Trump Administration Eyeing Low-Income Subsidies in Obamacare Repeal Bill


The Trump administration would like to see health insurance subsidies for low-income people funded through the Republican Obamacare repeal bill being considered in Congress.

The administration is continuing to examine legal issues surrounding whether the cost-sharing reduction subsidies, which help low-income people pay out-of-pocket costs in Affordable Care Act exchange plans, can be paid, Brian Blase, special assistant to President Donald Trump in the National Economic Council and a health-care scholar, told me in an interview.

But, Blase said, “there's a desire” to include the subsidies in the Republican American Health Care Act (AHCA) passed May 4 by the House of Representatives.

Even with major insurers, such as Anthem Inc., assuming that the cost-sharing reduction subsidies will be continued, proposed premium increases filed for 2018 for ACA exchanges in Virginia, Delaware and Connecticut are in the range of 30 percent to 40 percent. That’s on top of premium increases in 2017 that averaged 25 percent nationwide.

The insurance markets are continuing to deteriorate, Blase said. Insurers have been losing money in the exchanges because they’re covering people who are sicker than expected, and major national insurers, such as UnitedHealth Group Inc., Aetna Inc. and Humana Inc., have pulled out of most of the exchange markets.

Blase also said funding in the AHCA for high-risk pools or reinsurance plans in states that dropped Obamacare requirements, such as coverage of a comprehensive set of benefits, would be more than adequate to cover people with pre-existing chronic conditions.

The three-year Obamacare reinsurance program provided about $6.5 billion a year while the AHCA would provide more than $12 billion a year, Blase said.

While Blase said a 30 percent surcharge included in the AHCA on people who didn’t keep continuous coverage needed to be changed in the Senate, he said the ability to get premiums down and stabilize the individual market hinges on passage of the bill.

”Any policy is not going to change the market overnight,” he said. “The hope is that eventually states get more control over their insurance markets.”

Read my full article here.

Stay on top of new developments in health law and regulation with a free trial to the Health Law Resource Center.

Learn more about Bloomberg Law and sign up for a free trial.