Trump Again Calls for Repealing Obamacare


Repealing Obamacare is still on the agenda for the Trump administration.

The fiscal 2019 budget submitted to Congress calls for a two-part approach to repealing and replacing the Affordable Care Act. It would start with enacting legislation put forward in 2017 by four Republican senators led by Sen. Lindsey Graham (R-S.C.), which would repeal ACA mandates to buy insurance and cover employees and provide states with block grants to promote health-care coverage.

At the same time, the Department of Health and Human Services’s budget calls for funding payments to health insurers to cover cost-sharing reductions they are required to provide under the ACA to lower out-of-pocket costs for deductibles and copayments for low-income people who enroll in exchange plans.

The administration discontinued the cost-sharing reduction payments in 2017, citing a federal court decision that the payments were illegal without a congressional appropriation. Insurers raised premiums an estimated 20 percent on average to cover the lost payments.

But funding the CSRs for fiscal 2018, which ends Sept. 30, “doesn't make any sense at all,” Joseph Antos, a health-care analyst with the conservative American Enterprise Institute, told me.

Premiums for 2018 are already set and can't be changed, Antos said. And making the payments to insurers in 2018 would not benefit consumers.

Funding the CSRs for 2019 would make more sense since premiums haven't yet been set, Antos said. “It's a politically safe thing for the administration to do,” he said.

“If you want to get the maximum political impact, then you wait until September” to fund the CSRs, Antos said. If Democrats support it, it would be easier to pass and premiums could be lowered shortly before 2019 open enrollment starts and before the 2018 midterm elections, he said.

“Then the White House and Republicans are going say we did this, we got your premiums lower,” Antos said. “If, on the other hand, the Democrats block it, premiums won't go down and Republicans will be able to say we would have lowered your premiums but Democrats forced you to pay more.”

Read my full article here.

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