MONDAY UPDATE: Some clarification about what President Donald Trump may be referring to in his vague threats to cut off “bailouts.” There are two kinds of subsidy payments made by the federal government to reduce costs to patients, what’s known as Advanced Premium Tax Credits, which directly offset premium costs, and Cost Sharing Reduction Subsidies. Trump’s Twitter threats appear to target the cost-sharing reduction subsidies, which help low-income patients on “silver” plans cover copays and out-of-pocket responsibilities. As the letter below from insurers and the American Medical Association makes clear, the effect on poor patients from cutting off the CSR subsidies would still be extremely serious, as “a tremendous number of Americans will simply go without coverage and move to the ranks of the uninsured.”
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As the Los Angeles Times reports–how can you call this government? There are other words that apply:
Frustrated by the failure of the Obamacare repeal in the Senate, President Trump on Saturday threatened to end federal subsidies for healthcare insurance — for Congress as well as the rest of the country…
“If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!” Trump tweeted, fuming about Congress’ failure to repeal the Affordable Care Act, which he said was “imploding.”
Such a move could cause havoc and much higher premiums in insurance markets, since many low- and moderate-income people depend on those subsidies to help cover the cost of their policies. Through a series of administrative maneuvers by Congress and the Obama administration, members and their staffs also benefit from those subsidies.
…Trump’s longstanding threat to let the health insurance plans fail would come with its own political price. The federal government sends about $600 million a month to insurance companies to help cover the cost, and Trump is threatening to cut that off to allow Obamacare markets to collapse. [Pols emphasis]
To simply cut off the subsides that have been helping millions of Americans afford private health coverage would be severely disruptive to much more than the health care markets. The cost in individual human terms would be immense as patients suddenly found themselves faced with unaffordable out-of-pocket costs, and in many cases disruption of health care treatments they are undergoing at the time.
The American Medical Association, all the major health insurers, and the Federation of American Hospitals laid out the stark consequences in a letter earlier this year to Senate leadership:
Millions of Americans do not receive health insurance through an employer, Medicare or Medicaid. The individual market is their only option for getting coverage. Unless CSRs are funded, a tremendous number of Americans will simply go without coverage and move to the ranks of the uninsured. This threatens not just their own health and financial stability, but also the economic stability of their communities… [Pols emphasis]
Simply put, continued uncertainty, particularly the lack of clarity around CSR payments, has led several insurers to conclude that they cannot participate for 2018. Those who will participate are responding to the market uncertainty with premium requests that are as much as 60 percent higher than last year.
That’s a nice way of say that such a move would kill people. Not in some remote sense, insulated by layers of process and bureaucracy. We’re talking about killing people in some of the most direct terms possible without actually lining them up and shooting them. The idea that Donald Trump, the President of the United States, would threaten something so plainly harmful to millions of Americans seems like it should be unthinkable.
Except it isn’t. He’s really threatening to do this.
However you feel about the 2010 Affordable Care Act, whether you support it or oppose it, you cannot deny that it exists today–and that millions of Americans depend on it for their health coverage. Repealing the ACA would have negative effects far beyond the Americans who get subsidy help to pay their expenses, but they are the ones who will be made to suffer first if Trump makes good on this threat to cut these subsidies off. The rest of us will feel the effects secondarily as the entire health care system absorbs the shock.
Even if you want Obamacare repealed, how can anyone in good conscience support something like this? It’s not a rhetorical question, since there is a percentage of automatic support for anything Trump says, and beyond that no small number of hard-right ideologues who wouldn’t mind a little human suffering to “teach liberals a lesson.”
But you people out there with a shred of decency left in you. What about you?
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Trump Supporters Furious That They Still Have Health Care
"So I asked myself . . .
. . . Don Trumpote, you magnificent knight, what good are fucking lances if we never get to run people through??!??”
Trump is a terrorist threatening to kill hostages
"…how can anyone in good conscience support something like this?” Easy. The Yam doesn't have one.
His ardent supporters don't either.
Well, isn't she a special little snowf(l)ake? IOKIYAR: "Do as I say, not as I do."
this is not only a call to arms against Der Trumpster-fire, but an imperative for Establishment Corporate (and Compromised!) Democrats to pull their heads out of their asses.
Democrats do need new, and younger, blood at the top of the party. Otherwise, that's the only valid point I see there.
CHB…..occasionally Zappy has a valid point. The Democratic Party does need some younger, new blood.
