First came word that Trump had scrapped his original tax plan and would be starting again from square one, meaning there's little hope the administration will hit the August deadline that Treasury Secretary Steve Mnuchin set for himself. But the insurance industry quickly said the changes don't go far enough.
While members were unable to reach a consensus before they for their two-week left for Easter recess, members say they are inching closer to striking a deal, with many noting the deficit reduction from repealing Obamacare would make accomplishing tax reform easier for the legislative body. When it comes to many Republican policymakers and health care, though, that depth might be closer to a centimeter. So the administration is trying to keep the existing system going temporarily as it pursues a total remake.
The Trump administration last week took what insurers call meek steps to try and stop insurers from leaving the Affordable Care Act exchanges and the off-exchange market en masse.
Image source: Obama White House, Flickr. Under the ACA, insurers are required to reduce deductibles, copayments and other forms of cost-sharing for the lowest-income enrollees. They're separate from the better-known premium subsidies that most customers receive, the wire service said.
"There is still too much instability and uncertainty in this market", Marilyn Tavenner, president of America's Health Insurance Plans, said in a written statement after the HHS market stabilization rule was released. The payments are expected to cost $7 billion this year.
No. Mr. Trump should be working to preserve the Affordable Care Act, which is delivering health insurance to millions of Americans. But the president also said he hasn't made up his mind, and that he doesn't want people to get hurt.
"What I think should happen - and will happen - is the Democrats will start calling me and negotiating", he said. In response, Democrats are planning to tie that money to the government funding bill that needs to pass at the end of the month.
But the biggest concern-long-term continuation of cost-sharing subsidies-was mentioned only in passing in the rule.
House Minority Leader Nancy Pelosi, Democrat of California, responded predictably to the threat to cut off the payments to insurers, saying, "Refusing to make the Cost Sharing Reduction payments has no goal but to hurt millions of people, and manufacture a crisis".
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Customers will have 45 days to shop for 2018 coverage, starting November 1 and ending December 15. They shorten the enrollment period to a month and a half, from three months, and require people to prove that they're eligible for special enrollment periods. Insurers say loose enforcement of these periods has been an expensive problem because it also allows people to game the system.
-Allowing an insurer to collect past debt for unpaid premiums from the prior 12 months before applying a consumer's payments to a new policy.
Whether these changes help convince insurers to stick around for 2018 remains to be seen.
Consumers probably won't know for certain what insurance choices they will have until late summer or early fall, according to the AP.
A million dollars for a weekend trip to Florida is actually chump change for the Pentagon, with its annual budget of $600 billion, but Gallego says that isn't really the point.
Most communities will have competing insurers on their public marketplaces next year, but a growing number will be down to one, and some areas may face having none. Wellmark Blue Cross and Blue Shield announced April 3 it is pulling out of the Iowa exchanges, saying a lack of clarity "makes it hard to establish plans for 2018". CEO Joseph Swedish has said his company would not commit to participating next year. That we need bigger subsidies so people can buy better coverage that doesn't make them pay as much out-of-pocket.
But abandoning the goal altogether is not just politically questionable, it also would threaten the success of all future endeavors for a very straightforward reason: In order to pass tax reform via the reconciliation process, Congress can not make changes that run up the deficit.
The health law uses a complex formula to divide plans into metallic tiers - bronze, silver, gold and platinum - based on an average percentage of a typical year's health care bills that each level of plan covers. "Additionally, today's final rule from HHS is noticeably silent on the issue of cost-sharing subsidies, which is the single most important action for market stability".
A federal district judge in a lawsuit brought by House Republicans found the federal payments for the cost-sharing reductions unconstitutional.