The Trump administration “blinks”; provides Obamacare funding

.“The Trump administration will make this month’s Obamacare payments to insurers, a White House spokesman confirmed today, despite the president’s repeated threats to cut off the subsidies and potentially tip the insurance markets into turmoil.
It’s widely anticipated that insurers would jack up premiums or exit the Obamacare markets altogether if the subsidies, worth about $7 billion this year, are eliminated. Insurance premiums for the most popular Obamacare plans would likely rise by 20 percent next year if the payments are stopped, according to a Tuesday CBO analysis…
At issue are subsidies that insurers rely on to reduce out-of-pocket costs for low-income Obamacare customers. Insurers would still be on the hook to provide the discounted rates even if the federal payments stop.” (A)

If payments were not made…
“CBO -If President Trump decides to cut off payments to insurance companies called for under the Affordable Care Act…. it’s going to cost taxpayers — about $194 billion over 10 years.
An analysis by the Congressional Budget Office released Tuesday found that ending cost-sharing reduction payments to insurers, a move that President Trump is contemplating, would raise the deficit by $194 billion over 10 years.
If President Trump decides to cut off payments to insurance companies called for under the Affordable Care Act, it’s going to cost him.
Or, more accurately, it’s going to cost taxpayers — about $194 billion over 10 years….
The deficit figure comes from the Congressional Budget Office, which on Tuesday released an estimate of the budget impact of ending what is known as cost-sharing reduction payments. Those are payments the federal government makes to insurance companies to reimburse them for the discounts on copays and deductibles that they’re required by law to give to low-income customers. (B)

“The public had also changed its tune. Although Medicaid had started as a program of welfare medicine, over time it had expanded well into the middle class. A 2011 poll found that 85 percent of respondents opposed cuts to Medicaid. Medicaid had become as popular as social security and Medicare.”
That shift in public opinion left Republicans without a coherent message for rallying support to repeal. Robbed of their big government bluff, Republicans could only lambast Obamacare for reasons the public no longer believed. Meanwhile, Democrats drew upon an alternative message, defining Republicans’ health care plans as divisive and un-American. When House Speaker Paul Ryan praised the House bill as “an act of mercy,” Rep. Joe Kennedy (D-Mass.) fired back: “With all due respect to our speaker, he and I must have read different Scripture. The one that I read calls on us to feed the hungry, to clothe the naked, to shelter the homeless and to comfort the sick. It reminds us that we are judged not by how we treat the powerful, but by how we care for the least among us.” “ (C)

Here are five decisions looming for the GOP. Should there be one more effort at ObamaCare repeal? Should we work with Democrats? Should we back legislation to make key payments to insurers? What’s to be done with CHIP? What’s to be done with ‘bare’ counties? (D)

“Around 4 in 5 want the Trump administration to take actions that help Obama’s law function properly, rather than trying to undermine it. Trump has suggested steps like halting subsidies to insurers who reduce out-of-pockets health costs for millions of consumers. His administration has discussed other moves like curbing outreach programs that persuade people to buy coverage and not enforcing the tax penalty the statute imposes on those who remain uninsured.
Just 3 in 10 want Trump and Republicans to continue their drive to repeal and replace the statute. Most prefer that they instead move to shore up the law’s marketplaces, which are seeing rising premiums and in some areas few insurers willing to sell policies. “(E)

“This much becomes clear looking at the latest polling data from the Kaiser Family Foundation, which finds that 60 percent of Americans think it’s a “good thing” that the Senate health care bill failed — and 78 percent expect the Trump administration to “do what they can” to make the law work better.
Right now, President Trump is not doing what he can to make Obamacare work. His administration remains cagey about whether it will continue to pay key subsidies. It has not let the thousands of insurance enrollment workers across the country know what type of outreach campaigns it will run, if any. Many insurance plans are nervous that the Trump administration won’t enforce the mandate to purchase coverage, and they are jacking up their premiums as a result.
Trump seems to have had, for months now, a theory about how Obamacare’s failure could play to his advantage. If the marketplaces blew up, he seemed to expect that voters would blame former President Barack Obama for a poorly drafted law — and that Congress would rush to fix these problems with a repeal-and-replace package.” (F)

Interestingly, a bipartisan group of governors has already issued their recommendations.
“Congress should be working to make health care more affordable while stabilizing the health insurance market, but this bill and similar proposals won’t accomplish these goals,” said one statement issued by 13 governors – seven Democrats and six Republicans. “The bill still threatens coverage for millions of hardworking, middle-class Americans.”
The governors then go on to get into the policy weeds on reinsurance, waivers and drug formularies, among others. Their overriding concerns, however, are to retain control over the health insurance markets within each of their states while shoring up and expanding the private insurance market through federal dollars.
So how can America achieve universal coverage regardless of pre-existing conditions — which is what most polls show most Americans want – but at an affordable price? The group of bipartisan governors is not quite ready for a single, national insurance system. But they are willing to consider benchmark standards similar to Obamacare, then have the federal government step in with bigger subsidies for the sickest patients with the highest claims. Under the ACA, those patients cannot be charged higher premiums because of their pre-existing health conditions. Insurers say they cannot sustain those losses without charging higher premiums to those patients or getting financial help.” (G)

(A) Trump administration will make this month’s Obamacare payments but leaves program’s future in limbo, by PAUL DEMKO, http://www.politico.com/story/2017/08/16/trump-obamacare-subsidy-payments-241712
(B) CBO Predicts Rise In Deficit If Trump Cuts Payments To Insurance Companies, by Alison Kodjak, http://www.npr.org/sections/health-shots/2017/08/15/543714171/cbo-predicts-rise-in-deficit-if-trump-cuts-payments-to-insurance-companies
(C) GOP DOOMED ITS OWN HEALTH CARE PROPOSALS WITH ‘POLITICS OF DESTRUCTION’, by JILL QUADAGNO, http://www.newsweek.com/gop-doomed-health-care-proposals-politics-destruction-650700
(D) Five tough decisions for the GOP on healthcare, by RACHEL ROUBEIN AND NATHANIEL WEIXEL, http://thehill.com/policy/healthcare/345385-five-tough-decisions-for-the-gop-on-healthcare
(E) Around 4 in 5 Americans Want the Effort to Repeal Obamacare to End, Poll Finds, Alan Fram, http://time.com/4896747/obamacare-repeal-poll-trump-gop-aca/
(F) Most Trump voters don’t want Trump to sabotage Obamacare, Updated by Sarah Kliff, http://time.com/4896747/obamacare-repeal-poll-trump-gop-aca/
(G) Our View: Let governors have a crack at Obamacare, http://azdailysun.com/news/local/our-view-let-governors-have-a-crack-at-obamacare/article_1f2dc4ca-dbb7-5f41-92e9-a30dde58f55a.html

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