White House steps up its criticism of Affordable Care Act
Federal subsidies at risk in new GOP law
As critical Affordable Care Act dates near, the Trump administration is stepping up its negative rhetoric about the law, which it claims is in a death spiral.
President Trump had lunch Tuesday with 13 Senate Republicans working on the Housepassed ACA replacement bill. Before the meeting, Trump said the new bill will be “generous, kind (and) with heart,” and that the legislation will be signed “as soon as we can do it.”
Trump said there was an “urgent need to repeal and replace the disaster known as Obamacare.” The meeting followed a Tuesday Centers for Medicare and Medicaid Services (CMS) announcement that nearly 50 counties now have no insurers planning to sell on the exchanges for 2018, while about 40% — or 1,200 counties — will only have one.
Also Tuesday, insurer Centene announced plans to sell insurance on the ACA exchanges in Missouri, Kansas and Nevada and to expand in states including Florida, Ohio, Texas and Washington.
About 85% of people get federal subsidies to help pay for their ACA insurance and those consumers have to buy it on the exchanges.
Trump, however, stepped on his message during the Tuesday lunch. An aide to a Republican senator who attended the meeting with Trump said that the president called the House version of the bill “mean” and requested that senators put more money into their version of the legislation. When the House passed their repeal and replace bill in May, the president celebrated its passage by hosting Republican lawmakers at the White House.
It is the White House’s own actions that have undermined the law, some insurers and Democratic critics of the administration say. At risk are the subsidies, which the White House has not said whether it will continue to reimburse insurers.
Anthem cited these subsidies, along with the overall uncertainty surrounding the exchanges, when it announced it would stop selling insurance in Ohio. That decision left several counties without an exchange insurer.
“The uncertain policy environment has not been conducive to carrier participation, and we have seen a lot of exits,” says Katherine Hempstead, who heads the insur- ance team at the Robert Wood Johnson Foundation, a group that aims to improve U.S. health.
That, she says, makes Centene’s announcement “quite interesting, since they are proposing to enter a number of states that are at risk for bare counties.”
Both administrations put their own spins on similar enrollment numbers.
Late Monday, CMS released data that showed nearly 2 million consumers dropped their ACA plans in early 2017 — which wasn’t much higher than it was last year during the Obama administration. As of March 15, the Department of Health and Human Services says about 1.9 million people either never paid or stopped paying their premiums for new 2017 ACA plans. Last year, that was the case for about 1.6 million people by the end of June.
“This drop off rate is very comparable to what’s happened in previous years; it’s just the way it’s being spun is quite different,” says Larry Levitt, executive vice president of the Kaiser Family Foundation. “As with many things, the Obama administration tried to put a positive face on numbers like this, while the Trump administration is working to put as a negative face as possible.”
Heath and Human Services Secretary Tom Price said it showed “fewer Americans can afford to pay more and get less for health care.” CMS administrator Seema Verma called its new county data, “yet another failing report card” for the exchanges.
Along with trouble paying premiums, those who drop plans sometimes do so because they get jobs that provide insurance or turn 65 and become eligible for Medicare.
Insurers have to file their ACA rates no later than June 21; some already have. These filings will signal whether they are likely to continue selling insurance on the state and federal exchanges. The Senate is preparing to vote on the House-passed ACA replacement bill by its July 4 recess.