Trump gets health care reform started

Spurred by Congress’ inability to pass health care reform, President Trump took action this past week seeking to free millions of Americans from some of the more onerous constraints of Obamacare.

President Donald Trump jumpstarted health care reform. Congress must now step up and write a new law.

The White House began executive actions on Thursday to undo rules and workarounds employed by the Obama administration to mask the costs of the Affordable Care Act.

The previous administration deliberately removed lower-cost options for health insurance, and it found a stealthy method of subsidizing insurance companies with public funds not authorized by Congress for that purpose.

President Trump has now decided to end the annual expenditure of $7 billion paid to insurers that offered the midlevel silver plans in the health insurance exchanges.

The money reimbursed the companies for the cost of discounting deductibles and copayments to low-income policy holders. These subsidies are known as cost-sharing reduction payments.

In 2013, the Obama White House deleted this item from its 2014 budget request and instead quietly sent insurance companies funds appropriated by Congress for another purpose.

Questions and document requests from congressional committees about the mystery payments were ignored.

Finally, the House of Representatives filed a lawsuit against the president, and won. In May, 2016, a federal court ruled the payments illegal, but the judge permitted them to continue while the White House appealed the decision.

That gave President Trump the option of ending both the appeal and the payments at his discretion.

Meanwhile, the uncertainty about the continuation of the payments caused some insurers to sharply increase premiums and others to pull out of the exchanges completely.

Lawmakers have always had the option of directly appropriating funds for the insurance company subsidies, estimated by the Congressional Budget Office to cost $7 billion this year and $10 billion for 2018.

To this point, Republicans haven’t wanted to do that, and Democrats haven’t had the leverage to force them.

In a separate action, President Trump signed an executive order aimed at making lower-cost health insurance policies available to those who want to buy them.

The Obama administration had intentionally constrained these options out of fear that healthy people would choose the less expensive policies, leaving the exchanges deprived of their much-needed premium dollars.

Trump directed the Labor, Treasury and Health and Human Services Departments to write new rules that expand the availability and duration of short-term plans, barebones coverage that’s sometimes a good option for people who are between jobs, leaving college or retiring early.

The Obama administration had limited these plans to three months and made them non-renewable.

The president also directed his Labor secretary to consider rules that would expand access to association health plans, which allow small businesses, even in different states, to band together and buy a policy as if they were one large employer.

A third directive seeks an expansion of “health reimbursement arrangements,” to allow employers to fund accounts that employees can use to buy insurance as well as pay medical bills.

The rule-making process will take months, and the president’s actions could face legal challenges.

Nonetheless, Trump has opened the door to an honest discussion of the costs of the Affordable Care Act, both in tax dollars and in high premiums.

Congress must now step up and work in a bipartisan manner to write a new law. It must protect Americans with preexisting conditions as its first priority, and it must be transparent with the public about what it’s going to cost. — Orange County Register,

Digital First Media