President's latest move on healthcare reform - What's Your Point? October 15, 2017

- The panelists this week include Bob Price - associate editor for Breitbart Texas, Wayne Dolcefino - media consultant, Tony Diaz - educator and Chicano activist, Nyanza Moore - Houston attorney and progressive commentator, Marcus Davis, radio host of "Sunday Morning Live", and Republican strategist Jessica Colon join host Greg Groogan for a lively discussion regarding President Trump's latest move on healthcare reform

 

WASHINGTON (AP) - President Donald Trump's abrupt move to cut off federal payments to insurers jolted America's health care and political worlds alike, threatening to boost premiums for millions, disrupt insurance markets and shove Republicans into a renewed civil war over their efforts to shred "Obamacare."

Defiant Democrats, convinced they have important leverage, promised to press for a bipartisan deal to restore the money by year's end. That drive could split the GOP. On one side: pragmatists seeking to avoid political damage from hurting consumers. On the other: conservatives demanding a major weakening of the Affordable Care Act as the price for returning the money.

"The American people will know exactly where to place the blame," declared Senate Minority Leader Chuck Schumer, D-N.Y., all but daring Trump to aggravate what could be a major issue in the 2018 congressional elections.

The money goes to companies for lowering out-of-pocket costs like co-payments and deductibles for low- and middle-income customers. It will cost about $7 billion this year and help more than 6 million people.

Ending the payments would affect insurers because President Barack Obama's law requires them to reduce their poorer customers' costs. Carriers are likely to recoup the lost money by increasing 2018 premiums for people buying their own health insurance policies.

The National Association of Insurance Commissioners estimates that Trump's move would produce a 12 percent to 15 percent upsurge in premiums, while the nonpartisan Congressional Budget Office has put the figure at 20 percent. That's on top of premium increases from growing medical costs.

Medical organizations as well as the U.S. Chamber of Commerce, the country's largest business group, joined Saturday in a letter to House and Senate leaders imploring Congress to restore the payments. Without congressional action, the letter said, "millions will face higher premiums, fewer choices, and less access to the medical care they need."

The insurance industry behemoths America's Health Insurance Plans and Blue Cross Blue Shield Association signed the letter, along with the American Medical Association, the American Academy of Family Physicians, the leading hospital associations and more.

Experts say the political instability over Trump's effort to undermine Obama's health care law could also prompt more insurers to leave markets. As Trump frequently points out, next year about half of U.S. counties will have only one insurer on "Obamacare's" online marketplaces, up from the one-third of counties with one carrier in 2017.

Trump relished his latest blow against the law he pledged to repeal during his presidential campaign, only to see the effort crash in the GOP-run Senate this summer. He's long derided the subsidies as bailouts to insurers, even though the payments and the cost reductions for consumers are required by law.

The scrapping of subsidies would affect millions more consumers in states won by Trump last year, such as Florida, Alabama and Mississippi, than in states won by Democrat Hillary Clinton. Nearly 70 percent of the 6 million who benefit from the cost-sharing subsidies are in states that voted for the Republican.

"Congress, they forgot what their pledges were," Trump told religious conservative activists Friday, recalling GOP candidates' repeated vows to repeal Obama's law. "So we're going a little different route. But you know what? In the end, it's going to be just as effective, and maybe it will even be better."

He later reiterated his belief that his move would press Democrats to bargain over major changes in the law and said, "There's going to be time to negotiate health care that's going to be good for everybody."

Trump's move was hailed by conservative groups, including Heritage Action for America and Freedom Partners, backed by the Koch brothers. Rallying against it were medical and consumer organizations as well as the chamber.

Nineteen Democratic state attorneys general are suing Trump over the stoppage. Attorneys general from California, Kentucky, Massachusetts and New York were among those who filed the lawsuit in federal court in California to stop Trump's attempt "to gut the health and well-being of our country."

A federal judge has found that Congress never properly approved the payments. The subsidies have continued under Obama and Trump until now, despite prior Trump threats to block them.

Schumer told reporters that Trump's "threats and bullying are not going to work." He said he saw a good chance of forcing money for the cost-sharing reductions into a massive spending bill Congress is expected to approve late this year.

Democrats think Trump would have little clout to block a bipartisan deal, citing support for the payments by some Republicans and polls suggesting the public would fault the GOP for any failure. Some Republicans privately agree.

"Now, President Trump has his fingerprints all over the knife," said Maryland Sen. Chris Van Hollen, who heads Senate Democrats' campaign committee.

In a survey released Friday by the nonpartisan Kaiser Family Foundation, 7 in 10 - , including nearly half of Republicans - said the administration should help Obama's law work, not undermine it. The same foundation conducted an August poll finding 6 in 10 people would blame Trump and the GOP for future health care woes.

Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., have been seeking a deal that Alexander said in a recent interview would reinstate the payments for two years. He said in exchange, Republicans want "meaningful flexibility for states" to offer lower-cost insurance policies with less coverage than Obama's law mandates.

Republicans are divided over that effort.

Rep. Mark Meadows, R-N.C., who leads the conservative House Freedom Caucus, said in an interview that he's willing to back the payments if they're "part of a transition from Obamacare to something else" with greater state flexibility than Alexander and Murray are discussing. Another conservative leader, Rep. Mark Walker, R-N.C., said "under no circumstance" should the payments be revived.

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President Donald Trump's decision to end a provision of the Affordable Care Act that was benefiting roughly 6 million Americans helps fulfill a campaign promise, but it also risks harming some of the very people who helped him win the presidency.

