The unintended consequences of Trump's sabotage

Gold plans would attract a larger share of enrollees under the policy—mostly people with income between 200 percent and 400 percent of the FPL who would have purchased a silver plan under the baseline. In addition to the larger premium tax credits under the policy, lower gross premiums would eventually contribute to higher enrollment. Under the policy, gross premiums for gold plans would eventually be lower than those for silver plans because, the agencies expect, silver plans would almost exclusively insure people with income between 100 percent and 200 percent of the FPL and (with CSRs) provide actuarial values of 87 percent or 94 percent—significantly higher than the actuarial value of around 80 percent for gold plans.

Click to expand...

California’s health insurance exchange said Wednesday it has ordered insurers to add a surcharge to certain policies next year because the Trump administration has yet to commit to paying a key set of consumer subsidies under the Affordable Care Act.

The decision to impose a 12.4% surcharge on silver-level health plans in 2018 means the total premium increase for those policies will average nearly 25%, according to Covered California.

Taxpayers, not consumers, will bear the brunt of the extra rate hike because federal premium assistance for policyholders, which is pegged to the cost of coverage, will also increase.

Click to expand...

In order to ensure carriers can continue to offer coverage in Oregon, DCBS is ordering health insurance companies offering plans on HealthCare.gov to increase their already approved silver metal tier 2018 plan rates by 7.1 percent.

Non-silver metal tier plan rates (e.g., bronze and gold) will remain unaffected.

This increase will affect plans both on and off HealthCare.gov, and will compensate for the $49 million worth of cost-sharing reduction payments that the federal government will no longer be making to Oregon insurance companies in 2018.

“These rate increases are necessary to ensure the stability of the health insurance market,” said Acting Director Straight. “Oregonians who receive financial assistance through the Marketplace will find that premium assistance will also increase, shielding them from most of the increase.”

Click to expand...

Hawkeye10 said:

And as things work even less well confidence in leadership will continue its plummet.

This does not end well, but it started way before Trump came along.

Doing things poorly.

Click to expand...

trblmkr said:

I believe that's a Trump motto. " Do it poorly or don't do it at all".

Click to expand...

Hawkeye10 said:

No, it's "Give it a try, be smart about it, and HAVE FUN!".

Click to expand...

trblmkr said:

That sounds more like spring break instructions given to a teenager.

Click to expand...

Greenbeard said:

Things are about to start getting weird.

As the CBO pointed out when they analyzed what would happen if Trump stopped the deductible-lowering subsidies, that course of action will naturally tend to bring down the relative premium of gold plans. Partly because insurers will need to jack up premiums on silver plans. And partly because, since the premium subsidies are a fixed dollar amount tagged to the price of silver plans but applicable to any metal tier plan you want, the rising premium subsidy values will tend to make gold plans cheaper for anyone eligible for a subsidy.



That should happen naturally over time, but states can step in to accelerate it and increase the amount of federal premium subsidies flowing into their marketplaces. All they have to do is find a way to make silver (and only silver) plans more expensive, and the subsidy amounts will automatically increase. And every non-silver plan gets cheaper for anyone eligible for a subsidy.

California's doing it:


And Oregon's doing it:


More states will likely move to fight back, playing off the feds to boost their residents' premium subsidies. If Congress doesn't check Trump and step in to restore the ACA to the way it's designed to work, it's going to be a wild ride.

Click to expand...

MaggieD said:

It’s not working the way it’s designed. What do you say to that?

Click to expand...

Hawkeye10 said:

Yes, and Trump knows that, and if he were here he would tell you that staying young at heart is absolutely the right move.

Trump figured this out by experimentation, and so now he is sure that he is right.

I AGREE!

Click to expand...

MaggieD said:

It’s not working the way it’s designed. What do you say to that?

Click to expand...

Greenbeard said:

It hasn't been implemented as designed. The risk mitigation features during the startup phase were deliberately destroyed by the GOP Congress, which killed some competitors entirely and drove others out. Even against those headwinds, the markets had stabilized by last year. So Trump and the GOP got to work, generating 20-30 extra percentage points of rate increase for next year out of thin air.

Click to expand...

MaggieD said:

I don’t believe that. I wouldn’t just be hearing about this now. Links?

Click to expand...

Greenbeard said:

Things are about to start getting weird.

As the CBO pointed out when they analyzed what would happen if Trump stopped the deductible-lowering subsidies, that course of action will naturally tend to bring down the relative premium of gold plans. Partly because insurers will need to jack up premiums on silver plans. And partly because, since the premium subsidies are a fixed dollar amount tagged to the price of silver plans but applicable to any metal tier plan you want, the rising premium subsidy values will tend to make gold plans cheaper for anyone eligible for a subsidy.



