News Update for April 14, 2017
CSR Subsidy Funding Now a Top Priority for Democrats
After President Trump’s suggestions that he would use cost-sharing reduction (CSR) subsidies as a negotiating tactic, Democrats are insisting that any new healthcare spending bill should guarantee funding for subsidies. A Senate Democratic aide said, “Given [Trump’s] threat, we’ll be pushing for a robust cost-sharing reduction appropriation.”
Aside from prompting a funding requirement to be included in the next healthcare bill, Trump’s tactic of potentially withholding CSR funding has received negative criticism from Democrats.
- Senator Ron Wyden: “There is no outcome in which the administration sabotaging insurance markets persuades Democrats to pass Trumpcare, a disastrous proposal which would only make our health care system worse. When the president drops his threats on Americans’ health care — including the latest threat to withhold insurance payments, which he clearly understands puts people’s care in danger — Democrats will be prepared to work on bipartisan improvements to the Affordable Care Act.”
- Senate Democratic Leader Chuck Schumer: “Our position remains unchanged: drop repeal, stop undermining our health care system, and we will certainly sit down and talk about ways to improve the Affordable Care Act.”
- House Democratic Caucus Head Joseph Crowley: “Rather than improving our country’s healthcare system, President Trump is bent on destroying it. His most recent threat — to raise premiums for millions of Americans by withholding the law’s cost-sharing reduction payments — amounts to nothing more than political blackmail.”
Administration Finalizes Proposed Market Stabilization Rule
Late Thursday, a proposed rule aimed at stabilizing the ACA marketplace was finalized. As reported yesterday, the final rule affects outstanding premium payments and plan renewals, the open enrollment period, special enrollment verifications, and actuarial value requirements. Read the final rule document produced by the Department of Health and Human Services here.
Trump’s Statement on CSRs Concerns Health Insurance Industry
The threat of discontinuing CSRs in order to pull Democrats into negotiations is also weighing heavily on the health insurance industry. Chief Executive of Avalere Health commented on Trump’s recent statements: “This is a very potent threat, because the administration has the authority unilaterally to do this, and this is really a kill switch. This makes the program unprofitable for the majority of health plans operating in it today. The timing of this threat is really curious, in the sense that now is the time that the plans have to be deciding whether to bid on 2018. If you’re on the bubble and the president is making a threat like this … this just puts more uncertainty on the program.”
News Update for April 13, 2017
Trump Plans to Use CSR Subsidies as a Negotiation Tactic
Three administration officials told Politico that “President Donald Trump wants to use a key Obamacare subsidy program as leverage to draw Democrats to the negotiating table on health care.” During an interview with The Wall Street Journal, President Trump acknowledged his plans to use the cost-sharing reduction (CSR) subsidies to start negotiations. “I don’t want people to get hurt. What I think should happen—and will happen—is the Democrats will start calling me and negotiating,” said Trump.
Democratic Senator Chuck Schumer criticized Trump’s statements, saying, “President Trump is threatening to hold hostage health care for millions of Americans, many of whom voted for him, to achieve a political goal of repeal that would take health care away from millions more. This cynical strategy will fail.”
Healthcare Groups Write Letter to Trump, Calling on Administration to Continue CSR Payments
Healthcare industry groups wrote a direct appeal letter to the President and administration on April 12. In an excerpt from the letter, the groups state that “the most critical action to help stabilize the individual market for 2017 and 2018 is to remove uncertainty about continued funding for cost sharing reductions (CSRs).” Along with the clarity needed by insurance companies, the letter explains what will happen if CSR funding is lost.
A Proposed Rule Could Make Big Changes to the ACA Marketplace
The Trump administration has proposed a rule to try and stabilize the Marketplace. The current draft’s changes to the Affordable Care Act (ACA) Marketplace include:
- Allowing insurance companies to require customers to pay outstanding premiums before issuing a new plan. (For example: If you owe 2 months of premiums at the end of 2017, you will have to pay them before your 2018 plan begins.)
- Shortening the open enrollment period to run from November 1 through December 15. (The previous open enrollment period ran from November 1 through January 31.)
