President Trump Deals Yet Another Critical Blow to Healthcare System

Matt Rourke/AP

Yesterday President Trump dealt yet another critical blow to the healthcare system established under the Affordable Care Act by announcing his administration would end critical Cost-Sharing Reduction (CSR) payment subsidies. These payments – projected to total roughly $9 billion in 2018 and $100 billion over the next 10 years – are made to help offset costs of co-payments, co-insurance, and deductibles for low-income Americans who enroll in individual health insurance coverage under the ACA’s exchanges.

The decision to end these payments will result in higher costs for low- and middle-income Americans and will threaten the ability of these individuals to afford coverage. The administration has treated these payments as a political bargaining chip for months; ending them, in combination with yesterday’s Executive Order on association health plans, will have an immediate and negative impact on Americans’ ability to access critical healthcare services. ANA reiterates: the Trump administration is making a deliberate attempt to undermine the system put in place by the ACA for political gain, at the expense of some of the most vulnerable Americans.

Individuals enrolled in health insurance coverage through the ACA’s individual marketplace with household income between 100% ($12,060 for an individual and $24,600 for a family of four) and 250% ($30,150 for an individual and $61,500 for a family of four) of the Federal Poverty Guideline are currently eligible for cost-sharing reductions. CSRs reduce the amount that low-income individuals pay out-of-pocket for co-payments, co-insurance, and deductibles. In effect, these cost-sharing reductions currently make it more likely that these individuals get critical preventive and other healthcare services and avoid more serious and/or chronic health issues long-term.

The Commonwealth Fund reported in March 2016 that as many as seven million individuals might have plans that are aided by  CSRs, representing a significant portion of the individuals who signed up for coverage through the individual exchanges under the ACA. This Commonwealth Fund report also noted that – according to government data – out-of-pocket healthcare spending declined significantly in 2014 (the year the ACA was implemented). In short, it is abundantly clear that the ACA’s cost-sharing reductions have in fact helped low-income individuals receive critical healthcare services.

We will continue to urge Congress and the administration to work toward market stabilization and to strengthen the existing system – which has resulted in coverage for tens of millions of Americans since 2014 – and to put an end to these attempts to sabotage Americans’ healthcare for political gain. ANA is committed to working with Congress and the administration on legislation and policy which aligns with our four core principles of health system transformation. The President’s actions this week fly in the face of ANA’s principles and will cause significant harm to millions of American families.

(Photo: Matt Rourke/AP)

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