But otherwise, when he goes off with his constant tirades about centrists and moderates, he sounds like Moderatus but of the left.
I could hear him now: "Stay strong, Senators Warren and Sanders. Voters will thank you some day!"
I don't think Elizabeth Warren is left enough for Zappy. I'm not even sure Bernie Sanders is.
Zappatero is one of the most valuable and effective bloggers on this site.
After years of working in political confrontation with Republicans (principally, but not exclusively, from the "awl bidness") I can tell you they are masters at moving goal posts. In every negotiation in the confrontation between industry and environmentalists there is an extreme group on both ends and a bunch of "bi-partisan" hopefuls in the middle.
Many of you will note that I often spring to Zaps' defense and I am going to do so again. "We" never get anywhere if we start from the middle. Any negotiator knows it is the bomb throwers who draw the line and stake out the territory we really want. Zap is in a place where I believe almost all progressives should be…I am there.
I have been politically involved for many years. I have, though, walked away in recent years from groups like the Democratic Party…the Western Colorado Congress…Conservation Colorado…all for the same reason. None of you want us around if our rhetoric or behavior threatens your access to whomever you desire to have relationships with (governors, county commissioners, etc.). You don't listen to us, and more often than not, we get ridiculed or chided because we are speaking our truth and sticking to it. But you bi-partisany types would never get anywhere without the loud voice of the activist…pushing…demanding…and never being willing to paint over the truth in the interests of "bi-partisanship." Monied interests love to take advantage of those who, unlike them, are conflict averse.
More than once I have heard a legislator remind their constituents that they desperately need pressure from their own side to arm themselves for the negotiation. I have played that role…so does Zap.
I admire Zappatero. I admire his unwavering intention to hold a marginally (if that) progressive elected official to account for his apparent fealty to certain, wealthy industries. Is he right about everything? No. Is everything Bennet does evil? No.
But, I will never chastise our Zapster for hounding a legislator that needs hounding. Nor for sticking to his Liberal ethos. Zap…I am with you, brother. Let them call you what they will…let them minimize and try to marginalize your message. Michael Bennet became a senator in a process which I rejected then, and he has never convinced me he is committed to taking care of me and my family.
All in all, I would give him (Bennet) a C+….I know there are a number of folks here who will give me some shit for my criticism of their fair-haired, banker boy. So…
Let er rip, ya'll.
Wake me when Zappy says something intelligent. I expect a good long rest
What you have said is fair. Bennet is far from perfect. I don't really care about access. What I care about is winning as many fights as we can and regaining majorities. Expecting purity is going to undercut that effort.
Look, Bennet has his issues. But he also voted against the bad ACA bills. Gardner voted for them. That alone in my mind makes Bennet better than any Republican.
Zappy focuses with Ahab like obsession on Bennet. I agree we need to forward with a positive message. One that effectively ties Economic and social issues together.
What I don't like is the idea that we should just turn our backs and vote for Jill Stein because "they're both equally bad". They're not. The Dems are deeply flawed to be sure. But the Repubs are evil. So I will come home 99% of the time. Even if I'm not thrilled with the candidates.
I voted for Michael.
But, I will consider anyone who tries to primary him. I will probably never again vote for a Republican. I have only very rarely done so.
It's a dirty, thankless job…but somebody has to do it.
Maybe. But he doesn't have to blame him for EVERYTHING. That gets old fast.
Bennet is getting to be a more effective Senator. I liked his recent leadership on health care. He still needs to be pushed on health care, energy, Wall St reform, and other issues. Bennet unfortunately does have a tendency to vote the right way when it's not going to count – i.e., when a Presidential veto or override, or a Republican avalanche of votes, is certain to make his vote irrelevant.
Of course, he's better than any Republican out there. But that's a low bar.
Focus on the policy, not the person. Zap undercuts his own arguments when he doesn't cite policy and vote specifics.
unnamed, I considered voting for Jill Stein, ultimately did not, for pragmatic reasons. Please don’t tar all progressives with the same brush. If we see flaws in our representatives and want to push them leftward, that is a good thing.
We have many ornery curmudgeons grinding axes on this site. It's part of its charm, if you will.
Unfortunately, we spend way too much time on schoolyard he said-she said type stuff, and too little on learning about actual votes and policies, and how to influence them.
