Chipping Away at the Affordable Care Act: Payments to Insurers Suspended

One of the campaign promises Donald Trump appears to care about living up to is undermining all things Obama, not the least of which is the Affordable Care Act (ACA). The Trump administration’s latest bit of chipping away at the Affordable Care Act has been to suspend billions of dollars of “risk adjustment” payments to insurers who offer plans through the health exchanges set up as a result of the Affordable Care Act.

“Risk adjustment” payments pool risk for insurance companies, stabilize markets, and eliminate the incentive for insurers to restrict coverage only to healthier individuals and those without pre-existing conditions. The Affordable Care Act prohibits insurers from rejecting either type of potential member. Risk adjustment funds use money collected from insurers with healthier participants (and lower costs) to help supplement costs for insurers who take on the higher costs of enrolling sicker members.

The Trump administration cites a New Mexico district court ruling that disputes the current government formula for calculating the payments, and calls for their temporary suspension. A Massachusetts district court, however, upheld the current formula. Though the two rulings are in direct opposition to each other, the Trump administration has decided that it must abide by the New Mexico ruling – the one that would be most likely to lead to one more unraveling of the Affordable Care Act.

This is another step in making the marketplace “as inhospitable as possible,” according to Rodney Whitlock, Vice President of Health Policy at ML Strategies.

“The executive order the president signed, not long after he got to the White House after the [Inaugural] Parade was effectively, ‘We’re declaring war on the Affordable Care Act,'” says Whitlock.

Each year, fewer insurers participate in the health exchanges. Without the $10.4 billion in adjustment payments, or even with a delay in the payments, it’s likely that next year will see even fewer participating insurers and plans. Those who do participate are likely to significantly increase premiums for 2019. The result will be that even fewer small business owners and individuals – especially those who are very ill – will have access to affordable health care coverage.

With an administration that plainly cares more about abolishing Obama-era policy than it does about providing actual solutions for Americans, we’ll continue to lose not only our access to affordable health care, but we’ll also lose many of the regulations, such as environmental and food safety regulations, that were put in place to keep us healthy.

The issue of affordable and accessible healthcare (and the lack of it) has become like a can of worms that is not likely to disappear from the forefront. Many Americans who are insured through an employer, and/or who are perfectly healthy, are currently unable to see how this issue impacts their lives.

When more Americans, however, do feel the impact, whether from developing a serious and expensive illness, trying to obtain insurance with a pre-existing condition, or having a sick loved one without access to affordable healthcare, I predict that they will be wide open to the idea of a single payer or universal healthcare system – much to the dismay of the party who were its unwitting catalysts by dismantling the Affordable Care Act simply for the sake of doing so.

Trump Suspends Obamacare Risk Payments | Wochit News [2018-07-09]

Some payments halted for Obamacare program | Newsy | [2018-07-08]

Does the Tax Cuts and Jobs Act Repeal Obamacare?; How Obamacare Has Failed (or Not)

This week, Donald Trump and the GOP celebrated the passage, along party lines, of the Tax Cuts and Jobs Act. In his celebratory speech, Trump told his audience that, among other things, the Republicans’ tax bill “essentially repeals Obamacare.”

Below is Trump’s speech, including, at 4:58 in the clip, his assertion that the Tax Cuts and Jobs Act will end Obamacare (The Affordable Care Act):

President Trump & GOP Full VICTORY Speech at White House After Tax Bill Passes |  Right Side Broadcasting Network |  [2017/12/20]

Though the Republican tax bill does include a change to Obamacare, it doesn’t wipe out the entire law; it only puts an end to the individual mandate portion. The Affordable Care Act’s individual mandate requires that all Americans purchase health insurance coverage or pay a tax penalty.

Trump boasts about sneaky provision in tax bill that ‘repeals’ Obamacare
New York Daily News | [2017/12/20]

House Republicans Have Passed the Tax Cuts & Jobs Act | House Republicans | [2017/12/19]

Some say that the tax bill’s elimination of the individual mandate is a good thing (people who don’t feel they need health insurance will no longer be required to buy it). Others argue that with fewer healthy people in insurance pools, premiums will increase for those who do elect to buy health insurance.

Middle-income Americans who opt out of purchasing health insurance will either rejoice in the newfound money in their pockets once the tax bill is implemented, or they’ll be surprised at how little it impacts them at all – perhaps until they are sick and need to visit an emergency room.

Will most Americans be relieved that they will no longer have to spend money on health insurance premiums if they choose not to be covered? Or will the increased number of uninsured Americans as a result of the Republicans’ tax bill cause a chain of costly events that ultimately leads to frustration with the American health care system? Will this eventually lead to Americans’ ripeness for a complete health care system overhaul…say, to a single payer system?

How Obamacare Has Failed (Or Not)
The GOP has long insisted that the Affordable Care Act (Obamacare) is a “massive failure.” They cite such issues as the high cost of many health exchange participants’ premiums, the limited choices of insurers and plans available on the exchanges, and the increased costs of providing health care.

Obamacare has failed the American people |  The White House | [2017/6/21]

Obamacare Must Go  |  CNN Money  |  2017/2/7

Most Democrats, while admitting that the Affordable Care Act currently has its failings, maintain that it’s been a significant step toward ensuring that all Americans have access to health care. They point out the fact that since the passage of Obamacare, approximately 20 million more people now have health insurance. In addition, Democrats tout such aspects of the Affordable Care Act as limits on out-of-pocket spending for health care, and the requirement to cover those with pre-existing conditions while protecting them against higher premiums.

Perhaps one of the most misunderstood, but most meaningful aspects of the Affordable Care Act, though, is the guaranteed coverage of a list of “essential health benefits.” These include preventive care (such as annual physical exams), mental health services, prescriptions, and other services deemed necessary for maintaining good health (and thus, ideally, helping to prevent the high cost of illness).

Obamacare’s “Essential Benefits” Explained | CNN | [2017/3/24]

Whether you’re feeling alarmed or victorious about this change to Obamacare through the Tax Cuts and Jobs Act, and whether you think Obamacare is a miserable failure or a huge success, the changes to it will impact all of us.