- Increasing verification before individuals may enroll in special enrollment period plans (sold outside of the normal open enrollment period).
- Increasing the allowable variation of actuarial values used in metal tier plan determination. “Bronze plans, for example, currently must cover an average of 60 percent of costs, while a silver one is 70 percent — and insurers are allowed wiggle room of plus or minus 2 percent around those averages. The Trump proposal would tweak the formula. … So, for example, a bronze plan might cover only 56 percent of costs and silver 66 percent.”
Poll Shows Support for a Single-Payer Healthcare System
In a Morning Consult/Politico poll of 1,988 registered voters, 44 percent of those polled were in favor of a single-payer healthcare system. Thirty-six percent oppose it, and 19 percent don’t know. Read here to see more on the poll and how political affiliation affected individuals’ outlooks.
News Update for April 12, 2017
Freedom Caucus Working With Paul Ryan on 2 Healthcare Reform Options
Rep. Mark Meadows, the House Freedom Caucus leader, stated Tuesday that Republicans are close to striking a deal on healthcare reform. Meadows stated that his group is waiting for Paul Ryan to contact them today about two potential options, adding during a local radio show, “We’re very close. The biggest thing for all of us is we want to make sure we don’t just have repeal, but we have a replacement that drives down insurance premiums. It’s our encouragement to have a vote as soon as we possibly can, even perhaps before we return back to DC in 13 days.”
Meadows also spoke to USA TODAY about the deal. “What I’m getting to [Ryan] is based on conversations that I’ve had with (Tuesday Group co-chairman) Tom MacArthur and leadership, but I wouldn’t say that it’s approved at this point. What we’re trying to do is work through issues that are important to all of us but make sure that pre-existing conditions are taken care of.”
CSR Subsidies Still Not in the Clear
Despite previous statements, the Department of Health and Human Services (HHS) seems to be walking back assurances for cost-sharing reduction (CSR) subsidies. HHS spokesperson Alleigh Marré gave this statement recently after a New York Times article stated that CSRs were safe during the lawsuit:
“The New York Times report is inaccurate. The administration is currently deciding its position on this matter. We have not been contacted by Democrats to help save Obamacare, perhaps because they consider Obamacare to be a losing cause. Democrats need to help solve this failed Obamacare plan. The report was in reference to the current status of the lawsuit and is not an indication of what will happen in the future. No decisions have been made about how the administration will proceed.”
Trump Interview Confirms President Isn’t Moving Past Healthcare if He Can Help It
During an interview between President Trump and Fox Business Network, Trump stated his desire to pass healthcare reform legislation before moving on to tax reform. “We’re going to have a phenomenal tax reform, but I have to do health care first. I want to do it first to really do it right.” However, he isn’t willing to hold back on tax reform if healthcare takes too long. “Now, if it doesn’t happen fast enough, I’ll start the taxes. But the tax reform and the tax cuts are better if I can do health care first.”
Moderate Republicans Calling for Bipartisanship on Healthcare Reform
Co-chair of the moderate Tuesday Group, Rep. Charlie Dent, spoke to Axios about the need for bipartisanship when trying to reform healthcare. “If we attempt to muscle this thing through on a partisan basis, I feel we’ll have a similar result … the reform won’t be durable.”
Republican Senator David Perdue also talked about the need to make a bipartisan effort to reform healthcare. “How’d the other direction work out? It didn’t work out very well when we pretty much ignored them. There’s a great chasm up there and I would argue that polarization is one of our great threats to solving a problem. I believe there’s no danger to finding a compromise solution.”
Democrats Fight Back in Battle of Ad Campaigns
A $1 million ad campaign supported by “a liberal group backed by labor and progressive interests” is targeting seven Republicans. The campaign attacks these Republicans’ support of the American Health Care Act (AHCA), utilizing growing support for Obamacare.
News Update for April 11, 2017
Ad Campaigns Target Moderates and Democrats Over Healthcare Reform During April Recess
Club for Growth, a conservative group, wants moderate Republicans to accept the most recent healthcare bill proposal. The group announced Monday that it will use a $1 million dollar ad campaign to target at least 10 moderate House Republicans. Club for Growth President David McIntosh commented on the campaign, “Our message in this ad is: Come on board, keep the promise that you and our party made to finally repeal Obamacare and lower health-care insurance costs for Americans across the board.”
