamacare Marketplaces At Risk

Only hours after signing an executive order that undermines several key aspects of the current health care law, President Trump has made good on his repeated threat to pull the plug on billions of dollars in subsidies provided by the federal government to insurers in the individual plan market. The Affordable Care Act provides for the federal government to make significant monthly payments to insurers who participate in the individual health insurance exchanges. These subsidies — which will total around $7 billion this year — are intended to keep out-of-pocket expenses, like co-pays and deductibles, low, particularly for Americans making between 100% and 250% of the federal poverty line. Trump has made no effort to hide his distaste for these payments, referring to them as a “bailout” for the insurance industry. Since the subsidies are not appropriated by Congress, the White House has repeatedly made the argument that it has the authority to stop the payments at any time. Hours after the President signed an executive order that the administration claims will increase the availability of affordable insurance — but which critics counter will only result in people buying insurance that covers less, and drives up costs for those who need coverage — the White House released a statement declaring an end to the subsidies. The administration claims in its statement that the Department of Justice and Department of Health and Human Services have concluded that these payments are not legal, as they were not appropriated by Congress. That claim has been the subject of an ongoing legal dispute, started by a lawsuit filed in 2014 by Republican members of the House of Representatives. “The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system,” reads the White House statement. “Congress needs to repeal and replace the disastrous Obamacare law and provide real relief to the American people.” While the statement gives no definite end date for the subsidies, the Washington Post reports that they may cease as of November. How Will This Affect Insurance Rates?
Even though rates are already locked in for the 2018 Obamacare open enrollment period that begins Nov. 1, the seeming inevitability of the end to the subsidies has already had an effect on the cost of insurance. Many insurance companies, sensing that the Trump administration might cut off the subsidies at some point in the coming year, significantly raised their base premiums for policies to be sold on the individual market for 2018. These premium hikes, said some insurers, were intended as a buffer in case the payments did cease. Without these subsidies, some insurers will certainly abandon the individual marketplace going forward, putting the structure put in place by the Affordable Care Act in serious jeopardy and possibly leaving millions of additional Americans with only one — or possibly no — insurance company to choose from in their region. Tonight’s decision will most certainly face a legal challenge from those states who have already intervened to protect the subsidies in court after the administration abandoned their defense. New York state Attorney General Eric Schneiderman, who had previously stated that he would do “whatever we have to” to defend the payments, said on Thursday night that he intends to file a lawsuit against the administration to protect the subsidies. “I will not allow President Trump to once again use New York families as political pawns in his dangerous, partisan campaign to eviscerate the Affordable Care Act at any cost,” said Schneiderman. The other option would be for Congress to do what it didn’t do when the Affordable Care Act was passed nearly a decade ago, and use the appropriations process to provide these funds to insurers. Given the hardline conservative opposition to the payments, it would require Republicans and Democrats to work together to garner sufficient support for such appropriations.