Obamacare wars just got personal

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About 1.1 million Pennsylvanians – one in 10 under the age of 65 – are insured under the Affordable Care Act, according to state data.

As of February, more than 426,000 Pennsylvanians signed up for individual plans with more than 75 percent of them receiving financial assistance to offset premiums. Another 700,000 in the state receive health care through the Medicaid expansion which was implemented by Gov. Wolf in 2015. The rate of uninsured fell to 5.6 percent in 2016, the lowest rate on record.

New Jersey’s total enrollment is 244,000, about 52 percent of those are eligible for the subsidy assistance.

What just happened?

After  Republicans failed to follow through on a key Trump campaign promise abolishing the Affordable Health Care Act, President Trump on Thursday delivered a gut punch to Obamacare, announcing the administration would stop $9 billion in subsidized payments to insurers that enable middle- and lower-income Americans to afford coverage.

Currently, about 9 million Americans rely on Obamacare for coverage.

What does this mean?

The individual insurance market could quickly implode. Without the subsidies, premiums would soar or insurers would withdraw en masse, leaving more people without insurance.

When will this happen?

The Obama and Trump administrations had been making the subsidy payments month by month so the Trump announcement raises the possibility that the payments could be immediately halted. At the same time, the move would likely  face legal and political challenges. It also could be a gambit that Trump is floating to extract a bill from Congress.

What else is coming?

Trump laid the groundwork for easing the requirement that those opting out of insurance must pay a penalty. He would weaken the directive that policies have to provide a minimum set of benefits regardless of the patient’s health, leading to cheaper policies that could be offered by associations of small employers and wouldn’t  cover pre-existing conditions or maternity care. Another possible consequence could include measures to curb consolidation of hospitals, doctors and insurers which could drive up prices.

Most of these changes need public comment and agency reviews so it could take months for new regulations to be adopted.  The coverage next year could be unaffected, but major changes could be coming in 2019.


What Trump tweeted:
What Republican’s are saying

Sen. Lindsey Graham, R-S.C., said in a statement on Thursday he supported Trump’s executive order, in part because it accomplishes some of what he aimed to do with his own health care proposal, which failed to advance to a vote in the Senate in late September.

“This decision, combined with creating more consumer choices for health care policies, will improve quality and lower costs,” Graham said,  according to Charleston’s Post and Courier.

Republican House Leader Paul Ryan voiced his approval for the plan in a statement tweeted out by Sahil Kapur, National political reporter for Bloomberg News.
“Obamacare ha proven itself to be a fatally flawed law, and the House will continue to work with Trump administration to provide the American people with a better system,” Ryan stated.

Democrats took to social media to voice their concerns.
Reaction has been swift from those in the health care industry:

Daniel J. Hilferty, president and CEO of Independence Health Group
“We want to assure our members that their coverage remains in effect and unchanged. We are currently evaluating what this announcement may mean for individual consumer plans in the future.”

Antoinette Kraus, Executive Director of the Pennsylvania Health Access Network:
“The reckless and short-sighted decision by the Administration to end cost-sharing subsidies for 233,663 Pennsylvanians — 55 percent of all Marketplace enrollees — will leave hardworking people facing higher premiums and a chaotic insurance market. In many states, rates are certain to increase and some insurers may leave the market. In Pennsylvania, however, proactive planning on the part of the state’s Insurance Department means that no insurers will leave the market, although rates are likely to increase by a bare minimum of 20 percent.”

Andy Carter, president and CEO of The Hospital and Healthsystem Association of Pennsylvania:
“Pennsylvania’s hospital community is deeply disappointed by the President’s executive action to end the federal cost-sharing subsidies that help lower-income individuals secure health care coverage.
Under the Affordable Care Act, Pennsylvania has made great strides to lower the state’s uninsured population and improve the overall health of its residents. While we are concerned by this action, Pennsylvania’s hospital community remains committed to working with policymakers to safeguard access to high-quality health care coverage. We implore Congress to take swift, bipartisan action to protect consumers from these steep premium increases and help support a robust and competitive insurance market.”
Betsy Ryan, New Jersey Hospital Association,President and CEO
“We call on Congress to step in and swiftly complete work on a repair plan, including reauthorizing the Children’s Health Insurance Program. That critical program to protect our kids expired Sept. 30 with no action by our elected officials. This is a very troubling time for U.S. families.”

When is open enrollment?

The executive orders come three weeks before open enrollment for subsidized private insurance on Healthcare.gov begins on Nov. 1, and is set to run through Dec. 15.



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