The National Republican Congressional Committee (NRCC) is also using ad campaigns to target those who opposed the most recent healthcare reform draft: Democrats. NRCC is aiming at 5 Democrats with digital billboards. The billboards highlight “each Democrats’ support for Obamacare and [urge] constituents to contact their representatives.”
Lawyers Create Watchdog Group to Monitor Conversations Surrounding Obamacare
A group of lawyers have created the watchdog group called “American Oversight.” By using the Freedom of Information Act, they hope to review emails and other conversational documents between Department of Health and Human Services (HHS) officials and other agencies concerning Obamacare. Their ultimate goal is to promote transparency, discover how Obamacare decisions are being made, and “[look] for evidence of ‘sabotage.’”
“The topics they’re focusing on:
- The decision to cut back Obamacare advertising in the last week of enrollment
- Whether HHS will advertise in the next enrollment season
- What it will do about the law’s ‘essential health benefits’
- What it will do about the cost-sharing subsidies
- Any changes it might make to the Obamacare marketplaces
- What insurers have told the Trump administration about whether they’ll participate next year”
News Update for April 10, 2017
Health Insurance Companies May Start Seeing Obamacare Profits, According to S&P
Standard & Poor’s (S&P) analyzed the performance of many Blue Cross plans operating in different states. According to the analysis, these insurance companies stemmed their losses in 2016, could break even in 2017, and could make a marginal profit in 2018. S&P analysts commented on their findings: “We are seeing the first signs in 2016 that this market could be manageable for most health insurers. The market is not in a ‘death spiral.’ ”
House Republicans Defending Popular Obamacare Policies in Face of Freedom Caucus’ Demands
Many House Republicans are speaking up for popular Obamacare policies. This support is in opposition to the Freedom Caucus’ strict goal of repealing them. Coverage for pre-existing conditions, Medicaid expansion, and coverage mandates for mental health services and prescription drugs are all getting support from the middle-right.
News Update for April 7, 2017
House Goes on April Recess But Continues Healthcare Reform Talks
After last-minute amendments to the latest healthcare reform draft, the House commenced its two-week recess. The changes intended to swing the Freedom Caucus seem to be working, with Freedom Caucus chairman Rep. Mark Meadows stating positively that “the majority of the Freedom Caucus would be favorably inclined to vote for” a bill that eliminated essential health benefits, community ratings, and guaranteed issue plans. While these changes suit conservative Republicans, moderates seem less enthusiastic. Moderate GOP Rep. Leonard Lance said of the latest draft, “I favor making sure no one is denied coverage due to a pre-existing condition. So I doubt [the latest revision] would be enough.”
Despite the recess, healthcare reform talks are still in progress. House Majority Leader Kevin McCarthy warned representatives that the planned recess could be cut short. If a healthcare reform deal can be made between moderates and conservatives, representatives could be called back to vote on a new bill.
Aetna Leaves Iowa’s Marketplace
Aetna announced on Thursday that it would stop selling individual health insurance plans in Iowa, both on and off of the Affordable Care Act (ACA) Marketplace. Aetna made the decision based on “financial risk and an uncertain outlook for the marketplace.” After the Wellmark Blue Cross and Blue Shield withdraw — and now Aetna’s withdraw — from Iowa, this leaves 5 counties with two insurance options and the remaining 99 counties with only one health insurance option.
Cost-Sharing Reduction Subsidies and Medicaid: What Effects Would Funding Cuts Have?
Based on a recent Kaiser Family Foundation analysis, the loss of cost-sharing reduction (CSR) funding would lead to a 19% increase in silver tier plan premiums. “The analysis … finds that the estimated premium increase for silver plans would be higher (21%) in states that did not expand Medicaid under the ACA than in states that expanded Medicaid (15%).” And according to the Commonwealth Fund, cuts to Medicaid funding would mostly affect older and sicker individuals. “Any changes to the Medicaid program could disproportionately affect many of our neediest, sickest Americans.”