Charles Gaba's blog

 

(sigh) Yes, this is the second time I've used the same headline and clip.

According to The Hill, just moments ago:

WH to Dems: We’ll continue paying ObamaCare subsidies

The Trump administration has told Democrats it will continue paying controversial ObamaCare insurer subsidies, lowering fears that a fight over the issue could cause a government shutdown.

The move marks something of a shift for President Trump, who had threatened earlier this month to withhold the subsidies, known as cost-sharing reductions, as a way to move Democrats to negotiate on a healthcare overhaul.

"A shift"? He shifts so often he should be in the next Fast & Furious movie.

Rep. Tony Cardenas (D-Calif.), for one, said Wednesday that he doesn’t trust the president enough to take him at his word.

You don't say.

The Kaiser Family Foundation took a national survey from March 28 - April 3 (the week following the GOP's first failed attempt to pass their Trumpcare bill), and included among the questions they asked was this one:

With the future of any other replacement plans uncertain, this month’s survey also gauges who the public views as responsible for the 2010 health care law going forward. A majority (61 percent) of the public say that because President Trump and Republicans in Congress are in control of the government, they are now responsible for any problems with the ACA moving forward. About three in ten Americans (31 percent) say that because President Obama and Democrats in Congress passed the law, they are responsible for any problems with it.

UPDATE 7/17/17: Dusting it off AGAIN because with the Senate GOP's #BCRAP replacement bill supposedly dead, Mitch McConnell is now claiming he's gonna go back to "Repeal/Delay", while Trump is once again threatening to simply "let Obamacare fail completely"...which CSR sabotage would definitely be a part of. Simply substitute the month of "AUGUST" for "MAY" in the entry below.

UPDATE 7/29/17: OK, BCRAP is dead but now Trump is really pissed off and is openly promising (not just threatening) to cut off CSR payments starting in August, which means the following scenario could kick in effective SEPTEMBER.

 

(sigh) Yes, this is the third time I've used the exact same clip from "Dead Again". That's no coincidence; Zombie Trumpcare keeps shuffling back every few weeks, but this time they appear to actually be serious about it (again).

Others have already written up more detailed explainers on the latest changes, so I'm not gonna go into too much detail, but Sarah Kliff of Vox wraps it up nicely:

Republicans’ new health amendment lets insurers charge sick people more, cover less

Here's the basics: In addition to (or in revised versions of) everything awful about the AHCA ("American Health Care Bill") which gave it a mere 17% approval and led to it being yanked off the House floor mere moments before it was scheduled to be voted on, the new version also includes the following:

Presented without comment other than to say "My, how things have changed..."

In strategy and substance, the American public disagrees with the course that President Trump and congressional Republicans are pursuing to replace the Affordable Care Act with conservative policies, according to a new Washington Post-ABC News poll.

Large majorities oppose the ideas at the heart of the most recent GOP negotiations to forge a plan that could pass in the House.

...Public sentiment is particularly lopsided in favor of an aspect of the current health-care law that blocks insurers from charging more or denying coverage to customers with medical conditions. Roughly 8 in 10 Democrats, 7 in 10 independents and even a slight majority of Republicans say that should continue to be a national mandate...

A couple of weeks back, the Kaiser Family Foundation crunched the numbers to see just how much insurance carriers would likely raise their full-price premiums on individual market policies to make up for lost CSR assistance reimbursements in the event that Donald Trump makes good on his threat to discontinue them. Their conclusion?

A new Kaiser Family Foundation analysis finds that the average premium for a benchmark silver plan in Affordable Care Act (ACA) marketplaces would need to increase by an estimated 19 percent for insurers to compensate for lost funding if they don’t receive federal payment for ACA cost-sharing subsidies.

Again, that's an average onf 19% on top of whatever the carriers would otherwise be increasing rates for other reasons.

This has been confirmed by a separate report from the American Academy of Actuaries, which draws the same conclusion:

(sigh) Over at the Arkansas Times, healthcare reporter extraordinaire David Ramsey has the skinny on the latest mucking around with ACA Medicaid expansion being attempted by GOP Gov. Asa Hutchinson and the state Republican leadership:

The feds would have to approve the state's waiver proposal in order to enact the governor's plan, but the feds will only move forward if legislation is already in place. That's the reason for the special session: The governor will ask the legislature to pass laws granting him the authority to seek the waiver and his plan will be spelled out, in broad terms, in legislative language in these laws. Most expect that the governor will be able to get legislative approval relatively easily (he needs a simple majority). Note that some of the fine print will still have to wait for the state's actual waiver proposal and the terms and conditions if the Trump administration grants the waiver.

Here are some of the changes that Hutchinson will be pushing in the special session:

 

I used to write about Kentucky quite a bit shortly after incoming GOP Governor Matt Bevin made good on his promise to disassemble their beloved and award-winning "kynect" state ACA exchange. I haven't written much about the state since then, however, until now.

Bevin made two major campaign promises while running to replace former Democratic Governor Steve Beshear (who expanded Medicaid and established kynect via executive order): He said he'd kill kynect and get rid of ACA Medicaid expansion. He stuck to his guns on the former, and while it's a damned shame that he did so for a number of reasons (it was working perfectly well, had a high public image and awareness, etc), it didn't cause too much damage, since KY simply shifted to the federal exchange instead (HealthCare.Gov). Enrollment did drop off by over 13% year over year, but a few other states saw similar drops, so the move probably wasn't a major factor.

As I posted yesterday, here's a rough overview of what total Individual Market Enrollment has looked like since 2010, and how Trump's threat to cut-off CSR reimbursements would impact it:

The blue section is off-exchange enrollees...around 7 million people today, all of whom are paying full price. This includes perhaps 1.8 million people still enrolled in Grandfathered or Transitional plans (which are part of a separate risk pool), although that number is highly speculative.

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