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Donald Trump Will Now Drive Up Your 2019 Health Insurance Premiums: You’re Welcome America!

Who wants to pay more for insurance? Show of hands...

By Doktor Zoom as originally published over at Wonkette and reposted here with permission 

The Trump administration is still unhappy it couldn’t get Congress to repeal the Affordable Care Act last year. So — always working! — it took another whack at the program this weekend! This time, the Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) announced the suspension of payments to insurers under one of the ACA’s cost containment programs. Boring, right? What does it mean? Just more of that good old “market uncertainty” that’s been driving up premiums for plans in the individual markets, just when insurers are setting their premiums for 2019. Since the ACA keeps refusing to collapse under its own weight, Trump’s people keep pounding away at it with million-pound shithammers.

The new Trumpfuckery involves Obamacare’s risk adjustment program, which doesn’t involve any taxpayer funds — instead, the government takes some money from insurers that have mostly healthier, less-costly enrollees, to transfer to insurers that have sicker customers who generate higher costs. It’s a bit like insurance for insurance companies, spreading out the costs of insurance to keep premiums lower overall. As Jordan Weissmann ‘splainers at Slate:

The payments, worth billions of dollars a year, are designed to discourage carriers from cherry-picking low-risk insurance shoppers, while keeping health plans afloat if they get unlucky and end up stuck paying the medical costs of an unusually ill group of patients.

The CMS decision stems from a couple of federal lawsuits brought by small insurance companies over the formula used to determine how those payments would be made. The formula was upheld in a case in Massachusetts, but struck down in a New Mexico case in which the judge said the formula might be valid, but the government hadn’t explained why it constructed the formula as it did. Because we love you, the reader, we will not go into the weeds on the details here, but what it comes down to is that while the government continues to litigate the New Mexico case, CMS administrator Seema Verma says the ruling means the government has no choice but to halt the payments for the 2017 plan year (about $10.4 billion) — which a lot of your healthcare policy experts say is just plain not true. Here’s Weissmann again:

This is an extremely strange decision by the administration. When a single trial court judge strikes down a regulation, the government typically doesn’t just stop enforcing it. “I haven’t heard of such a thing happening before,” University of Maryland law professor Frank Pasquale told me. Instead, the Justice Department can appeal the decision to a higher court and ask for a stay stopping the lower court’s decision from going into effect. It can choose to interpret the ruling narrowly, so that it doesn’t apply to the entire country. If it wants to, the administration can also issue a new, “interim” version of a regulation that goes into effect while the litigation rolls on. That would be a triflingly easy thing to do in this instance, since the administration has already tweaked the risk-adjustment rule for next year to address the court’s concerns

Translation: The New Mexico ruling looks a hell of a lot like an excuse to throw the ACA’s individual markets into more chaos, at a particularly sensitive time of year, as insurance companies set their rates for 2019. Some companies are going to jack up premiums, and some may decide to pull out of the markets, and some smaller insurers may just go belly up if they aren’t reimbursed for services they already covered. Why yes, that is the Trump Way: Stiff businesses for compensation that was due to them.

There are plenty of steps the government could take to prevent this instead of just stopping the payments. Burt why wouldn’t they just choose chaos? That’s their damn mandate.

“They’re doing this because they want to,” Georgetown University Law Center professor David Super said. “They’re doing this because they don’t like these payments.”

One result of this decision will be higher premiums for plans on the exchanges; for people who qualify for premium subsidies, that price increase will be borne by taxpayers, but for individuals whose income is too high to qualify for subsidies, and for small businesses, it will mean much pricier insurance. It also means companies dropping out of the market altogether, which is what Trump hoped for last year when he eliminated payments for “cost-sharing reduction” payments to insurers — also with the excuse that a lawsuit forced him to, although that suit hadn’t actually been completed, either. The GOP’s tax bill also killed the individual mandate, further driving up premiums. Because the ACA was designed to protect most customers from premium hikes, the real effects of those actions was to reduce the availability of plans, price middle-class people out of the market, and raise costs to taxpayers without making the ACA vanish. But hey, Trump gets to brag that he killed Obamacare, and that’s all that really matters.

One rightwing website was perfectly happy to brag about the real motive for the administration’s action:

Hurr Hurr. Making it harder for sick people to get medical care!

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7 comments on “Donald Trump Will Now Drive Up Your 2019 Health Insurance Premiums: You’re Welcome America!

  1. The toddler-president has ALWAYS refused to pay his contractors and even his investors (bankruptcies). What do you expect from a guy who thought it was “a terrific idea” to sell steaks through mail order, and who took student’s money for tuition to a scam university that carried his name? Now that he owes money to the Russian mop, I wonder if he is smart enough to make sure he pays them back…in one way or an other.

    • ai, did you read yesterday that trump’s own personal driver has now sued him — also reported by CNN and Bloomberg – but here is the story from WaPo. There really is no end to what he gets away with, for how long he gets away with it, and why people let him get away with it. He especially likes to take advantage of those that most likely do not have the funds to fight him in court and pay for a lawyer. And trumpass calls that “winning”. No class, no grace, no scruples, no morals, no honesty, no shame.

      https://www.washingtonpost.com/politics/trumps-longtime-personal-driver-sues-for-overtime-wages/2018/07/09/17bfb4f4-839e-11e8-8f6c-46cb43e3f306_story.html?utm_term=.09684745c9a3

      • Murphy,
        Every day, I think to myself it can’t get any uglier, but the next day trumpass does something uglier. The worst aspect of all this is that the Donald is a mirror of too-large a part of America who are not going away when he eventually does (hopefully in an orange jumpsuit).

        • ai, they may not go away but then again, they have always been there – they will just go back under their slimy rocks and eventually they will all die off, go to jail or kill each other. They are cowards and they know they cannot win against the better millions that will not tolerate their despicable vile behavior.

          The mere fact that we have this reprehensible man in the WH was not the result of them winning the election, vote to vote — they actually lost by 3 million votes.

          We need to abolish the Electoral College and demand quality candidates by adding requirements to qualify for office — let’s require disclosure of 10 years tax returns, no history of nor pending lawsuits, no former bankruptcies, thorough investigation of foreign connections … and more!

          We ended up here because we never expected a cretin to illegally win an election by interference from a foreign government and our failure to not have interceptors in place to prevent it. It will not happen again. Ever.

  2. ai, you are absolutely correct on that one! We probably miss the best candidates because they don’t have huge money promoting them or buying them!

    • That is my point. Money shouldn’t be the determinant factor. If you make it so that parties or independents can only spend x-amount, say $10 million on an election, then maybe the electorate won’t be bamboozled by all the hype and distractions that the $billions buys, and they’ll be able to focus on ideas.

      As it is now, money installs legislators, and the legislators work in favor of the money.

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