GOP Rep Urges Trump to End Lawmakers' Healthcare Subsidies

Bruno Cirelli
Agosto 4, 2017

In that case, the premium increases for individual coverage would rise by an average of 20.3 percent, according to the insurers.

"Trump thinks he's holding all the cards".

Case Western Reserve University law professor Jonathan Adler said he isn't convinced that the administration can halt the payments "unless and until the case goes away". Rob Portman, said. Portman, an Ohio Republican, "will continue working with colleagues on both sides of the aisle to help Ohio families who are suffering under the failed status quo", Benavides said in an email. Ruling in their favor in May 2016, U.S. District Judge Rosemary Collyer in Washington barred the government from paying the subsidies without an appropriation but put her decision on hold for an anticipated Obama administration appeal.

Amid all the uncertainty, insurers are running out of time to plan for next year. For example, BlueCross BlueShield of Arizona this week announced a 7.2 percent average hike for 2018. The company hasn't said how high the increase could be without the subsidy. The average proposed increase was 8.8 percent for individual plans and 6.6 percent for small group plans. The subsidies help keep premiums in check, but they are under a legal cloud because of a dispute over the wording of the ACA. In one case, Health Care Service Corp., a major regional insurer, is seeking increases of 8.3 percent in Oklahoma, 23.6 percent in Texas, and 16 percent in IL.

Insurance companies have spent months now begging the administration to commit to making these payments through the end of next year.

Even though Congress has been unable to agree on a plan to repeal or replace the health care law, Trump himself has said he wants it to fail.

Trump mentioned the subsidies in a tweet over the weekend, saying he would end "bailouts" for insurance companies and lawmakers on Capitol Hill if efforts to repeal and replace Obamacare continue to founder.

The court's decision is "a check on the ability of the president to sabotage the Affordable Care Act in one very important way", said Tim Jost, professor emeritus at Washington and Lee University School of Law in Virginia, a supporter of the ACA who has followed the issue closely.

Without the payments, insurers have said that they may drop out of the Affordable Care Act's exchanges or substantially raise premiums.

Steep rate increases would only mean more pain for those who've had to pay rapidly rising premiums under Obamacare because younger, healthier people have not offset the cost of coverage to sicker and older individuals in need of medical care. Almost 3 in 5 HealthCare.gov customers qualify for the assistance, which can reduce a deductible of $3,500 to several hundred dollars. Abandoned United Healthcare subscribers can still buy coverage from Blue Shield, but their annual premium cost is expected to leap by 24 percent. Most of the insurance executives I've spoken to in the past few weeks are planning to assume the CSR payments are not coming unless they see some big change on behalf of the White House. It is the state governments that actually operate the insurance exchanges, even though they were set up under federal law, in the ACA. Levitt notes that Congress could end the ambiguity over the payments by appropriating the money for them.

A district court judge past year ruled in favor of the House, finding the subsidies were illegal and must stop. "But if you're house is on fire, you want to put out the fire". A group of state attorneys general asked the court earlier this year to let them join the case in defense of the subsidies, and on Tuesday the court agreed. The states coalition says it is preparing for that possibility and is ready to take the White House to court if necessary.

The state attorneys general - or, for that matter, anyone else who claims they would be hurt if the subsidy payments stopped - could file a new lawsuit challenging Trump's actions in federal court.

The payments are at the center of a court battle between the House and the Trump administration, which inherited it from the Obama administration.

The threat of such increases now looms. If healthy Americans are allowed to flee the Obamacare marketplace, insurers will still have to cover older consumers and those with pre-existing conditions, which is likely to result in exorbitant premium increases.

The insurance industry lobbied the Democrat-controlled Congress in 2010 to design Obamacare to be more expensive than traditional private insurance by dramatically expanding services covered in the health benefit packages.

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