Republicans are already moving in Congress to repeal the Affordable Care Act. Critics say without a replacement in place first at least 18 million people will lose their health insurance. President Trump has vowed — to the chagrin of hardcore Republicans — to make sure all Americans have health insurance.
Just how he’ll do that is a mystery worthy of master sleuth Sherlock Holmes.
What we do know is the president is already moving. One of Trump’s first acts as president is an executive order telling all federal agencies — like Health and Human Services (HHS) — with involvement in the Affordable Care Act to “ease the burden of ObamaCare."
What the order doesn’t do is tell them exactly what to do.
All it says is they are to ease the regulatory requirements of ObamaCare and do so immediately because — as Trump told reporters while signing the order — “it is imperative for the executive branch to ensure that the law is being efficiently implemented.”
Trump’s action and the actions of Congress have health insurance companies wondering how to respond. And it has grabbed the attention of the nation’s insurance commissioners. California Insurance Commissioner Dave Jones was quick to react to Trump’s executive order.
“The effect of the Executive Order will be to create uncertainty in health insurance markets as to whether the federal government will enforce critically important provisions of the Affordable Care Act. The Executive Order specifically directs federal agencies not to enforce ACA provisions that make sure that all Americans are getting health insurance so that the costs of treating sick and unhealthy Americans are spread across large enough risk pools to make it possible for private health insurers to provide health insurance,” Jones wrote in a statement.
His biggest concern is health insurers withdrawing from the nation’s exchanges. That will decrease competition and cause health insurance prices to skyrocket. “Based on my experience as the regulator of the largest insurance market in the United States, this Executive Order is likely to destabilize health insurance markets across the United States. President Trump's Executive Order also is contrary to his promise to provide health care coverage to all Americans,” Jones added.
Former Oregon Insurance Administrator and now Pennsylvania Insurance Commissioner Teresa Miller is as worried as Jones. She said several insurance companies threatened to leave her state’s exchange last year and many are currently thinking of abandoning them this year.
“That would create a nightmare scenario,” she said.
Robert Laszewski heads the consulting company Health Policy and Strategy Associates. He calls Trump’s order a “bomb” and said it will have a huge impact on an already shaky insurance market.
Republican leaders are happy with Trump’s order. The Senate’s Health, Education, Labor and Pensions Committee Chairman and Tennessee Republican Sen. Lamar Alexander said the president is “right to make the urgent work of rescuing Americans trapped in a collapsing Obamacare system a top priority on his first day in office.”
Senate Majority Leader Mitch McConnell agreed and said, “President Obama implemented a lot of Obamacare himself, so President Trump will be able to undo a lot of it himself.”
Democrats aren’t so happy and are very critical of what the Republicans and the president are doing. Senate Minority Leader Chuck Schumer of New York questions their actions. “They don’t know what to do. They can repeal, but they don’t have a plan for replace. The president’s executive order just mirrored that,” he said.
As for the health insurance insurers? As of Monday morning January 23rd, they haven’t said much. Kristine Grow of America’s Health Insurance Plans — who represents 1,300 health insurers — said they aren’t sure what to think. “There is no question the individual health-care market has been challenged from the start. The president said he would take swift action to move our country to improve it, and he has,” she said.
As for the president, Trump has been vague on what he’s going to do. He told Fox News last week, “we’re going to have a plan that’s going to be great for people.”
Okay. So, what does that mean?
Trump told The Washington Post that he wants everyone covered. As noted in the opening paragraph of this story, that has the most conservative of Republicans concerned.
“We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us,” Trump said.
It’s a statement with no details. Maybe that coverage concept will come in the form of the Medicaid block grants he’s suggested giving to states to let them implement nearly universal health insurance. “Whether it's Medicaid block grants or whatever it may be, we must make sure that people are taken care of and it's going to be a very important part to me,” Trump said.
Governors like Ohio’s Republican — and former presidential contender — John Kasich aren’t so sure of the idea. “The difference between a good block grant and a dangerous block grant is in the detail,” Kasich said in a recent letter to Congress.
Trump — and most Republicans — want to keep some of ObamaCare’s more popular laws like those regarding preexisting conditions and keeping children on a parent’s health insurance plan until they reach age 26.
One thing that is popular with Democrats is Trump’s call for giving Medicare the ability to negotiate drug prices.
But repealing the whole thing isn’t working for Democrats and for many moderate Republicans. Sen. Bill Cassidy of Louisiana and Sen. Susan Collins of Maine have what they think is a better idea than tossing the proverbial baby out with the bathwater. Their plan would — if even considered — keep ObamaCare’s taxes in place to give a replacement plan its revenue.
At that point states would have the option to keep ObamaCare, its subsidies, mandates and protections. Or opt out in which case the taxes would go to finance tax credits that is linked to Health Savings Accounts (HSA) which would give citizens in that state a more basic, less comprehensive health insurance plan.
Source links: The Hill — link 1, link 2, The Washington Post, Insurance Business America, MSN