{"id":47402,"date":"2017-10-14T05:30:02","date_gmt":"2017-10-14T05:30:02","guid":{"rendered":"https:\/\/www.biphoo.com\/bipnews\/?p=47402"},"modified":"2017-10-14T05:30:02","modified_gmt":"2017-10-14T05:30:02","slug":"end-health-care-subsidies-puts-congress-tight-spot","status":"publish","type":"post","link":"https:\/\/www.biphoo.com\/bipnews\/news\/end-health-care-subsidies-puts-congress-tight-spot.html","title":{"rendered":"End to Health Care Subsidies Puts Congress in a Tight Spot"},"content":{"rendered":"

End to Health Care Subsidies Puts Congress in a Tight Spot<\/span><\/strong><\/span><\/h2>\n

End to Health Care Subsidies Puts Congress in a Tight Spot:- President Trump\u2019s decision to cut off critical payments to health insurance companies ratcheted up the pressure on Congress on Friday to take action to protect consumers from soaring premiums, while also adding a combustible new issue to negotiations to avert a government shutdown this year.<\/span><\/p>\n

Mr. Trump\u2019s move, announced Thursday night, could cause chaos in insurance markets, sending insurers fleeing from the Affordable Care Act\u2019s marketplaces, raising the federal government\u2019s costs and pricing out some consumers. It came just hours after he signed an executive order that also undermined the health law by encouraging the development of lower-cost insurance policies not subject to the Affordable Care Act\u2019s rigorous coverage standards.<\/span><\/p>\n

But the president suggested on Friday that he was trying to get Democrats to the negotiating table.<\/span><\/p>\n

\u201cIf the Democrats were smart, what they\u2019d do is come and negotiate something where people could really get the kind of health care that they deserve,\u201d Mr. Trump told reporters, insisting that the subsidies were \u201cmaking insurance companies rich.\u201d<\/span><\/p>\n

He kept up the drumbeat on Friday night, writing on Twitter:<\/span><\/p>\n

The subsidies, known as cost-sharing reduction payments, go to insurance companies to offset the cost of reducing out-of-pocket expenses like deductibles and co-payments for low-income customers. Under the Affordable Care Act, insurers will still have to help those customers, but without the help of Washington, they say, they will increase premiums. And with their profits squeezed, they could abandon the marketplaces.<\/span><\/p>\n

Even before Mr. Trump\u2019s decision, Senators Lamar Alexander, Republican of Tennessee, and Patty Murray, Democrat of Washington, were working on legislation to extend the subsidies, paired with other measures to offer states more flexibility regulating health plans offered under President Barack Obama\u2019s health law.<\/span><\/p>\n

But Republicans in Congress are divided. Some worry that ending the subsidies would hurt their constituents. Others are loath to do anything that could be seen as propping up the health law that they had promised to tear down.<\/span><\/p>\n

For their part, Democrats are convinced that any blame for rising premiums and shrinking choices will fall on Republicans, who now control the White House and Congress. After spending the year trying to preserve the Affordable Care Act, Democrats did not appear ready on Friday to make major concessions.<\/span><\/p>\n

\u201cUnless our Republican colleagues act, the American people will know exactly where to place the blame when their premiums shoot up and when millions lose coverage,\u201d said Senator Chuck Schumer of New York, the Democratic leader.<\/span><\/p>\n

The uncertainty over the payments to insurers has loomed over Congress for months, but Mr. Trump\u2019s action is forcing lawmakers to confront the issue head on less than three weeks before the start of the annual open enrollment season under the Affordable Care Act.<\/span><\/p>\n

Even with the president\u2019s move, it was far from clear whether lawmakers could agree on steps to continue the payments. The negotiations between Mr. Alexander and Ms. Murray had stalled over how much latitude to give states seeking waivers from requirements of the Affordable Care Act.<\/span><\/p>\n

Still, Ms. Murray expressed optimism and called on Republican leaders to support the efforts.<\/span><\/p>\n

About seven million people benefit from the cost-sharing subsidies. The president\u2019s decision, by destabilizing insurance markets and driving up premiums, could adversely affect millions of others who buy insurance on their own and do not receive federal subsidies, health policy experts said.<\/span><\/p>\n

Representative Tom Reed, Republican of New York and co-chairman of a bipartisan group of lawmakers called the Problem Solvers Caucus, said Mr. Trump\u2019s decision \u201cincreased the stakes\u201d for Congress. More than two months ago, Mr. Reed\u2019s group offered a series of proposals to shore up insurance markets, including funding the subsidies.<\/span><\/p>\n

\u201cIt\u2019s only going to get worse as this marketplace continues to destabilize,\u201d Mr. Reed said. \u201cIf we stay where we are and do nothing, I think this is going to be a pox on all of our houses.\u201d<\/span><\/p>\n

