Published: Thu, April 20, 2017
Health | By Jay Jacobs

Trump to Democrats: Negotiate on Obamacare, or Else

Trump to Democrats: Negotiate on Obamacare, or Else

More desperate than clever, Trump's talk of annihilating Obamacare, for which he would be justly blamed, is unlikely to coerce Democrats into supporting anything like the House Republican repeal-and-replace plan he backed, which failed to attract enough GOP support to pass the House.

Three weeks after Republican infighting killed an initial effort at repealing the Affordable Care Act, Trump is poised to use a maneuver that could effectively undermine the sustainability of Obamacare and expedite its collapse. So the administration is trying to keep the existing system going temporarily as it pursues a total remake. Without them, insurers would have to hike individual market premiums by some 19 percent, likely leading to the market meltdown that Republicans have warned against. That lower-cost coverage could come with a higher deductible, though, which means those customers will need to pay more out of their own pockets for most care before the insurer starts paying. They are different from the premium tax credits most low-income patrons receive to decrease premiums. Is this complicated gambit on health care really more important to Trump than defunding Planned Parenthood or getting money for a border wall?

"The president's comments on stopping the Cost Sharing Reduction payments will increase costs, is a threat to the good health of the American people and a threat to keeping government open", an aide to House Democratic leader Nancy Pelosi told The Hill. Insurers and medical groups penned a letter to Mr Trump urging him to remain funding the subsidies, which amount to around $7 billion a year and are paid directly to insurers. But without them, experts say the government marketplaces that provide subsidized private insurance could face turmoil.

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".

"Refusing to make the Cost Sharing Reduction payments has no goal but to hurt millions of people, and manufacture a crisis", House Minority Leader Nancy Pelosi, D-Calif., said in a statement. The new administration has continued to make cost-sharing payments to insurers as it weighs options.

Shortening the sign-up period for 2018 by half, lasting from November 1 to December 15.

An open-enrollment window that is roughly half as long as the current window of 90 days.

The new regulation cuts the length of the next Obamacare annual enrollment period in half and makes it more hard to obtain a special enrollment period. Insurers say loose enforcement of these periods has been an expensive problem because it also allows people to game the system.

Allowing insurers to require people to pay past-due premiums before enrolling in a new plan with the same insurer the following year. Without that certainty, insurers facing deadlines may decide not to sell plans on the marketplaces set up by the Affordable Care Act - or be forced to raise their premiums significantly.

Analyst Larry Levitt of the nonpartisan Kaiser Family Foundation said the new rules will be "meaningless" in encouraging insurance companies to stay in the market if the government ends cost-sharing subsidy payments. Major insurance companies panicked and major participants like Humana Inc. and Aetna, have left or announced their intention to leave the Obamacare exchanges, citing multi-million-dollar losses and patient populations that are far costlier and sicker than they expected.

Consumers probably won't know for certain what insurance choices they will have until late summer or early fall, according to the AP.

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