Worry follows Trump order
State insurance markets brace for fallout after move ends some Obamacare subsidies
TALLAHASSEE — President Donald Trump’s order Friday ending some subsidies for Obamacare health plans could destabilize an already jittery health insurance market in Florida, according to navigators helping consumers sign up for coverage.
“It’s going to be devastating to the people that we work with,” said Anne Packham, marketing project director for Primary Care Access Network, a Central Florida-based group.
The executive order removes $7 billion in subsidies, known as cost-sharing reductions, paid to health insurers offering plans on Affordable Care Act exchanges. The subsidies help consumers pay out-of-pocket expenses for care.
About 1.7 million Floridians receive coverage through the exchanges. Many of them receive subsidies that lower their monthly premiums, but those are unaffected by Trump’s order.
Still, Democrats and healthcare-access advocates are warning the change could lead to higher deductibles, pricing many
people out of the marketplace. Most worrying is the prospect of younger, healthier consumers leaving the exchanges, leading to a smaller, older, sicker and more expensive risk pool.
“The threat of the healthy and the young population pulling out from the Affordable Care Act health plans would cause the pool to shift,” said Islara Souto, statewide navigation project manager for the Epilepsy Foundation of Florida.
Packham talked about an uninsured woman with a moderate income with heart problems who would likely wait for a serious diagnosis before signing up for coverage.
“Those are the kinds of decisions that people are going back and forth with, and it’s going to be harder for us to convince people that this is in their best interest if they see that deductible [increase],” Packham said.
Trump had hinted earlier that he could remove the subsidies. Audrey Brown, Florida Association of Health Plans president and CEO, noted insurers filed contingency rate increases — some as high as 71 percent — with regulators in case the subsidies were eliminated.
“We are monitoring further actions from Washington and will proceed accordingly, but, because this contingency was in place for Florida, there are approved rates for 2018 that do not include this funding,” Brown said in an email.
But Brown didn’t answer a question about whether insurers might withdraw from the exchange market in some areas because of the order.
A spokeswoman for the Florida Office of Insurance Regulation said the agency was still reviewing the order and could not comment.
U.S. Sen. Bill Nelson, DOrlando, slammed Trump’s actions as a deliberate attempt to undermine Obamacare.
“In just two moves this week, President Trump continued his sabotage of the nation’s health care law by allowing for health care without the necessary protections for people with pre-existing conditions and in his latest move, ending payments that help people afford their health coverage,” Nelson stated.
Some Republicans praised Trump, saying his order corrected former President Barack Obama’s decision to issue the payments, which was not approved by Congress and subject to ongoing legal challenges. The White House statement announcing the order pointed to a Department of Justice legal opinion asserting that further payments would be unlawful.
“Obamacare has proven itself to be a fatally flawed law, and the House will continue to work with the Trump administration to provide the American people a better system,” said House Speaker Paul Ryan, R-Wisc., according to The Hill newspaper.
Navigators say they’re still gearing up to help consumers sign up for coverage when the 2018 enrollment period begins Nov. 1. The enrollment period is scheduled to end after Dec. 15, but areas affected by Hurricane Irma, which includes most of the state, have until Dec. 31.
But they’ll also be working with smaller budgets than last year, after the Trump administration cut their budget from $62.5 million last year to $36.8 million this year. The advertising budget was slashed from $100 million to $10 million. Trump also cut the sign-up period by six weeks.
Trump’s order eliminating the subsidies comes on the heels of another executive order on Thursday allowing association health plans to be sold across state lines and removing some of the protections against charging higher rates for pre-existing conditions installed by Obamacare.