Representative Mark Meadows, Republican of North Carolina and the chairman of the hard-line conservative House Freedom Caucus, said he had been in discussions with other Republicans over proposals to drive down premiums that could be tied to a continuation of the subsidies for insurers.<\/span><\/p>\n

\u201cThe fundamental question is, what do you get in terms of relief for insurance premiums and health care costs, broadly, in exchange for continuing a bailout to the insurance companies in the short run or long run?\u201d Mr. Meadows said.<\/span><\/p>\n

As lawmakers mulled how to move forward, doctors, hospitals, insurers, state insurance commissioners and advocates for patients denounced Mr. Trump\u2019s decision.<\/span><\/p>\n

\u201cOur patients will ultimately pay the price,\u201d said Dr. David O. Barbe, the president of the American Medical Association. \u201cWe urge Congress to accelerate its efforts to reinstate these payments before further damage is done.\u201d<\/span><\/p>\n

Governors also weighed in, expressing alarm at the termination of the subsidies. \u201cWe are deeply concerned that the administration has declined to continue these payments, further increasing uncertainty for state marketplaces,\u201d the National Governors Association said.<\/span><\/p>\n

Gov. Brian Sandoval of Nevada, a Republican, told The Nevada Independent that the president\u2019s decision was \u201cgoing to hurt kids.\u201d He continued: \u201cIt\u2019s going to hurt families. It\u2019s going to hurt individuals. It\u2019s going to hurt people with mental health issues. It\u2019s going to hurt veterans. It\u2019s going to hurt everybody.\u201d<\/span><\/p>\n

The attorneys general of 18 states, including California, Massachusetts and New York, filed suit on Friday to prevent any interruption in the payments.<\/span><\/p>\n

But the Trump administration insisted that a federal district judge was right in ruling last year that the payments were unconstitutional because Congress never explicitly provided money for them.<\/span><\/p>\n

\u201cCongress has the power of the purse, and it is up to Congress to decide which programs it will and will not fund,\u201d Attorney General Jeff Sessions said in a legal opinion, adding: \u201cThe executive branch cannot unilaterally spend money that Congress has not appropriated.\u201d<\/span><\/p>\n

The cost-sharing subsidies are available to people with incomes of 100 percent to 250 percent of the federal poverty level, or about $12,060 to $30,150 a year for an individual.<\/span><\/p>\n

\u201cCost sharing reductions are critical to low income Americans,\u201d Representative Carlos Curbelo, Republican of Florida, wrote on Twitter. \u201cCongress should guarantee their funding through the appropriations process.\u201d<\/span><\/p>\n

In fact, the consequences of the president\u2019s action would ripple through the individual market. The premium increases would be felt most by middle-class consumers who do not qualify for federal aid with either their premiums or their out-of-pocket costs.<\/span><\/p>\n

The government\u2019s costs are also likely to rise, since subsidies to purchase insurance through the marketplaces increase as premiums rise. The Congressional Budget Office said in August that if the cost-sharing subsidies were cut off, premiums would shoot up 20 percent next year, and federal budget deficits would increase by $194 billion in the coming decade.<\/span><\/p>\n

Yet conservative Republicans made clear they have no appetite for providing billions of dollars to insurers.<\/span><\/p>\n

\u201cUnder no circumstance should Congress attempt to expand Obamacare by cutting a check for President Obama\u2019s bailout of insurance companies,\u201d said Representative Mark Walker of North Carolina, the chairman of the conservative Republican Study Committee.<\/span><\/p>\n

Representative Dave Brat, a conservative Republican from Virginia, said Mr. Trump was simply correcting a \u201cconstitutional error\u201d made by the Obama administration.<\/span><\/p>\n

Mr. Brat said he did not want to provide money for the subsidies because they would just \u201cprop up a failing system in which the government coerces people to buy gold-plated insurance policies that no one can afford.\u201d<\/span><\/p>\n

The showdown increased tensions over a fiscal deadline facing lawmakers. Mr. Trump and Democrats struck a deal in September that included a stopgap spending measure to keep the government funded through Dec. 8.<\/span><\/p>\n

Now, the fate of the cost-sharing reduction payments could wind up intertwined in the negotiations over a spending measure to avert a government shutdown. Already, the contentious issue of immigration could become part of those spending talks, as Democrats are determined, in the coming months, to secure protections for the young undocumented immigrants known as Dreamers.<\/span><\/p>\n

Mr. Schumer said the coming spending measure offered a \u201cvery good opportunity\u201d to secure money for the subsidies.<\/span><\/p>\n

Source:-\u00a0https:\/\/www.nytimes.com\/2017\/10\/13\/us\/politics\/trump-congress-obamacare-insurance-subsidies.html<\/span><\/p>\n

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