Trump to scrap sub­si­dies

Pres­i­dent or­ders po­ten­tially sweep­ing changes to ACA

The Dallas Morning News - - Front Page - Robert Pear, Mag­gie Haber­man and Reed Abelson, The New York Times

WASH­ING­TON — Pres­i­dent Don­ald Trump will scrap sub­si­dies to health in­sur­ance com­pa­nies that help pay out-of-pocket costs of low-in­come peo­ple, the White House said late Thurs­day. His plans were dis­closed hours af­ter the pres­i­dent or­dered po­ten­tially sweep­ing changes in the na­tion’s in­sur­ance sys­tem, in­clud­ing sales of cheaper poli­cies with fewer ben­e­fits and fewer pro­tec­tions for con­sumers.

The twin hits to the Af­ford­able Care Act could un­ravel Pres­i­dent Barack Obama’s sig­na­ture do­mes­tic achieve­ment, send­ing in­sur­ance pre­mi­ums soar­ing and in­sur­ance com­pa­nies flee­ing from the health law’s on­line mar­ket­places. Af­ter Repub­li­cans failed to re­peal the health law in Con­gress, Trump ap­pears de­ter­mined to

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dis­man­tle it on his own.

With­out the sub­si­dies, in­sur­ance mar­kets could quickly un­ravel. In­sur­ers have said they will need much higher pre­mi­ums and may pull out of the in­sur­ance ex­changes cre­ated un­der the Af­ford­able Care Act if the sub­si­dies were cut off. Known as cost-shar­ing re­duc­tion pay­ments, or CSRS, the sub­si­dies were ex­pected to to­tal $9 bil­lion in the com­ing year and nearly $100 bil­lion in the com­ing decade.

“The govern­ment can­not law­fully make the cost-shar­ing re­duc­tion pay­ments,” the White House said in a state­ment.

It con­cluded: “Con­gress needs to re­peal and re­place the dis­as­trous Oba­macare law and pro­vide real re­lief to the Amer­i­can peo­ple.”

Trump’s de­ci­sion to halt the sub­sidy amounts to a re­buke to mem­bers of Con­gress from both par­ties who have urged him to con­tinue the pay­ments.

Trump had raised the pos­si­bil­ity of elim­i­nat­ing the sub­sidy with Re­pub­li­can sen­a­tors at a White House meet­ing sev­eral months ago. At the time, one se­na­tor told him that the Re­pub­li­can Party would ef­fec­tively “own health care” as a po­lit­i­cal is­sue if the pres­i­dent did so.

By late Thurs­day night, a back­lash against Trump — in­clud­ing from fel­low Repub­li­cans — ap­peared im­mi­nent as law­mak­ers voiced con­cern over how end­ing the sub­si­dies would af­fect their con­stituents.

“Cut­ting health care sub­si­dies will mean more unin­sured in my district,” Rep. Ileana Ros-le­hti­nen, R-fla., wrote on Twit­ter. She added that Trump “promised more ac­cess, af­ford­able cov­er­age. This does op­po­site.”

Democrats im­me­di­ately re­acted with out­rage, warn­ing that Trump was in­flict­ing harm on the na­tion’s health care sys­tem.

Sen. Richard Durbin, D-ill., wrote on Twit­ter, “The pres­i­dent is de­stroy­ing health care to make a po­lit­i­cal point.”

The fu­ture of the pay­ments has been in doubt be­cause of a law­suit filed in 2014 by House Repub­li­cans, who said the Obama ad­min­is­tra­tion was pay­ing the sub­si­dies il­le­gally. Judge Rose­mary Col­lyer of U.S. District Court in Wash­ing­ton agreed, find­ing that Con­gress had never ap­pro­pri­ated money for the cost­shar­ing sub­si­dies.

The Obama ad­min­is­tra­tion ap­pealed the rul­ing. The Trump ad­min­is­tra­tion has con­tin­ued the pay­ments from month to month, even though Trump has made clear that he de­tests the pay­ments and sees them as a bailout for in­sur­ance com­pa­nies.

This sum­mer, a group of states, in­clud­ing New York and Cal­i­for­nia, was al­lowed to in­ter­vene in the court case over the sub­si­dies. The New York at­tor­ney gen­eral, Eric Sch­nei­der­man, said Thurs­day night that the coali­tion of states “stands ready to sue” if Trump cuts off the sub­si­dies.

The de­ci­sion to end the sub­sidy came on the heels of Trump’s ex­ec­u­tive or­der, which he signed ear­lier Thurs­day, which in­cludes sales of cheaper poli­cies with fewer ben­e­fits and pro­tec­tions for con­sumers than those man­dated un­der the Af­ford­able Care Act.

The pres­i­dent’s plan, an 1,100-word di­rec­tive to fed­eral agen­cies, laid the ground­work for an ex­pand­ing ar­ray of health in­sur­ance prod­ucts, mainly less com­pre­hen­sive plans of­fered through as­so­ci­a­tions of small em­ploy­ers and greater use of short-term med­i­cal cov­er­age.

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