Editors' pickPolitics

A classic scam?

A classic scam?

by Tom Sullivan

 

It’s a classic scam. Stores artificially inflate prices in advance of a “sale” so they can brag how much they’ve slashed prices to lure customers. Is that the point of the White House‘s concerted efforts to sabotage Obamacare? Drive up premiums so high that any GOPish replacement looks cheaper? That would be in character, although with the sitting president using that term is being generous.

He may not be much for political strategy, but scams? Donald knows scams. But mostly he’s obsessed with undoing any of his predecessor’s accomplishments.

Health insurance is on the brain this morning because of the notice from BlueCross BlueShield that they’re replacing our old, grandfathered policy with a shiny new one with a 377% premium increase.

Premium increases in North Carolina that average 14.1 percent come on the heels of a move by the sitting president to curtail subsidy payments to insurers under Obamacare. Associated Press called the decision “likely to roil insurance markets.” Buyers in the individual market, AP reported, “could face prohibitive increases.” (See previous paragraph.)

Drive up the number of uninsured

A Gallup survey released Friday showed an uptick in the uninsured rate for the first time since the sitting sitting president took office. The rate has jumped 1.4 percent, reversing the record low rates under the Obamacare program. Gallup reports:

The uninsured rate, measured by Gallup and Sharecare since 2008, had fallen to a record low of 10.9% in the third and fourth quarters of 2016. However, the 1.4-point increase in the percentage of adults without health insurance since the end of last year represents nearly 3.5 million Americans who have entered the ranks of the uninsured.

Still, the uninsured rate remains well below its peak of 18.0% measured in the third quarter of 2013, prior to the implementation of the Affordable Care Act’s (ACA) mandated healthcare exchanges and the associated requirement that all adults have health insurance or be subject to a fine.

Two reasons Gallup suggests for the reversal: a decline in competition in some regions and uncertainty about the fate of the health care law itself.

The Los Angeles Times’ Michael Hiltzik writes:

Make no mistake: Those are related phenomena, and they place the blame squarely with Trump and his GOP colleagues on Capitol Hill. One reason that insurance companies have been backing away from the exchanges is that Trump has continually threatened to undermine the law in every way possible. For months he threatened to cancel reimbursements due insurers for cost-sharing reductions they are required by law to offer low-income buyers; he finally followed through on that threat Oct. 12, raising the prospect of billions of dollars in losses for insurers this year.

The GOP’s efforts to repeal the Affordable Care Act this year have failed in Congress but have left a miasma of confusion among consumers. The confusion is about more than merely whether the government would enforce the individual mandate, which requires all households to carry health coverage or pay a penalty; it’s about whether the exchange plans would even continue to exist, and how much they would cost.

Should the uninsured rate and premiums jump up in the short term, the man with the fake university can blame it on the inherent awfulness of Obamacare. Any later move on the sitting president’s part that lowers them again modestly will be spun as a triumph.

We will be shopping, of course. But the sitting president has made that more difficult as well. By cutting the annual enrollment period in half, cutting the budget for ACA navigators almost in half, and by closing the ACA exchanges on Sunday, the administration has added another wrinkle to renewing coverage. The Washington Post explains:

The complication arises when people who already have health plans under the law are automatically re-enrolled in the same plan. In the past, a few million consumers each year have been auto-enrolled and then were sent government notices encouraging them to check whether they could find better or more affordable coverage.

This time, according to a federal document obtained by The Washington Post, the automatic enrollment will take place after it is too late to make any changes. Auto-enrollment will occur immediately after the last day of the ACA sign-up season, which the Trump administration has shortened, leaving the vast majority of such consumers stranded without any way to switch to a plan they might prefer.

Unfaithful stewardship

Abbe Gluck from the Solomon Center for Health Law and Policy at Yale Law School believes these moves by the administration violate the law, or at least his duty to “take Care that the laws be faithfully executed.” The sitting president’s “intentional, multi-pronged sabotage of the ACA” is not merely permissible exercise of executive prerogative:

Trump’s strangulation of broad parts of the ACA does not stem from his decision to prioritize what he views as other, more important sections of the law. No budgetary or policy justification has been offered by the White House for canceling enrollment support; nor has anyone claimed taxpayers will be saved money. In fact, the Congressional Budget Office estimates that the president’s efforts to shut down cost-sharing reduction payments to insurance companies will cost the federal government almost $200 billion. […]

Motive matters, with respect to whether the president exercises his power legally. If the president exercises his discretion to further the purpose of a statute, he complies with the take care clause. If he uses his power pretextually or unreasonably, he violates the Constitution. President Trump’s motives are unambiguous.

Like he cares?

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