Photo: AP/ Alex Brandon
Photo: AP/ Alex Brandon
October 19, 2017 05:42 AM
If President Donald Trump prevails in shutting down a major "Obamacare" health insurance subsidy, it would have the unintended consequence of making free basic coverage available to more people, and making upper-tier plans more affordable.
The unexpected assessment comes from consultants, policy experts, and state officials trying to discern the potential fallout from a Washington health care debate that's becoming harder to follow.
What's driving the predictions? It's because another of the health law's subsidies would go up for people with low-to-moderate incomes, offsetting Trump's move.
"It's a kind of counter-intuitive result," said Kurt Giesa, a health insurance expert with the Oliver Wyman consulting firm.
According to one estimate, more consumers would sign up for coverage next year even though Trump says the Affordable Care Act is "virtually dead."
On Wednesday, the fate of the health law's subsidy for copays and deductibles remained unclear as a bipartisan congressional deal to continue payments ran into political roadblocks. Separately, state attorneys general asked a federal court to order the administration to keep the money flowing.
But if Trump succeeds, it may be like pushing down on one end of a see-saw only to see the other end go up.
His attempt to shut off the subsidy for copays and deductibles would cause a different subsidy to jump up, the one for premiums.
The Obama-era health care law actually has two major subsidies that benefit consumers with low-to-moderate incomes. The subsidy Trump targeted reimburses insurers for reducing copays and deductibles, and is under a legal cloud. The other subsidy is a tax credit that reduces the premiums people pay, and it is not in jeopardy.
If the subsidy for copays and deductibles gets erased, insurers would raise premiums to recoup the money, since by law they have to keep offering reduced copays and deductibles to consumers with modest incomes.
The subsidy for premiums is designed to increase with the rising price of insurance. So government spending to subsidize premiums would jump.
"This is where the counting gets sort of weird," said Matthew Buettgens, a senior research analyst with the Urban Institute.
The nonpartisan policy research group has estimated that richer premium subsidies could entice up to 600,000 more people to sign up for health law coverage, depending on how insurers and state regulators adjust.
The group also found that the federal government would end up spending more overall on health insurance through higher premium subsidies.
That hasn't been lost on officials at the state level.
The Associated Press
Created: October 19, 2017 05:42 AM
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