Officials reaffirm goal of repealing Obama-era law.
The Trump administration released limited fixes Thursday for shaky health insurance markets, even as it reaffirmed its goal of dismantling the Obamaera law that created them and now covers millions.
Republicans contend that the Affordable Care Act, or ACA, is beyond repair, but their “repeal and replace” slogan hasn’t been easy to put into practice, or politically popular. So the administration is taking steps to keep the existing system going even as it pursues its ambition of a total remake.
Many of the changes announced Thursday follow recommendations from insurers, who wanted the government to address shortcomings with HealthCare.gov markets, including complaints that some people are gaming the system by signing up only when they get sick, and then dropping out after being treated.
But the White House remained mum on the biggest concern. Insurers, doctors, hospitals and the business community have asked President Donald Trump to preserve ACA “cost-sharing” subsidies that pare down high deductibles and copayments for consumers with modest incomes. They’re separate from the better-known premium subsidies that most customers receive.
Estimated at $7 billion this year, the cost-sharing subsidies are under a legal cloud. Without them, experts say the government marketplaces that provide subsidized private insurance for about 12 million people will be overwhelmed by premium increases and insurer departures.
In a Wall Street Journal interview this week, Trump raised the possibility of shutting off the money if Democrats won’t bargain on health care. But the president also said he hasn’t made up his mind yet, and doesn’t want people to get hurt. House Democratic Leader Nancy Pelosi of California called that an “appalling threat,” and said Trump is trying to “manufacture a crisis.” The new administration has continued to make cost-sharing payments to insurers as it weighs options.
The changes announced Thursday include:
A shortened sign-up window of 45 days, starting with coverage for 2018. That’s about half as long as the current open enrollment season. Some insurers say a tighter sign-up schedule will allow for more focused marketing. Consumer advocates are worried uninsured people may be left out.
Curbs on “special enrollment periods” that allow consumers to sign up outside the normal open enrollment window. Insurers say these have been too easily granted, allowing some people to sign up only when they need costly treatment.
Allowing an insurer to collect past debt for unpaid premiums from the prior 12 months before applying a consumer’s payments to a new policy.
Giving insurers more flexibility to design low-premium plans that can be tailored to young adults. Administration releases some health care fixes