Nearly 70 percent of those benefiting from the so-called cost-sharing subsidies live in states Trump won last November, according to an analysis by The Associated Press. The number underscores the political risk for Trump and his party, which could end up owning the blame for increased costs and chaos in the insurance marketplace.

The subsidies are paid to insurers by the federal government to help lower consumers' deductibles and co-pays. People who benefit will continue receiving the discounts because insurers are obligated by law to provide them. But to make up for the lost federal funding, health insurers will have to raise premiums substantially, potentially putting coverage out of reach for many consumers.

Some insurers may decide to bail out of markets altogether.

"I woke up, really, in horror," said Alice Thompson, 62, an environmental consultant from the Milwaukee area who purchases insurance on Wisconsin's federally run health insurance exchange.

Thompson, who spoke with reporters on a call organized by a health care advocacy group, said she expects to pay 30 percent to 50 percent more per year for her monthly premium, potentially more than her mortgage payment. Officials in Wisconsin, a state that went for a Republican presidential candidate for the first time in decades last fall, assumed the federal subsidy would end when they approved premium rate increases averaging 36 percent for the coming year.

An estimated 4 million people were benefiting from the cost-sharing payments in the 30 states Trump carried, according to an analysis of 2017 enrollment data from the U.S. Centers for Medicare and Medicaid Services. Of the 10 states with the highest percentage of consumers benefiting from cost-sharing, all but one - Massachusetts - went for Trump.

Kentucky embraced former President Barack Obama's Affordable Care Act under its last governor, a Democrat, and posted some of the largest gains in getting its residents insured. Its new governor, a Republican, favors the GOP stance to replace it with something else.

Roughly half of the estimated 71,000 Kentuckians buying health insurance on the federal exchange were benefiting from the cost-sharing subsidies Trump just ended. Despite the gains from Obama's law, the state went for Trump last fall even as he vowed to repeal it.

Consumers such as Marsha Clark fear what will happen in the years ahead, as insurers raise premiums on everyone to make up for the end of the federal money that helped lower deductibles and co-pays.

"I'm stressed out about the insurance, stressed out about the overall economy, and I'm very stressed out about our president," said Clark, a 61-year-old real estate broker who lives in a small town about an hour's drive south of Louisville. She pays $1,108 a month for health insurance purchased on the exchange.

While she earns too much to benefit from the cost-sharing subsidy, she is worried that monthly premiums will rise so high in the future that it will make insurance unaffordable.

Sherry Riggs has a similar fear. The Fort Pierce, Florida, barber benefits from the deductible and co-pay discounts, as do more than 1 million other Floridians, the highest number of cost-sharing beneficiaries of any state.

She had bypass surgery following a heart attack last year and pays just $10 a visit to see her cardiologist and only a few dollars for the medications she takes twice a day.

Her monthly premium is heavily subsidized by the federal government, but she worries about the cost soaring in the future. Florida, another state that swung for Trump, has approved rate increases averaging 45 percent.

"Probably for some people it would be a death sentence," she said. "I think it's kind of a tragic decision on the president's part. It scares me because I don't think I'll be able to afford it next year."

Rates already were rising in the immediate aftermath of Trump's decision. Insurance regulators in Arkansas, another state that went for Trump, approved premium increases on Friday ranging from 14 percent to nearly 25 percent for plans offered through the insurance marketplace. Had federal cost-sharing been retained, the premiums would have risen by no more than 10 percent.

In Mississippi, another state Trump won, an estimated 80 percent of consumers who buy coverage on the insurance exchange benefit from the deductible and co-pay discounts, the highest percentage of any state. Premiums there will increase by 47 percent next year, after regulators assumed Trump would end the cost-sharing payments.

The National Association of Insurance Commissioners has estimated the loss of the subsidies would result in a 12 percent to 15 percent increase in premiums, while the nonpartisan Congressional Budget Office has put the figure at 20 percent. Experts say the political instability over Trump's effort to undermine Obama's health care law could prompt more insurers to leave markets, reducing competition and driving up prices.

Trump's move concerned some Republicans, worried the party will be blamed for the effects on consumers and insurance markets.

"I think the president is ill-advised to take this course of action, because we, at the end of the day, will own this," Republican Rep. Charlie Dent of Pennsylvania said Friday on CNN. "We, the Republican Party, will own this."

Dent is not running for re-election.

In announcing his decision, Trump argued the subsidies were payouts to insurance companies, and the government could not legally continue to make them. The subsidies have been the subject of an ongoing legal battle because the health care law failed to include a congressional appropriation, which is required before federal money can be spent.

The subsidies will cost about $7 billion this year.

Many Republicans praised Trump's action, saying Obama's law has led to a spike in insurance costs for those who have to buy policies on the individual market.

Among them is Republican Rep. Andy Biggs of Arizona, a state Trump won. An estimated 78,000 Arizonans were benefiting from the federal subsidies for deductibles and co-pays.

"While his actions do not take the place of real legislative repeal and revitalization of free-market health care, he is doing everything possible to save Americans from crippling health care costs and decreasing quality of care," Biggs said.

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Cassidy reported from Atlanta, Georgia. Hoyer, an AP data journalist, reported from Washington, D.C.

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Associated Press writers Jeff Amy in Jackson, Mississippi; Scott Bauer in Madison, Wisconsin; Kelli Kennedy in Fort Lauderdale, Florida; Philip Marcelo in Boston; and Kevin Vineys in Washington, D.C., contributed to this report.

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Follow Cassidy on Twitter at http://twitter.com/AP_Christina and Hoyer at https://twitter.com/MeghanHoyer .

Associated Press writers Ken Thomas and Jill Colvin contributed.

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