Associated
Press February 8, 2019
WASHINGTON (AP) — A new report from the White House tries to
shift the Trump administration's combative rhetoric on health care, suggesting
changes to the Affordable Care Act under President Donald Trump do not
fundamentally undermine the health law.
Due out Friday, the report from the Council of Economic
Advisers says Obama-era subsidies that help low- and middle-income customers
pay their premiums will help keep HealthCare.gov afloat even if some healthy people
drop out or seek other coverage because of Trump's changes. Nearly 90 percent
or customers get taxpayer-provided assistance.
The report reflects the outcome of 2018 midterm elections in
which Democrats successfully campaigned on keeping the ACA and effectively
ended Trump's drive to repeal it. Democratic 2020 White House hopefuls are
seizing on health care as an issue, with some pushing for a government-run
system that would cover all Americans and replace the ACA, better known as
"Obamacare."
The council is a White House agency that advises the
president. A copy of the report was provided to The Associated Press.
Larry Levitt, of the nonpartisan Kaiser Family Foundation,
reviewed the report for the AP and said it suggests to him the administration
is trying to move on from the battle over the ACA, which Trump and Republicans
in Congress failed to repeal.
"The president seemed to take pride in undermining the
ACA, but now his administration is resisting the argument that they have
undermined the health law," Levitt said. "They can point to benefits
of deregulation but will also have to live with the costs, which include higher
premiums for middle-class people with pre-existing conditions."
The ACA has risen in popularity with the public.
The report looks at three big changes under Trump that affect
former President Barack Obama's health care law. They are congressional repeal
of the law's unpopular fines on people who go uninsured, "association
health plans" for small businesses and low-cost short-term health
insurance that doesn't have to cover basic benefits like prescription drugs.
"These reforms do not 'sabotage' the ACA but rather
provide a more efficient focus of tax-funded care to those in need," the
report says.
The report comes as House Democrats under Speaker Nancy
Pelosi, D-Calif., are moving to shore up the ACA, including trying to undo some
of Trump's insurance changes. Although such a rollback seems unlikely to
succeed under divided government, there has been bipartisan support for
measures that would help reduce premiums and guarantee coverage for
pre-existing conditions. Restoring the ad budget for HealthCare.gov
slashed by Trump is also a possibility.
About 10 million people continue to get private insurance
through the ACA's subsidized markets, or exchanges, and another 12 million are
covered by its Medicaid expansion. The GOP's drive to repeal the ACA in 2017
fell flat, and Democrats effectively blocked another try by gaining control of
the House.
Casey Mulligan, chief economist for the White House council,
said it turns out that the penalty for people going uninsured wasn't really
essential for the Obama health law to function. The subsidies were more
important.
"Removing the tax penalty and opening up more
affordable options was able to save taxpayer dollars, give families more
choice, without destabilizing the exchanges," he said.
The report didn't address constitutional arguments in a
Texas court case against the ACA brought by red-state officials. But its
economic analysis could have a bearing on that case.
The plaintiffs contend that the whole law was made
unconstitutional by congressional repeal of the fines on the uninsured. A
federal district court judge agreed, and that ruling is on appeal. The Justice
Department has said in connection with the case that it will no longer defend
the law's protections for people with pre-existing conditions.
Now the White House report undercuts the notion that the tax
penalties at issue in the case are central to the health law. Officials at the
Council of Economic Advisers said they're not policymakers or lawyers, but
economists.
The report also claims $450 billion in consumer benefits
over the next 10 years based on broader availability of less costly insurance
options, reduced taxpayer spending on subsidies and the cancelled fines. But it
acknowledges that premiums will go up for some middle- and upper-income
consumers.
Kaiser Foundation analyst Levitt said $450 billion seems
high to him.
This story
has been corrected to show the quote in the report is "reforms," not
"reports."
No comments:
Post a Comment