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Life Health > Health Insurance > Health Insurance

Trump Says He Had to Undermine Affordable Care Act to Force Changes

By Zachary Tracer, Justin Sink

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President Donald Trump said he had to blow up the Obamacare cost-sharing reduction (CSR) subsidy program in order to fix the U.S.’s health care problems.

“Republicans are meeting with Democrats because of what I did with the CSRs,” Trump said on Monday at a Cabinet meeting, referring to subsidies to insurers the administration said on Thursday it was cutting off. “If I didn’t cut the CSRs they wouldn’t be meeting, they’d be having lunch and enjoying themselves, alright. They’re right now having emergency meetings to have a short-term fix of health care.”

The administration’s explanation for Trump’s move is that the payments are illegal because they weren’t appropriated by Congress in the Affordable Care Act. That issue is the subject of a dispute now before the courts. But Trump’s former top strategist, Steve Bannon, said on Saturday that Trump ended the payments to sabotage the health law.

(Related: Math Geniuses Size Up 5 ACA Change Ideas)

Trump’s decision to stop paying the CSRs has added urgency to efforts to shore up the individual major medical insurance market, two weeks before the individual major medical open enrollment period for 2018 is set to begin. Insurers are boosting premiums significantly, and lawmakers led by Republican Sen. Lamar Alexander and Democratic Sen. Patty Murray have been working across the aisle to try to stabilize the health law, chiefly to avoid those rate hikes.

On Monday, Trump touted his role in pushing forward efforts by lawmakers to forge a deal.

“We’ll have a short-term fix with Republicans and Democrats getting together,” Trump said.

‘Serious Consequences’

Trump’s actions have brought together other unlikely allies as well. Insurers, doctors, hospitals and company lobbyists on Saturday sent a letter to lawmakers asking them to make sure the cost-sharing payments are funded.

“There will be serious consequences without Congressional action: millions will face higher premiums, fewer choices, and less access to the medical care they need,” said the groups, including America’s Health Insurance Plans, the American Medical Association, the U.S. Chamber of Commerce, and the American Hospital Association.

But the short time before enrollment begins means the window for fixes for 2018 has likely closed. Insurers are increasing premiums in many states in part to offset the end of the payments, which compensate them for providing almost 6 million poor people with lower out-of-pocket costs.

Trump said he’ll still push for a full repeal of Barack Obama’s signature health law using the budget process known as reconciliation. The process allows Republicans in the Senate to pass bills with 51 votes, rather than 60, though it limits the scope of their action. He said that would probably take place in March or April.

He said the plan would likely include “block granting the money back to the states — which does seem to make sense, the states running it, because it’s a smaller government that can be more individually sensitive.”

Nancy Pelosi, the Democratic leader in the House of Representatives, said Trump’s moves are bad for the working class.

“Hard-working families are suffering,” she said in a statement. “Democrats remain ready to work with Republicans to move quickly to stabilize the insurance marketplaces and lower costs for families. It is long past time for the President to stop the sabotage, and focus on bringing affordable, quality care to the American people.”

—-Read 3 Weird Ways an ACA Subsidy Cut Could Help You on ThinkAdvisor.


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