TRUMP END­ING ACA PAY­MENTS

Colorado’s top in­sur­ance reg­u­la­tor says changes “will cause problems”

The Denver Post - - FRONT PAGE - By Amy Gold­stein Den­ver Post staff writer John In­gold con­trib­uted to this re­port.

Pres­i­dent Don­ald Trump plans to end crit­i­cal pay­ments to health in­sur­ers that help mil­lions of lower-in­come Amer­i­cans af­ford cov­er­age un­der the Af­ford­able Care Act.

WASH­ING­TON» Pres­i­dent Don­ald Trump is throw­ing a bomb into the in­sur­ance mar­ket­places cre­ated un­der the Af­ford­able Care Act, choos­ing to end crit­i­cal pay­ments to health in­sur­ers that help mil­lions of lower-in­come Amer­i­cans af­ford cov­er­age. The de­ci­sion fol­lows an ex­ec­u­tive or­der on Thurs­day to al­low al­ter­na­tive health plans that skirt the law’s re­quire­ments.

The White House con­firmed late Thurs­day that it would halt fed­eral pay­ments for cost-shar­ing re­duc­tions, although a state­ment did not spec­ify when. Ac­cord­ing to two peo­ple briefed on the de­ci­sion, the cut­off will be as of Novem­ber. The sub­si­dies to­tal about $7 bil­lion this year.

Trump has threat­ened for months to stop the pay­ments, which help el­i­gi­ble con­sumers af­ford their de­ductibles and other outof-pocket ex­penses, but he held off while other ad­min­is­tra­tion of­fi­cials warned him that such a move would cause an im­plo­sion of the ACA mar­ket­places that could be blamed on Repub­li­cans.

Health in­sur­ers and state reg­u­la­tors have been in a state of high anx­i­ety over the prospect of the mar­ket­places cra­ter­ing be­cause of such White House ac­tion. The fifth year’s open-en­roll­ment sea­son for con­sumers to buy cov­er­age through ACA ex­changes will open in less than three weeks, and in­sur­ers have said that stop­ping the cost-shar­ing pay­ments would be the great­est step the Trump ad­min­is­tra­tion could take to harm the mar­ket­places — and the law.

End­ing the pay­ments is grounds for any in­surer to back out of its fed­eral con­tract to sell health plans for 2018.

The cost-shar­ing re­duc­tions have long been the sub­ject of a po­lit­i­cal and le­gal see­saw. Con­gres­sional Repub­li­cans ar­gued that the sprawl­ing 2010 health-care law that es­tab­lished the sub­si­dies does not in­clude spe­cific lan­guage pro­vid­ing ap­pro­pri­a­tions to cover the govern­ment’s cost. House Repub­li­cans sued Health and Hu­man Ser­vices over the pay­ments dur­ing for­mer Pres­i­dent Barack Obama’s sec­ond term. A fed­eral court agreed that they were il­le­gal, and the case has been pend­ing be­fore the U.S. Court of Ap­peals for the D.C. Cir­cuit.

Colorado’s top in­sur­ance reg­u­la­tor re­sponded on Thurs­day to Trump’s health care ex­ec­u­tive or­der about al­ter­na­tive health plans with con­cern, say­ing the poli­cies en­dorsed could lead to flim­sier cov­er­age in the state and much higher costs for the sick. “The lim­ited ben­e­fits, the fo­cus on the healthy at the ex­pense of those with pre-ex­ist­ing con­di­tions, and lack of reg­u­la­tory over­sight will cause problems for the health in­sur­ance mar­ket as a whole,” said Mar­guerite Salazar, the state’s in­sur­ance com­mis­sioner.

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