Trump to end key ACA subsidies, a move that will threaten the law’s marketplaces

WaPo ^ | 10-12-2017 | Amy Goldstein

[NRx]

President Trump is throwing a bomb into the insurance marketplaces created under the Affordable Care Act, choosing to end critical payments to health insurers that help millions of lower-income Americans afford coverage. The decision follows an executive order on Thursday to allow alternative health plans that skirt the law’s requirements.

The White House confirmed late Thursday that it would halt federal payments for cost-sharing reductions, although a statement did not specify when. According to two people briefed on the decision, the cutoff will be as of November. The subsidies total about $7 billion this year.

Trump has threatened for months to stop the payments, which help eligible consumers afford their deductibles and other out-of-pocket expenses, but held off while other administration officials warned him that such a move would cause an implosion of the ACA marketplaces that could be blamed on Republicans.

Health insurers and state regulators have been in a state of high anxiety over the prospect of the marketplaces cratering because of such White House action. The fifth year’s open-enrollment season for consumers to buy coverage through ACA exchanges will open in less than three weeks, and insurers have said that stopping the cost-sharing payments would be the single greatest step the Trump administration could take to harm the marketplaces — and the law.

Ending the payments is grounds for any insurer to back out of its federal contract to sell health plans for 2018.

[steve86]

That is just MediCal. Nothing like that “share of cost” in most other states. Surprisingly, California actually demands a bit of responsibility from its Medicaid clients.

[steve86]

A sliding scale based on income is exactly the way Medicaid MediCal works.

[CottonBall]

The RINOs had many chances to repeal this thing. They refused and so Trump is dismantling it piece by piece. It’s all he can do. End it takes mega-guts to do it.

[sheana]

I didn’t know that. I know each state has their own rules but they still work off federal guidelines.

[CottonBall]

Brilliant. Lots of bulk discounts there

[i_robot73]

>
Sounds like the payments are unconstitutional. If they are not a part of the law but are part of executive action, then they did not originate with Congress. But maybe I am missing something. If Congress did not include the subsidies in Obamacare, then President Trump stopping the payments is not his fault but the fault of Congress for not being honest when passing the albatross.
>

COURSE the payments are unconstitutional; course the argument on ‘origination’ is 20 steps PAST root of illegality anyway (no Const authority, welfare violating 5th/13th, etc.)

IIRC, the (R) ‘sued’ on the same (again, using step 20+) and left it as “Well, we TRIED to do *something*....”

[Steve Van Doorn]

That required the Federal government to act in May 2016. It took this long to sign this?
How can they do that?

[Bigg Red]

SNOWY!

[moehoward]

How does this jive with that.

http://www.foxnews.com/us/2017/08/02/dem-states-can-defend-obamacare-subsidies-court-rules.html

[catnipman]

“That required the Federal government to act in May 2016. It took this long to sign this? How can they do that?”

personally, i suspect that trump gave the GOP in Congress a certain deadline to repeal and replace obamacare and that if they didn’t act, then he’d start doing it himself.

[kabar]

The case was on appeal by the federal government. The judge allowed the subsidies to continue upon results of the appeal. Trump dropped the appeal and accepted the lower court’s ruling.

[Steve Van Doorn]

I agree. But it’s almost two years since the court order. When Trump had a court order the court stopped that action that day of the court order.

[moehoward]

This was just in August. It reads like it’s a different court with the dem state AGs appealing, not the White House. I’m missing something.

[kabar]

The AGs were anticipating a possible cutting of subsidies by Trump. The federal court ruling in August 2016 said the payments were illegal but allowed continued payment of the subsidies pending appeal by the Obama administration.

Trump had indicated earlier that he might stop the subsidies citing the court's ruling. He has now come out and ended the appeal that was begun under the Obama administration and ended the subsidies. No doubt the state AGs will take it to court.

Federal Court Rules That Obamacare Subsidies Were Illegally Funded

[moehoward]

Right, I read that. But after a quick search I found another article in the WAPO from Aug of 2017. The link to Fox is their version of that same story.

[kabar]

Different story. The AGs are just ensuring that they have standing to file a case against the federal government if the subsidies are terminated. The suits will follow the Trump announcement.

[moehoward]

Got it.

[blueyon]

“””Virginia’s eastern shore.”””

Where can I sign up or should I say lets start one......one for all us ESVA folks

[Persevero]

(God is infinite. The 7.2 billion is not an issue with Him. The very hairs on all those heads are numbered, and He knows if a sparrow falls to the ground. )

[Paul R.]

Well, 1st I’d have to make it to 65 w/o something serious going wrong. I’ll give that a 70% chance (of being ok).

Then once on Medicare I have to hope that either I don’t exhaust it or that supplemental insurance hasn’t gone through the roof, or that I don’t need extended care. (I have considerable background on this with my Dad - he was MUCH better off, financially, than I am, and the $$ went really quickly.) I’ll give that a 70% chance too (of being ok until age 70.)

Then there is care for my wife (several years younger than I, w/ family history that is a bit scary) and daughter. Many factor to consider, but given the time frame I stated, a 50% chance (of a positive outcome) is reasonable. Combine all percentages. Odds are...