Pro-Trump states affected by order
to make up for the lost federal funding, health insurers will have to raise premiums substantially, potentially putting coverage out of reach for many consumers.
Some insurers may decide to bail out of markets altogether.
“I woke up, really, in horror,” said Alice Thompson, 62, an environmental consultant from the Milwaukee area who purchases insurance on Wisconsin’s federally run health insurance exchange.
Ms. Thompson, who spoke with reporters on a call organized by a health care advocacy group, said she expects to pay 30 percent to 50 percent more per year for her monthly premium, potentially more than her mortgage payment. Officials in Wisconsin, a state that went for a Republican presidential candidate for the first time in decades last fall, assumed the federal subsidy would end when they approved premium rate increases averaging 36 percent for the coming year.
An estimated 4 million people were benefiting from the cost-sharing payments in the 30 states Mr. Trump carried, according to an analysis of 2017 enrollment data from the U.S. Centers for Medicare and Medicaid Services. Of the 10 states with the highest percentage of consumers benefiting from cost-sharing, all but one — Massachusetts — went for Mr. Trump.
Kentucky embraced former President Barack Obama’s Affordable Care Act under its last governor, a Democrat, and posted some of the largest gains in getting its residents insured. Its new governor, a Republican, favors the GOP stance to replace it with something else.
Roughly half of the estimated 71,000 Kentuckians buying health insurance on the federal exchange were benefiting from the costsharing subsidies Mr. Trump just ended. Despite the gains from Mr. Obama’s law, the state went for Mr. Trump last fall even as he vowed to repeal it.
Consumers such as Marsha Clark fear what will happen in the years ahead, as insurers raise premiums on everyone to make up for the end of the federal money that helped lower deductibles and co-pays.
“I’m stressed out about the insurance, stressed out about the overall economy, and I’m very stressed out about our president,” said Ms. Clark, a 61-year-old real estate broker who lives in a small town about an hour’s drive south of Louisville. She pays $1,108 a month for health insurance purchased on the exchange.
While she earns too much to benefit from the cost-sharing subsidy, she is worried that monthly premiums will rise so high in the future that it will make insurance unaffordable.
Sherry Riggs has a similar fear. The Fort Pierce, Fla., barber benefits from the deductible and co-pay discounts, as do more than 1 million other Floridians, the highest number of costsharing beneficiaries of any state.
She underwent bypass surgery following a heart attack last year and pays just $10 a visit to see her cardiologist and only a few dollars for the medications she takes twice a day.
Her monthly premium is heavily subsidized by the federal government, but she worries about the cost soaring in the future. Florida, another state that swung for Mr. Trump, has approved rate increases averaging 45 percent.
“Probably for some people it would be a death sentence,” she said. “I think it’s kind of a tragic decision on the president’s part. It scares me because I don’t think I’ll be able to afford it next year.”
Rates already were rising in the immediate aftermath of Mr. Trump’s decision. Insurance regulators in Arkansas, another state that went for Mr. Trump, approved premium increases on Friday ranging from 14 percent to nearly 25 percent for plans offered through the insurance marketplace. Had federal cost-sharing been retained, the premiums would have risen by no more than 10 percent.
In Mississippi, another state Mr. Trump won, an estimated 80 percent of consumers who buy coverage on the insurance exchange benefit from the deductible and co-pay discounts, the highest percentage of any state. Premiums there will increase by 47 percent next year, after regulators assumed Mr. Trump would end the cost-sharing payments.
The National Association of Insurance Commissioners has estimated the loss of the subsidies would result in a 12 percent to 15 percent increase in premiums, while the nonpartisan Congressional Budget Office has put the figure at 20 percent. Experts say the political instability over Mr. Trump’s effort to undermine Mr. Obama’s health care law could prompt more insurers to leave markets, reducing competition and driving up prices.
Mr. Trump’s move concerned some Republicans, worried the party will be blamed for the effects on consumers and insurance markets.
“I think the president is ill-advised to take this course of action, because we, at the end of the day, will own this,” Republican Rep. Charlie Dent of Pennsylvania said Friday on CNN. “We, the Republican Party, will own this.”