Trump considers provocative new hostage strategy on health care

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. Meanwhile, it's been reported that conservative House members and the Trump administration are discussing new ways to repeal and replace the law. So the only real change that's been made so far is that the IRS has said that they wouldn't send your return back if you didn't check that box saying whether or not you had health insurance. She expects her health-care costs will be about half of what she paid for herself alone a year ago, in part due to cost-sharing reductions. Trump also says that, "the president can not have a conflict of interest" a statement which simply is not true.

That means Obamacare, in one way or another will survive, perhaps with a different name but too many parts of the law are so popular that repealing and replacing the Affordable Care Act is a losing proposition. Ceci Connolly, president of the Alliance of Community Health Plans, said that if the funds were to go away, the nonprofit insurers that her group represents have said they would either have to make a hard decision about staying in the market at all, or hike premiums anywhere from 7 to 21 percent.

But the White House remained mum on the biggest concern.

"It's a snapshot cost, in the sense that there are other costs obviously involved that we could get, but the government just doesn't want to give it to us or they keep secret for some reason", Fitton says.

The other insurer on the Affordable Care Act exchange in Missouri, Cigna, did not respond to a request for comment.

Tavenner said, "There is still too much instability and uncertainty in this market".

Insurers, doctors, hospitals and the business community have asked the Trump administration to preserve "cost-sharing" subsidies that help reduce the impact of high deductibles and copayments for consumers with modest incomes. On Wednesday, Trump told the Wall Street Journal that he may withhold Obamacare payments to insurers that amount to about $7 billion a year to force Democrats back to the negotiating table.

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".

"The bottom line is that while the final rule addresses some of the challenges in the market, I think the reaction will be that it doesn't go far enough", said Cara Kelly, a vice president at the consulting firm Avalere Health. In response, Democrats are planning to tie that money to the government funding bill that needs to pass at the end of the month.

The Trump administration has indicated that the payments will continue as long as the case is being litigated, but insurers want more of an assurance that these subsidies will be available next year.

House Minority Leader Nancy Pelosi of Calif. speaks with reporters on Capitol Hill in Washington, Thursday, April 6, 2017.

The administration also placed curbs on "special enrollment periods" that allow consumers to sign up or change coverage outside the normal enrollment period if they have a big change in their life like a move, divorce or the birth of a child. If the mandate isn't enforced, sicker people will still participate in the insurance market because they need care, but younger, healthier people will be even more likely to stay out of the market.

-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.

Allowing insurers the flexibility to offer health plans with fewer options. This year alone, premiums for ACA plans rose by an average of 25 percent. "But the tax reform and the tax cuts are better if I can do healthcare first". Several major insurers, including Humana Inc and Aetna Inc, have announced plans to exit some state exchanges in 2018. CEO Joseph Swedish has said his company would not commit to participating next year.

Any bill that isn't scored by the Congressional Budget Office and isn't projected to genuinely improve health outcomes and the financial burden of costs associated with health care - while maintaining (or improving) current coverage levels - is not worth the political points the passing of legislation may earn those who vote for it.



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