An­a­lysts: Move would rock in­surance mar­kets

Cuts to pay­ments would sad­dle GOP with blame, harm­ing Trump.

The Washington Times Daily - - FRONT PAGE - BY TOM HOW­ELL JR.

Pres­i­dent Trump has re­newed his threat to yank crit­i­cal Oba­macare re­im­burse­ments from health in­sur­ers but an­a­lysts said it’s likely an empty ges­ture, in­sist­ing that if he does cut off the pay­ments it would leave the mar­kets even wob­blier — and the GOP would get the blame.

Mr. Trump’s threat ap­pears to be de­signed to in­tim­i­date Democrats into join­ing Oba­macare re­peal ne­go­ti­a­tions, with the White House say­ing that the pres­i­dent re­tains a num­ber of op­tions for uni­lat­eral ac­tion to evis­cer­ate his pre­de­ces­sor’s sig­na­ture health over­haul.

Health and Hu­man Ser­vices Sec­re­tary Tom Price has said he hasn’t ruled out the idea of grant­ing a waiver from the in­di­vid­ual man­date re­quir­ing ev­ery­one to have in­surance.

And Mr. Trump him­self seems fo­cused on yank­ing cost-shar­ing re­duc­tions, or “CSRs,” that re­im­burse in­sur­ers for pick­ing up low-in­come cus­tomers’ costs on Oba­macare’s ex­changes.

Democrats are in­sis­tent that those pay­ments con­tinue, even though Congress has never ap­proved them. Pres­i­dent Obama paid them any­way, and lost a court bat­tle in which a judge ruled the pay­ments il­le­gal.

Mr. Trump has con­tin­ued pay­ing them as the case plays out, but in re­cent days has once again sig­naled rest­less­ness.

“As I said from the be­gin­ning, let Oba­maCare im­plode, then deal. Watch!” Mr. Trump tweeted Thurs­day af­ter the wee-hours fail­ure of the Se­nate GOP’s bid to re­peal and re­place the 2010 Af­ford­able Care Act.

But it is un­clear when, or even if, Oba­macare would “im­plode” if Mr. Trump were to end the pay­ments.

In­sur­ers are re­quired to cover cus­tomers’ costs even if they’re never re­im­bursed by the gov­ern­ment, so they would likely raise their rates to make up for lost fund­ing.

“Fund­ing to lower con­sumers’ cost-shar­ing is passed through the health plans — health plans do not profit from that fund­ing,” said Kris­tine Grow, spokes­woman for Amer­ica’s Health In­surance Plans, a lob­by­ing group for in­sur­ers. “If that fund­ing goes away, pre­mi­ums for ev­ery­one who buys their own cov­er­age will go up by about 20 percent.”

Oba­macare’s pre­mi­ums sub­si­dies rise with rates, so many cus­tomers will be cush­ioned from the blow. More than 7 mil­lion peo­ple buy in­surance on their own, but earn too much money to qual­ify for tax­payer-funded as­sis­tance, so they would feel the full brunt of pre­mium in­creases.

“Iron­i­cally, these peo­ple, higher-in­come peo­ple, tend to more of­ten vote Repub­li­can. So, by fol­low­ing though on his threat, Trump re­ally only hurts his peo­ple,” said Robert Laszewski, a health pol­icy con­sul­tant in Alexandria, Vir­ginia.

Tax­pay­ers would feel the pain, too, by pay­ing out an es­ti­mated $2.3 bil­lion more — in net — to fund ris­ing pre­mium sub­si­dies even af­ter the sav­ings from ax­ing cost-shar­ing pay­ments is sub­tracted out, ac­cord­ing to the non­par­ti­san Kaiser Fam­ily Foun­da­tion.

Democrats who’ve suf­fered po­lit­i­cally for faults in their sig­na­ture health law say they’ll make sure Mr. Trump pays a po­lit­i­cal price if he pulls the trig­ger, sow­ing un­cer­tainty in the mar­kets.

“If he does, ‘You break it, you own it,’” said Sen. Bill Nel­son, Florida Demo­crat who spear­headed bi­par­ti­san talks among 10 sen­a­tors how to bol­ster ail­ing Oba­macare mar­kets.

Af­ter the Se­nate GOP’s stun­ning fail­ure last week, all sides are try­ing to fig­ure out the next steps.

A bi­par­ti­san House group known as the Prob­lem Solvers Cau­cus re­leased a mul­ti­pronged plan Mon­day that would fund the pay­ments, add more money to sta­bi­lize the mar­kets, loosen Oba­macare’s man­date re­quir­ing large em­ploy­ers to pro­vide in­surance and re­peal Oba­macare’s tax on med­i­cal de­vice sales — a levy that’s taken fire from both par­ties.

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