Last week, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the Affordable Care Act’s benefit and payment parameters that would raise costs and reduce coverage for millions of Americans. On top of reducing subsidies available to those who purchase health care through the exchange and increasing premiums, the Trump administration’s proposed rule changes would also raise the out-of-pocket maximum for people with employer-sponsored health care.
Here’s what news outlets have to say about the proposed changes:
Axios: Consumers Would Pay More Under New ACA Rules. “Turns out the Trump administration’s big ACA regulation packs a bit more punch than we realized at first. Some of the rule’s technical changes will end up requiring people to pay more for their coverage, while rolling back the cost of federal premium subsidies, my colleague Sam Baker reports…The federal government would end up spending about $900 million less on premium subsidies, according to the proposed regulation. The same change would also slightly loosen limits on out-of-pocket costs. The ACA capped total out-of-pocket spending at $8,000 per year for an individual and $16,000 per year for a family plan. The Trump proposal would raise those caps by $200 and $400, respectively, according to Brookings’ Matt Fiedler. That change would apply to people who get coverage through their jobs, not just the ACA’s insurance markets.” [Axios, 1/22/19]
Wall Street Journal: Trump’s Proposed ACA Rules Could Lift Costs For Millions Of People. “The Trump administration on Thursday proposed changes that could raise health insurance costs for millions of Americans who get coverage on the job or receive subsidies under the Affordable Care Act, a move that Republicans said is necessary to cut inflated subsidies but Democrats viewed as another GOP effort to sabotage the health law. The proposal, released by the Centers for Medicare and Medicaid Services, would raise the out-of-pocket maximum that people with employer-sponsored coverage pay in 2020. The individual maximum would increase by $200 to $8,200 annually, and the maximum for family coverage would increase by $400, analysts said. The plan would also change a calculation that determines how much people pay if they buy insurance from the ACA exchange and get credits to reduce their monthly premiums. The change could raise premiums next year for many of the roughly 9 million people who get the credit.” [Wall Street Journal, 1/17/19]
Los Angeles Times: Despite The Government Shutdown, Trump’s Efforts To Gut Obamacare Go Full Speed Ahead. “A good portion of the federal government may be shut down, but you can rest assured that the devoted Obamacare saboteurs at the Department of Health and Human Services are on the job. Late Thursday, they released proposed rule changes for the 2020 health insurance year — and requests for comments on further changes — that will drive up premiums for people on Affordable Care Act health plans, cut subsidies and discourage more Americans from enrolling. The proposals also could raise prescription costs for enrollees and raise costs even for families enrolled in employer plans. Longer-term changes proposed for 2021 and beyond could affect about 2 million ACA enrollees.” [Los Angeles Times, Hiltzik, 1/18/19]
Associated Press: White House Proposes To Increase Affordable Care Act Premiums. “The Trump administration Thursday announced proposed rule changes that would lead to a modest premium increase next year under the Affordable Care Act, potentially handing Democrats a new presidential-year health care issue. The roughly 1 percent increase could feed into the Democratic argument that the Trump administration is trying to ‘sabotage’ coverage for millions. The administration said the proposal is intended to improve the accuracy of a complex formula that affects what consumers pay for their premiums. Premiums under the health law were basically stable this year after several sharp annual hikes.” [Associated Press, 1/17/19]
Politico: CMS Wants To Reduce Obamacare Subsidies Through Formula Change. “The administration is proposing a technical change in the 2020 marketplace rules that is expected to result in less premium assistance for low-income Obamacare customers, POLITICO’s Paul Demko reports…A decrease in financial assistance of $900 million and 100,000 fewer Obamacare customers in 2020 if the proposal is adopted, according to CMS. The agency is justifying the change as a way to reduce big increases in federal subsidies that resulted from the Trump administration’s decision to cut off cost-sharing reduction payments.” [Politico, 1/18/19]
Buzzfeed News: Administration’s Proposed Rule Would “Result In Higher Premiums And More People Being Uninsured.” “The Trump administration revealed this week that it could try to take one more shot at weakening the Affordable Care Act’s individual markets before the end of Trump’s first term. A request for comment on a proposed rule change posted late Thursday contemplates a series of changes that would save the government $1 billion per year or more, but result in higher premiums and more people being uninsured…But now the administration is signaling it may try to end silver loading. Doing this on its own would lead to a major jump in premium costs and could badly destabilize the markets. The administration says it wants to kill silver loading in concert with Congress voting to bring back the old subsidies. However, Congress has so far shown a complete inability to come together to pass a bill to improve the Obamacare markets. The administration did not specifically say it will act without Congress, but it did so with premiums in the past and is asking for feedback on how it should ‘address’ the issue of silver loading.” [Buzzfeed News, 1/18/19]