This past week, after plunging insurance markets further into uncertainty by cutting off the risk adjustment payments that insurers who cover a disproportionate number of sick and costly patients are owed under the Affordable Care Act, the Trump administration said, “Just kidding!”
The Department of Health and Human Services issued a final rule clarifying methodology of the program, which redistributes money between different insurance companies and costs taxpayers nothing, and announced the payments would continue. Why they couldn’t have done this all along without threatening to terminate the program is unclear.
HHS also helped shore up the ACA’s markets by approving requests from Wisconsin and Maine to launch reinsurance programs aimed at lowering premiums in the state’s individual insurance market. Wisconsin Gov. Scott Walker, who is facing a tough reelection race this November, has not yet received an answer from the administration to his other request for a controversial Medicaid waiver that would include strict work requirements and drug tests for the tens of thousands of low-income residents enrolled in the program.
But lest anyone think that the Trump administration suddenly supports the ACA, a new investigation finds that Trump appointees at HHS’ research and policy office have combed through the agency’s archives and “deleted positive references to Obamacare.” The officials have also edited out references to LGBT health issues, released dubious and misleading reports about the impacts of the ACA, and cooked data in a health care study to yield an outcome more flattering to the administration.
HHS also plans to reject a waiver from Utah, and other states should they make the request, to partially expand Medicaid — up to just 100 percent of the federal poverty line instead of the 133 percent required by the ACA. The move, fueled by President Trump’s distaste for anything that appears to support Obamacare, may backfire on Republicans by fomenting support this November for a ballot initiative to fully expand Medicaid in Utah. (The Obama administration refused to allow partial expansions as well in an effort to push states to fully expand.)
The Trump administration is even less keen on what many on the left would like to see succeed the ACA: universal coverage via some form of “Medicare-for-All” system. Last week, CMS Administrator Seema Verma gave a speech bashing the growing number of Democrats campaigning on a Medicare-for-All platform and vowing to reject any waiver that aims to set up a state-level single-payer program.
Republicans are also seizing on a new study published by a libertarian think tank funded by the Koch brothers that estimates the cost of Sen. Bernie Sanders’ Medicare-for-All program to be just under $33 trillion over 10 years. Sounds like a lot, yes? But it’s actually a few trillion less than the projected cost of keeping the health care system we have now, and tens of millions more people would be insured.
Finally, happy 53rd birthday to both Medicare and Medicaid, though the Trump administration seems to be only celebrating the former.
Read More →