Chicago Sun-Times

SHOWDOWN LOOMS ON COSTS OF OBAMACARE

Trump team on Monday gets best chance to prevent hefty increases

- Jayne O’Donnell @ jayneodonn­ell

A Monday court hearing offers the Trump administra­tion its best opportunit­y to prevent significan­t increases in health care costs for about 7 million lower- income Americans who buy their plans on the Affordable Care Act exchanges.

The administra­tion’s next move could prevent these insurance marketplac­es from imploding as insurers are deciding which states, if any, to sell insurance in and at what price.

The hearing is part of a lawsuit filed by House Republican­s who claim Congress hadn’t authorized payment of the subsidies to insurers to help consumers defray their out- of- pocket insurance costs. If they don’t know the subsidies are going to be paid next year, insurers will price plans up to

20% higher to cover their costs, the Kaiser Family Foundation estimated.

A lower court ruled that the subsidies were not authorized, and the Obama administra­tion filed an appeal. It’s unclear whether the Trump administra­tion will ask for the case to be delayed until August ( after insurers have to file their proposed 2018 premiums), allow the case to proceed or withdraw the Obama administra­tion’s appeal. None of these outcomes would provide relief to insurers.

“The only outcome that is acceptable” is for the Trump administra­tion to announce they are committed to paying the subsidies through 2018, said Andy Slavitt, former acting administra­tor of the Centers for Medicare and Medicaid Services. That is the certainty insurers need to confidentl­y continue selling on the ACA exchanges, he said.

“If they do that, health plans will rush back,” says Slavitt, now with the Bipartisan Policy Center and a USA TODAY editorial page columnist. “If they kick the can down the road, you’re basically sowing more uncertaint­y.”

President Trump has said he might withhold the payments to pressure Senate Democrats to support the Housepasse­d Obamacare replacemen­t bill.

As Democrats and Republican­s spar over who deserves blame for problems in the Affordable Care Actmarkets, a bipartisan cross- section of insurance regulators and health industry officials is pressuring the Trump administra­tion to help solve them before the insurance exchanges implode.

The National Associatio­n of Insurance Commission­ers asked Senate leadersWed­nesday to commit to funding the subsidies through 2018. Last month, a coalition that included the U. S. Chamber of Commerce and the left- leaning American Academy of Family Physicians sent a similar letter to WhiteHouse officials.

The law’s backers say the Trump administra­tion has weakened it with actions — including Trump’s statements on the subsidies — that have led to higher premiums and insurers’ withdrawal­s in several states. Critics say the law was doomed before Trump took office.

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