San Francisco Chronicle

Trump backers stand to lose with health subsidy cut

- By Christina A. Cassidy and Meghan Hoyer Christina A. Cassidy and Meghan Hoyer are Associated Press writers.

President Trump’s decision to end a provision of the Affordable Care Act that was benefiting roughly 6 million Americans helps fulfill a campaign promise, but it also risks harming some of the very people who helped him win the presidency.

Nearly 70 percent of those benefiting from cost-sharing subsidies live in states Trump won last November, according to an analysis by the Associated Press. The number underscore­s the political risk for Trump and his party, which could end up owning the blame for increased costs and chaos in the insurance marketplac­e.

The subsidies are paid to insurers by the federal government to help lower consumers’ deductible­s and co-pays. People who benefit will continue receiving the discounts because insurers are obligated by law to provide them. But 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.

Thompson, who spoke with reporters on a call organized by a health care advocacy group, said she expects to pay up 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 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 costsharin­g, all but one — Massachuse­tts — went for 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 cost-sharing subsidies Trump just ended. Despite the gains from Obama’s law, the state went for Trump last fall even as he vowed to repeal it.

Rates already were rising in the immediate aftermath of Trump’s decision. Insurance regulators in Arkansas, another state that went for 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.

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