That should happen naturally over time, but states can step in to accelerate it and increase the amount of federal premium subsidies flowing into their marketplaces. All they have to do is find a way to make silver (and only silver) plans more expensive, and the subsidy amounts will automatically increase. And every non-silver plan gets cheaper for anyone eligible for a subsidy.

California's doing it:


And Oregon's doing it:


More states will likely move to fight back, playing off the feds to boost their residents' premium subsidies. If Congress doesn't check Trump and step in to restore the ACA to the way it's designed to work, it's going to be a wild ride.

Click to expand...

Greenbeard said:

You're just hearing about what? Trump threatening for the past eight months (during the 2018 premium-setting season) to end the critical CSR payments, and announcing last night he was doing exactly that?

This is the topic of this thread.

Click to expand...

MaggieD said:

Sorry. I didn’t understand it just happened. You mean to tell me that the Republican Congress actually passed some legislation?

Click to expand...

WASHINGTON—Nearly three weeks after Republican infighting sank an overhaul of the Affordable Care Act, President Donald Trump dug back into the battle on Wednesday, threatening to withhold payments to insurers to force Democrats to the negotiating table.

Click to expand...

Health insurers across the country are making plans to dramatically raise Obamacare premiums or exit marketplaces amid growing exasperation with the Trump administration’s erratic management of the program and its conflicting signals about the fate of aid for low-income consumers and other key issues. . .

Instead, according to many officials, it is the Trump administration that is driving much of the current instability by refusing to commit to steps to keep markets running, such as funding aid for low-income consumers or enforcing penalties for people who go without insurance.

Click to expand...

Because of policy "uncertainty" from the Trump administration that is "far outside the norm," some health insurers are considering double-digit increases to premiums in 2018, according to a new study from the Kaiser Family Foundation.

The study found that the vast majority of providers cited "uncertainty" over the individual mandate and cost sharing reductions, CSRs, as a factor in proposing increased premiums, according to preliminary rate filings in 20 states and Washington D.C.

Click to expand...

State insurance commissioners from Alaska, Pennsylvania, Tennessee, and Washington all said that Congress should continue subsidy payments to insurance companies that offer health insurance plans on the exchanges to cover cost sharing reductions (CSRs) that lower the amount that eligible consumers pay for deductibles, copays and coinsurance. They urged the committee to move quickly and meet its planned deadline of having legislation in place by the end of September to help stave off significant premium increases to be imposed by nervous insurers who may otherwise suffer the risk of substantial losses from providing coverage to disproportionate numbers of high-risk individuals.

Click to expand...

The Trump administration said Thursday that it would end the Affordable Care Act's cost-sharing reduction payments designed to help low-income Americans get health care. Not paying the subsidies, health care experts have warned, could send the health insurance exchanges into turmoil.

Click to expand...

Greenbeard said:

No, this is Trump we're talking about.

April: Trump Threatens to Withhold Payments to Insurers to Press Democrats on Health Bill


May: Health insurers plan big Obamacare rate hikes — and they blame Trump


August: Health insurers weigh double-digit premium increases amid Trump 'uncertainty': Study


September: State Insurance Commissioners Ask Senators to Continue Subsidy Payments to Insurers


Yesterday: Trump Administration To End Obamacare Subsidies For The Poor


You're a little late to the party, he's been a disaster on this all year. Trump generated huge rate hikes for 2018 on purpose and now is absurdly trying to make political hay of them.

Click to expand...

MaggieD said:

And where are Democrats? Why ARENT they at the table?

Click to expand...

Greenbeard said:

What table? These are Trump-induced crises, there's nothing to negotiate here. The solution is to stop doing what he's been doing. Oh, and reinsurance. Stop what Trump's doing, throw in a reinsurance program, and we're done.

Click to expand...

MaggieD said:

Then I guess instead of Oh-My-Godding all over the place, they should have been sending a unified message. Ya’ think?

Click to expand...

Greenbeard said:

Trump is raising your premiums 20% out of spite and you're blaming the Democrats for not "sending a unified message"?

Click to expand...

MaggieD said:

Link. If that is true, you’ve just clinched the 2018 mid-terms. Be happy.

Click to expand...

CriticalThought said:

Assuming ACA is a sinking ship, only Trump would be crazy enough to punch holes in it and believe nobody would hold him at least partly accountable when the water starts to rush in.

Click to expand...

WASHINGTON — If President Donald Trump prevails in shutting down a major "Obamacare" health insurance subsidy, it would have the unintended consequence of making free basic coverage available to more people, and making upper-tier plans more affordable.

Click to expand...

MaggieD said:

And where are Democrats? Why ARENT they at the table?

Click to expand...