In taking his actions, Trump made his usual dire and bombastic pronouncements saying that the ACA is “failing.” The good news is that the Affordable Care Act (ACA) is still the law of the land. Open enrollment begins in two weeks and most of those protected under the ACA will continue to have affordable health insurance that includes coverage for essential services such as women’s health, emergency services, hospitalization and mental health.
The ACA guarantee of coverage for essential health benefits is however undermined by Trump’s Executive Order. In it, the President called for new regulations that allow “associations” to offer lower cost plans and to sell these plans across state lines. Insurance companies will now be able to offer “junk” or “sham policies”- low cost plans that don’t cover essential services and don’t provide sufficient coverage for most serious medical situations. Importantly, these junk policies won’t be required to cover pre-existing conditions, leaving these individuals in higher cost markets while healthier individuals can take advantage of the cheaper, but unsatisfactory, policies.
Trump also announced that he is immediately ending the Cost Reduction Subsidies (CRS) the ACA makes to insurance companies to subsidize low income enrollees. Since the ACA mandates that everyone be able to buy a policy at a price they can afford, this means that insurance companies will not be reimbursed for the subsidies they must provide under the ACA. This will force them to raise the price of all their policies across the board. Low income people WILL NOT pay increased premiums. But those who make more than the base income thresholds and purchase insurance on the exchanges WILL see premium increases as insurance companies work to recover the lost resources that result from ending the Cost Reduction Subsidies. Ironically it is estimated that 70% of those negatively impacted by this decision live in states that went for Trump in November.
Organizations representing doctors, patients and hospitals universally oppose both of Trump’s orders. They support making the repairs to the ACA that are needed to put it on solid footing for the long term. The way to resolve this situation is for Congress to pass legislation to fund the CRS and to insure that all health insurance policies cover essential care services. The compromise legislation being negotiated by Senators Alexander (R) and Murray (D) is the best avenue to accomplish these goals.
Call To Action
Call your elected representatives.
Tell them to support bi-partisan legislation to fix the Affordable Care Act and, specifically, to fund the Cost Reduction Subsidies that Trump just axed and to mandate that all health insurance policies include the essential services guaranteed by the ACA. If they are already on board, urge them to be strong advocates and reach across the aisle to bring their reluctant colleagues on board.
Remind your friends and colleagues that the Affordable Care Act is still law and that they can and should sign up for insurance. Donald Trump hasn’t killed it yet. By using the ACA, we testify to the need it fills and value that it provides