States Win Right to Join Defense of Obamacare Subsidy Payments

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Insurer participation on the Obamacare Marketplaces Carrie Dann NBC News
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05 August, 2017

But these payments aren't created to compensate insurers for business failures.

"A first critical step.is to fully fund CSRs (cost-sharing reduction payments) for the remainder of calendar year 2017 through 2018", the statement said, adding this was needed in the short-term as Congress and the administration address long-term reform efforts.

Following the failure by Senate Republican leaders to repeal the Affordable Care Act last week, a group of 40 House members, including 20 Democrats and 20 Republicans, has emerged with a proposal to help strengthen the health care law.

"If the Trump administration wanted to stop making cost-sharing payments, the easiest way to do so would be to dismiss the appeal", Bagley said.

Scott says he hopes the plan will also give individual states more flexibility to develop innovative approaches to health care. Although employer contributions vary, 72 percent is in line with what other businesses offer their employees, said John Arensmeyer, head of the Small Business Majority.

"Without payment of these cost-sharing reductions", he said, "Americans will be hurt". Margaret Murray is CEO of the Association for Community Affiliated Plans, which represents these "safety net health plans" aimed at people with lower incomes.

Insurers are scheduled to receive their next round of cost-sharing payments on August 21. If that happens, "they will either raise their rates - our plans indicate that it could be by up to 23 percent - to compensate for these losses, or they will withdraw from the markets altogether".

He elaborated in an earlier tweet, "If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies...will end very soon!" Worse, more than one-fifth of Americans live in counties where there is only one insurer or none at all offering policies on health care exchanges - and the policies typically hammer their holders with both high premiums and high deductibles.

The Obamacare exchanges require insurance policies to conform to one of four "metal" levels - bronze, silver, gold or platinum - which coincide with how much an individual is expected to pay in premiums, deductibles and other out-of-pocket expenses.

In Kentucky, according to data posted by the federal government, Anthem has requested rate increases averaging 34 percent for plans covering 69,500 people. That's because another set of subsidies, income-based tax credits that lower monthly premiums for people who quality, would go up as premiums increase. Past year about 85 percent of people who bought Obamacare insurance got a credit, according to the Center for Medicare and Medicaid Services. Insurers can't count on the money, estimated at $10 billion for next year. "I think we're probably in that position where we'll let Obamacare fail", Trump said in July.

That means subsidies will have to rise for many people to meet those higher premiums.

In the District of Columbia insurance exchange, members of Congress earn too much ($174,000/2016) to qualify for any ACA subsidies toward their premiums.

"It could be disastrous", said Norman Ornstein, a scholar at the conservative-leaning American Enterprise Institute who specializes in Congress.

"I'm heartened by the outreach of those bipartisan House members to try and get something done", said Scott. It has guaranteed coverage for those with pre-existing conditions who previously were denied care for their chronic health problems.

Senator Bill Cassidy, Republican of Louisiana, met with Health and Human Services Secretary Tom Price and several Republican state governors at the White House on Monday to discuss a proposal Cassidy and others have made to send federal healthcare funds to the states in grants, Cassidy told reporters. Ruling in their favor, U.S. District Judge Rosemary Collyer in Washington simultaneously barred the government from making those payments without that appropriation, then put her decision on hold for an anticipated Obama administration appeal.

Although it's not completely clear what Trump is talking about by suggesting Obamacare should "hurt the insurance companies", it could be a reference to an ongoing issue of whether the Trump administration will continue cost-sharing payments to insurers.


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