Bi­par­ti­san Deal Could Give Tem­po­rary Pro­tec­tion to Oba­macare

Would cover cost of sub­si­dies to in­sur­ers for 2 years, but pas­sage in Congress un­cer­tain

The Jewish Voice - - HEALTH - By: Den­nis Thomp­son

Are Amer­i­cans en­rolled in Oba­macare health plans -- threat­ened by re­cent Trump Ad­min­is­tra­tion moves -- be­ing thrown a life­line?

Last Tues­day, two prom­i­nent Se­na­tors -- La­mar Alexan­der (R-Tenn.) and Patty Mur­ray (D-Wash.) -- an­nounced a bi­par­ti­san pro­posal that would fund vital sub­si­dies for in­sur­ers par­tic­i­pat­ing in Af­ford­able Care Act (ACA) pro­grams.

Last Fri­day, Pres­i­dent Don­ald Trump said he planned to sign an ex­ec­u­tive or­der that would elim­i­nate those sub­si­dies, known as cost-shar­ing re­duc­tions. The e sub­si­dies help in­sur­ers de­fray med­i­cal costs for low-in­come Amer­i­cans en­rolled in ACA plans.

How­ever, the Alexan­der-Mur­ray deal -- if ap­proved by Congress -- would cover the cost of those sub­si­dies for two years, of­fer­ing short-term as­sur­ances to in­sur­ers, The New York Times re­ported.

The move might even have the pres­i­dent's sup­port: Alexan­der said Trump had en­cour­aged him to work on the deal with Mur­ray, the Times said. Still, the deal's pas­sage is far from sure, be­cause it would need the sup­port of con­ser­va­tive Repub­li­can law­mak­ers in the House. Many have said they view such a move as a bailout for in­sur­ance com­pa­nies, the Times said.

The lat­est news con­tin­ues the roller coaster ride many Oba­macare ben­efici ries may feel they have been on as po­lit­i­cal bat­tles over the pro­gram con­tinue.

Last Fri­day, Trump sig­naled that he would is­sue an ex­ec­u­tive or­der killing the sub­si­dies, weak­en­ing the ACA.

"The govern­ment can­not law­fully make the cost-shar­ing re­duc­tion pay­ments," the White House said in a state­ment, adding that, "Congress needs to re­peal and re­place the dis­as­trous Oba­macare law and pro­vide real re­lief to the Amer­i­can peo­ple."

Trump's an­nounce­ment came just hours af­ter he signed an ex­ec­u­tive or­der that al­lows small busi­nesses to band to­gether and buy health in­sur­ance that fl uts ACA reg­u­la­tions. Ex­perts be­lieve that's an­other move that could crip­ple Oba­macare, al­low­ing health­ier en­rollees to fle to cheaper but skimpier plans.

Speak­ing last week, Trump said the move will pro­mote health care choice and com­pe­ti­tion.

"You'll get such low prices for such great care," he said just prior to sign­ing the ex­ec­u­tive or­der, CBS News re­ported.

But op­po­nents say the or­der will un­der­mine cov­er­age of­fered to mil­lions en­rolled in the ACA.

To­gether, the two moves could be death blows to Oba­macare un­less a move such as that pro­posed by Alexan­der and Mur­ray is ap­proved.

All of this comes af­ter Trump was un­suc­cess­ful mul­ti­ple times in get­ting the pro­gram re­pealed via Congress.

In a joint state­ment is­sued Thurs­day, the top Democrats in Congress, Sen­a­tor Chuck Schumer of New York and Rep­re­sen­ta­tive Nancy Pelosi of Cal­i­for­nia, said Mr. Trump had "ap­par­ently de­cided to pun­ish the Amer­i­can peo­ple for his in­abil­ity to im­prove our health care sys­tem," the Times re­ported. "It is a spite­ful act of vast, point­less sab­o­tage lev­eled at work­ing fam­i­lies and the mid­dle class in ev­ery cor­ner of Amer­ica," they said. "Make no mis­take about it, Trump will try to blame the Af­ford­able Care Act, but this will fall on his back and he will pay the price for it."

But House Speaker Paul Ryan, Repub­li­can of Wis­con­sin, sup­ported Trump's de­ci­sion. Ac­cord­ing to the Times, he said the Obama ad­min­is­tra­tion had over­rid­den Con­gres­sional au- thor­ity by pay­ing the sub­si­dies in the fi st place. "Un­der our Con­sti­tu­tion," Mr. Ryan said, "the power of the purse be­longs to Congress, not the ex­ec­u­tive branch." Moves to un­der­mine or pro­tect Oba­macare come less than three weeks be­fore the Nov. 1 start to the open en­roll­ment sign-up sea­son for the pro­gram. It's un­clear whether any new rule changes could be ready for im­ple­men­ta­tion within that time­frame, ex­perts said.

Larry Le­vitt, Kaiser Fam­ily Foun­da­tion's se­nior vice pres­i­dent, told the Wash­ing­ton Post that Trump's or­der to ex­pand health plan op­tions out­side of the ACA could do se­ri­ous dam­age.

"If there's a lot of hoopla around new op­tions that may be avail­able soon, it could be one more thing that dis­cour­ages en­roll­ment [in the ACA]," he said.

Trump's di­rec­tive ex­pands cross-state ac­cess to as­so­ci­a­tion health plans, which al­low small busi­nesses and trade groups to part­ner up and pur­chase health in­sur­ance. Em­ploy­ers also get wider lee­way in us­ing pre-tax dol­lars to cover work­ers' health ex­penses, avoid­ing rules im­posed by the ACA.

Un­der the new rules, as­so­ci­a­tion health plans will also be ex­empt from cer­tain ACA rules, such as re­quire­ments that they cover stan­dard ben­e­fits like pre­scrip­tion drug cov­er­age. Th y also could be sub­ject to lim­its on an­nual and life­time costs, and peo­ple with pre­ex­ist­ing con­di­tions could be charged more for their cov­er­age.

The Trump ad­min­is­tra­tion rule also elim­i­nates re­stric­tions on short-term health in­sur­ance plans, which of­fer lim­ited ben­e­fits and are in­tended as a stop­gap be­tween jobs.

Un­der the Obama ad­min­is­tra­tion, such short-term plans could not last more than three months, but Trump plans to ex­tend that du­ra­tion to nearly a year.

Crit­ics of the White House's lat­est move against the ACA in­clude state in­sur­ance com­mis­sion­ers, health care pol­icy ex­perts, and many within the health in­sur­ance in­dus­try.

Th y ar­gue that the or­der will lead to the creation of a "shadow" health in­sur­ance sys­tem that com­petes di­rectly against the ACA mar­ket­places, of­fer-

The Alexan­der-Mur­ray deal -- if ap­proved by Congress -- would cover the cost of those sub­si­dies for two years, of­fer­ing short­term as­sur­ances to in­sur­ers, The New York Times re­ported.

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