Ending 'bailouts' for insurers could cost millions their health coverage


A freshman GOP congressman said Tuesday he would like to President Donald Trump follow through on his threat to end healthcare subsidies for lawmakers.

Under the ACA, premium subsidies are calculated using the difference between the cost of coverage (which is based on the second lowest-cost silver plan available in a market) and affordability (which is based on a percentage of an individual's income).

The CSR payments are crucial for insurers, compensating them for covering some out-of-pocket costs for certain low-income consumers. The Trump administration has been doling out the payments on a month-to-month basis and threatening to end them altogether, which is spooking insurers into raising rates.

The states' entry into the legal battle complicates the president's cut-off gambit, two legal scholars said in separate interviews, although they reached different conclusions about what could be done to combat such a move.

The realities of politics and human behavior being what they are, it is time for US senators - and President Donald Trump - to take a break from attempts to reform health insurance.

US health insurer Anthem Inc is pulling back from 16 of 19 pricing regions in California where it offered Obamacare options this year in part due to uncertainty over the payments, state officials said on Tuesday.

"The President is working with his staff and his cabinet to consider the issues raised by the CSR payments", a White House statement said. Paid directly to insurers, the subsidies are expected to cost the federal government about $7 billion in 2017.

Anthem, which has already announced it will withdraw from three of its 14 states next year, said last week that it needs more predictability, particularly on the subsidies. They are required to do so by a provision in the health law itself.

SHAPIRO: So basically, if the federal government isn't paying this, then insurance companies are going to have to pay it. And that will lead the Treasury to spend more on subsidies to policyholders who qualify, according to an analysis by the consulting firm Oliver Wyman. A bronze plan covers about 60 percent of a customer's health care costs, with relatively low monthly premiums, while a platinum plan will cost more each month but pay 90 percent of total health costs. If the ACA were repealed, lawmakers could return to their previous, highly generous health insurance program - with comparable subsidies - under the Federal Employee Health Benefits system. We form, structure, regulate, and enforce markets through policy and institutions which reflect private and public interests. Obamacare depends on these people to buy overpriced plans that they don't need in order to subsidize older and sicker people.

One of them shrank today with news from OH, where insurance regulators announced they had found plans to cover 19 of the 20 counties that had zero insurers signed up to sell 2018 Obamacare coverage.

That means subsidies will have to rise for many people to meet those higher premiums.

The other thing that comes up that, you know, insurance companies really want is some kind of fund to offset their really expensive patient so that when they get someone with a million dollars in medical bills, that they have some kind of backup fund from the federal government. As part of their sabotage campaign against Obamacare, Republicans in Congress filed suit in 2014 to end the payments, resting their case on a legal fine point that the legislation promised the payments but did not technically appropriate them.

"I'm for helping the poor; always have been", Hatch said. U.S. District Judge Rosemary Collyer ruled this scheme unconstitutional previous year but the Obama administration filed an appeal. The expectation had been that the case would be dismissed because the Republican-controlled Congress was poised to repeal the Obamacare law. While Trump is fixated on pushing the repeal-and-replace rock up the hill again and again, we are encouraged by an emerging effort in Congress to find bi-partisan solutions to shore up the existing system - and, not incidentally, prevent the Trump administration from making its predictions about the Obamacare death spiral a self-fulfilling prophecy.



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