Agreed. I was not trying to paint anybody with a broad brush. But pointing to the type of person that Zappy is. A loud bothsiderist who always says he's taking his ball and going home and is largely focused on the person not the policy. Hope I make sense.
In Zappy's defense, he's no jilliot. He'll cuss democrats, vote for them and go back to cussing them. Never have I seen him suggest wasting a vote on a third party twit.
Zap is an anarchist who hates any and all organizations because they exist as a hierarchy of human organization. All such organizations are inherently bad because someone is on top and someone is on the bottom. The alternative is atoms of individuals who can't compete with the wealth and resources of more complex structures but get to feel the helpless victims of vast conspiracies arrayed against them. Some people feel that the sacrifice of autonomous behavior for combined wealth and resources is worth the results of concerted action to counter equally powerful enterprises. ALEC exists to blow away the disorganized resistance of discontented individuals. Good for you if you want to be the maverick loner. I'm sure you will be smugly rewarded for going your own way. I doubt you will end up achieving much on your own but it's a free country. Me? I'm throwing my lot in with the folks who think that Climate Change mitigation is worth the effort and protecting our Front Range watersheds is a high priority.
I'm with you, G.G. Zappy may not be that young, but he reminds me of The Angry Young Man.
https://www.youtube.com/watch?v=ErPywgiMb4k
With respect, GG, you can't actually claim to know what Zappy (or anyone) thinks or feels.
I have yet to see anything that indicates he's an anarchist, and I have my own beef with the modern anarchists and anti-fascists.
I happen to think Zap is a curmudgeon (like you, V, curmudgeon, myself sometimes, and any number of other Polsters).
Inference is the devil mama.
I was speaking from association with folks who are anarchists who display the same intensity of hatred for organizations as our esteemed colleague and fellow writer. Perhaps he will share with us his deep seated disregard for organizations that are comprised of many individuals and by the very nature of a broad pool of opinions must hew to some middle point.
I think of the impact of unions which are comprised of many individuals and are prone to the corruption of the elites but on the whole they have yielded results for the ordinary member that the individual could not have achieved if they had to negotiate with management by themselves. There is strength in numbers and disappointment with a complex hierarchy of humans. Without an organization, a person is a free thinker but they have few resources to make a difference. Pick your poison. Conform and be frustrated or be free and be impotent or realize that the good is not the enemy of the perfect. I'm OK with being a registered Democrat and can attend my county committee meeting and associate with people who share my perspective on compassion and protection of the environment. We are actually a fairly effective outfit and have helped progressive candidates win local county government elections who are committed to protecting the watersheds in Gilpin County. Viva la people who get involved. Sorry if I distorted your bummer attitude Zapster.
Well, such a drastic move WOULD make the stakes clear. those impacted would need to clarify "which side are you on." [with apologies for the archaic reference to gender]
I think there is a mistake in your argument:
Through executive action Trump can only remove risk-pool subsidies to the insurance companies, which will cause them to increase insurance policy prices. However, the subsidies to purchase health insurance on the exchange are tied to the price of Silver Plans. This will trigger HIGHER subsidies for the poor.
So personally I'm out-of-pocket for the increase in my middle-class (minimal-subsidy) Silver Plan, but poorer people won't be hurt so much because their plan subsidies go up.
The taxpayers will pay more, so the cost to the government will go up.
What, you mean Der Trump got his facts wrong? Shocking.
Trump is referring to the risk corridor payments to insurors . Marco Rubio also called this a "bailout", though it isn't. Rubio was successful in passing laws that said Congress couldn't set aside $$ to pay insurors for cost overruns, and so insurers are forced to try to recover costs from premiums (hence premium increases). This kos story "Risk Corridors, or how Marco Rubio Broke Obamacare" also does a good job explaining the risk corridors in the ACA.
I don't know how much leverage Trump would have with an executive order to try to sabotage this any further. The LA times article Pols cites is, I think, referring to these risk corridor payments, not to "subsidies", which come through Medicaid.
I'm trying to understand, but perhaps we have an insurance or ACA expert on here who can clarify. As the CEO of the Federal Government, Trump does have the power to end the 90% subsidies all Federal employees get on their health care.
And Congress has been very cagey about keeping those ACA funded subsidies in place for themselves through all their Kabuki on ACA/ AHCA / BRCA, etc.
Pols updated with a clarification of what Trump is (probably) talking about.
It's harder when Trump doesn't have a clue either I guess…