Washington Times (DC)
Governors want President Donald Trump to keep from destabilizing
the health insurance marketplaces.
State officials begged the Trump
administration Wednesday to keep making critical Obamacare payments to
insurers, but the White House refused to offer any long-term commitment,
heightening uncertainty as health plans begin to set their rates for 2018.
The relatively arcane payments have
again become a surprising flash point in Washington's fight over health care,
with insurers saying they could raise premiums by more than 20 percent if they
don't have assurances they'll continue to get taxpayers' money.
California's insurance commissioner
said a 12.5 percent premium raise already expected for next year would likely
double if President Trump halts what's known as cost-sharing payments.
The National Governors Association
said markets already reeling from dwindling choices and rising costs can't
handle the additional uncertainty Mr. Trump is causing.
"The Administration has the
opportunity to stabilize the health insurance market across our nation and
ensure that our residents can continue to access affordable health care
coverage," said Virginia Gov. Terry McAuliffe, a Democrat, and Massachusetts
Gov. Charlie Baker, a Republican.
Mr. Trump allowed Treasury to make
last month's payment but hasn't committed to anything beyond that.
"We've said, from the very
beginning, the time that he got into office, that we'd look at these on a
month-by-month basis. And that position has not changed," White House
Budget Director Mick Mulvaney told CNN.
Mr. Trump has suggested he might yank
the payments as a way to pressure Capitol Hill to take another stab at
repealing and replacing Obamacare.
Congress has never approved the
payments, and when President Obama made them anyway, the GOP-led
House took him
to court. A judge ruled the payments illegal but has stayed her decision while
it's under appeal.
A federal appeals court late Tuesday
said more than a dozen Democratic state attorneys general may step in and
defend the payments should Mr. Trump attempt to drop the case.
Analysts said the judges' order,
which highlighted the Trump team's "accumulating public statements"
about no longer representing the states' interest in preserving the payments,
will make it harder for Mr. Trump to blame any decision to cut off the money on
the court's prior ruling.
"The legal question is still
open, and if the president decides to end the payments, it will be his own
decision, which will likely be challenged in another lawsuit and may possibly
be stopped by the appellate court if the states ask it to stay any termination
of the CSRs pending a determination on the merits," said Timothy Jost, a
law professor at Washington and Lee University in Virginia who closely tracks
the 2010 health law.
Last weekend, White House counselor
Kellyanne Conway said Mr. Trump would make a decision on whether to continue
the payments this week. It hasn't happened yet.
"We will keep you posted when we
have a final announcement on that," White House press secretary Sarah
Huckabee Sanders told reporters Wednesday.
The governors association said it
needs an answer soon, because insurers are trying to set rates for 2018 by
mid-September.
"It is critically important to
provide insurers and states with certainty that CSRs will be funded," they
said as the fight shifts from Capitol Hill to the states.
Congressional Republicans, weary from
the health care fight, largely have moved on to tax reform and other business
ahead of a lengthy August recess.
Senate Health Committee Chairman
Lamar Alexander said he will push for a bipartisan, short-term bill to
stabilize the individual insurance markets when lawmakers return in September,
as exchange customers in 20 counties across Nevada, Indiana and Ohio face the
prospect of having no choices at all next year.
The Tennessee Republican said the
cost-sharing payments should be funded, at least temporarily, as part of those
efforts.
But some conservatives are still
fuming about the GOP's failure to dismantle Obamacare after seven years of
campaign promises to kill the 2010 law. They want to keep trying.
"I think it would be a serious
mistake to bail out the insurance companies instead of honoring our promise to
repeal Obamacare and provide real relief for the millions of Americans who have
been hurt by Obamacare," Sen. Ted Cruz, Texas Republican, told reporters
Wednesday.
White House officials said Mr. Trump
supported the payments as a stop-gap measure to get to a GOP replacement, but
isn't keen on them after Republicans failed to put a repeal bill on his desk.
Mr. Mulvaney said "the
president's attitude is fairly simple: If people are suffering, and they are,
and they will continue to suffer because we have not repealed or replaced
Obamacare, why shouldn't insurance companies similarly suffer?"
For their part, insurers say they do
not profit from the payments and are seeking what they're owed under the
contours of the law, which directed the federal government to reimburse
participating health plans.
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