Trump hedges on long-term Oba­macare pay­ments

May with­hold funds in name of re­peal

The Washington Times Daily - - POLITICS - BY TOM HOW­ELL JR.

State of­fi­cials begged the Trump ad­min­is­tra­tion Wed­nes­day to keep mak­ing crit­i­cal Oba­macare pay­ments to in­sur­ers, but the White House re­fused to of­fer any long-term com­mit­ment, height­en­ing un­cer­tainty as health plans be­gin to set their rates for 2018.

The rel­a­tively ar­cane pay­ments have again be­come a sur­pris­ing flash point in Washington’s fight over health care, with in­sur­ers say­ing they could raise pre­mi­ums by more than 20 per­cent if they don’t have as­sur­ances they’ll con­tinue to get tax­pay­ers’ money.

Cal­i­for­nia’s in­surance com­mis­sioner said a 12.5 per­cent pre­mium raise al­ready ex­pected for next year would likely dou­ble if Pres­i­dent Trump halts what’s known as cost-shar­ing pay­ments.

The Na­tional Gov­er­nors As­so­ci­a­tion said mar­kets al­ready reel­ing from dwin­dling choices and ris­ing costs can’t han­dle the ad­di­tional un­cer­tainty Mr. Trump is caus­ing.

“The Ad­min­is­tra­tion has the op­por­tu­nity to sta­bi­lize the health in­surance mar­ket across our na­tion and en­sure that our res­i­dents can con­tinue to ac­cess af­ford­able health care cov­er­age,” said Vir­ginia Gov. Terry McAuliffe, a Demo­crat, and Mas­sachusetts Gov. Char­lie Baker, a Repub­li­can.

Mr. Trump al­lowed Trea­sury to make last month’s pay­ment but hasn’t com­mit­ted to any­thing beyond that.

“We’ve said, from the very be­gin­ning, the time that he got into of­fice, that we’d look at these on a month-by-month ba­sis. And that po­si­tion has not changed,” White House Bud­get Di­rec­tor Mick Mul­vaney told CNN.

Mr. Trump has sug­gested he might yank the pay­ments as a way to pres­sure Capi­tol Hill to take an­other stab at re­peal­ing and re­plac­ing Oba­macare.

Congress has never ap­proved the pay­ments, and when Pres­i­dent Obama made them any­way, the GOP-led House took him to court. A judge ruled the pay­ments il­le­gal but has stayed her de­ci­sion while it’s un­der ap­peal.

A fed­eral ap­peals court late Tues­day said more than a dozen Demo­cratic state at­tor­neys gen­eral may step in and de­fend the pay­ments should Mr. Trump at­tempt to drop the case.

An­a­lysts said the judges’ or­der, which high­lighted the Trump team’s “ac­cu­mu­lat­ing pub­lic state­ments” about no longer rep­re­sent­ing the states’ in­ter­est in pre­serv­ing the pay­ments, will make it harder for Mr. Trump to blame any de­ci­sion to cut off the money on the court’s prior rul­ing.

“The le­gal ques­tion is still open, and if the pres­i­dent de­cides to end the pay­ments, it will be his own de­ci­sion, which will likely be chal­lenged in an­other law­suit and may pos­si­bly be stopped by the ap­pel­late court if the states ask it to stay any ter­mi­na­tion of the CSRs pend­ing a de­ter­mi­na­tion on the mer­its,” said Ti­mothy Jost, a law pro­fes­sor at Washington and Lee Univer­sity in Vir­ginia who closely tracks the 2010 health law.

Last week­end, White House coun­selor Kellyanne Con­way said Mr. Trump would make a de­ci­sion on whether to con­tinue the pay­ments this week. It hasn’t hap­pened yet.

“We will keep you posted when we have a fi­nal an­nounce­ment on that,” White House press sec­re­tary Sarah Huck­abee San­ders told re­porters Wed­nes­day.

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