Healthcare News; ACA and CHIPs

October 13, 2017
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Trump’s Healthcare Executive Order

Trump Signs Executive Order relaxing ACA health insurance rules. About a week or so ago, I had read this elsewhere, mentioned it, and was told there was no way this would happen. Similar to the three attempts to defund the ACA, Trump is doing what he says the Senate could not do and that is to take healthcare insurance away from the citizenry.

More of Trump’s Executive Order down the page.

Children’s Health Insurance Program

Also if you did not know this, the Children’s Health Insurance Program is being held hostage by the House. Rather than pass a clean bill, the House Republicans added provisions to the passage of new funding. 2017 CHIP Program funding was used up during the time period when Republicans were spending inordinate amounts of time trying to defund the ACA rather than attending to other needs of the country. Some states such as Minnesota have already run out of funds to pay for the 9 million children in the US who are dependent on this program; however, nothing appears to get in the way of the House working on a Tax Reform Budget Resolution giving $billions to 1% of the households making >$500,000 annually.

One provision put in place by Michigan Congressman Fred Upton is nonsensical and strictly for show. Mind you, Fred Upton was one of two Congressmen who tampered with the Risk Corridor Program causing premiums to rise for those in the individuals market place with incomes > 400%, Coops to go bankrupt, insurance companies to lose money, and insurance companies to withdraw from the exchanges. Today Mr. Upton proposes to increase Medicare payments for those making >$500,000 annually saying it will help offset the cost of CHIPs, these oldsters can afford it, and if they do not like it . . . do not sign up for Medicare.

Upton’s statement is cold hearted and mean except for the extra $135/ month means testing the “few” would endure. In the US there is ~1 million household with incomes in excess of $1 million annually. Few of them are old enough for Medicare and the return from the Republican proposed tax reform would more than outweigh the additional $135/month.

The Impact of Trump’s Healthcare Executive Order

President Trump’s Executive Order “directs the departments of Treasury, Labor and HHS to consider expanding healthcare coverage through low-cost, short-term health plans that are exempt from Affordable Care Act insurance market rules.” The plans would:

• Be Short Term and up to 364 days as opposed to the ACA’s 90 day limit.

• Would not have to comply with the 10 categories of minimum essential benefits or accept all applicants at the same rates without regard to pre-existing medical conditions.

• Expand access to so-called association health plans allowing employers to band together in healthcare plans and cross state lines.

• Allow the expanded association plans to market to individuals across state lines.

More than likely, the impact of the Executive Order will drive up premiums for those left in the ACA, increase premiums for those with pre-existing conditions, and increase premium costs for older citizens. Much of the increase could be covered by ACA premium subsidies; but, those with incomes > 400% FPL (~10 million) in the individuals market would bear the full cost increase.

Kaiser’s Larry Levitt said; “ Association plans exempt from the ACA can cherrypick healthy people and make coverage unaffordable for those with pre-existing conditions. Insurers will leave the ACA marketplaces as soon as they can or hike premiums a lot.”

The only thing standing in the way of Trump’s Executive Order “easing the ACA’s statutory insurance market rules” from taking place is the legal challenges. As one legal expert posited; “I do not believe you can solve this problem without changing the law. It has to be done by statute, not regulation.”

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