Tuesday, October 03, 2017

Trump is destroying Obamacare

Kevin Drum

The ACA is London after the Blitz:

Trump administration sabotage of the ACA has done serious damage and will likely do more. Uncertainty over CSR[Cost Share Reduction] reimbursement and enforcement of the individual mandate have themselves driven premiums up by over 20% in 2018 (Gaba's estimate) and driven many insurers out of the individual market.

Those premium hikes will probably knock several million unsubsidized buyers out of the individual market. Weakened mandate enforcement, real or perceived, will probably reduce the number of people enrolled not only in the individual market but also in employer-sponsored insurance and Medicaid. 

An increased percentage of unsubsidized enrollees in the individual market who do stay in will probably be underinsured, pushed into bronze plans and/or overburdened by the combination of rising premiums and out-of-pocket costs. 

Poor-to-nonexistent outreach from HHS may result in many current marketplace enrollees failing to shop anew and so re-enrolling in a suboptimal plan. Trump's threat to issue an executive order that reportedly would empower association health plans to evade state regulation via ERISA[Employee Retirement Income Security Act] could bleed health enrollees out of the individual market.

Red states, meanwhile, are lining up to accept HHS's invitation to propose work requirements, time limits and more frequent enrollment redeterminations on Medicaid enrollees, which will likely inhibit/reduce Medicaid takeup...

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