Donald Trump

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Here’s what Trump’s Obamacare ‘fix’ means for you

Trump is expected to shut down cost-sharing subsidies. Here's what you need to know.


Andrew Wyrich


Posted on Oct 13, 2017   Updated on May 22, 2021, 2:25 pm CDT

Frustrated by Congress’ inability to repeal and replace the Affordable Care Act, President Donald Trump has been making his own moves to “fix” to the healthcare law that he believes is failing.

Trump plans to halt subsidies to insurers selling Obamacare coverage, a move that coupled with his executive order that would allow for cheaper plans with fewer benefits, threatens to unravel the healthcare law established by former President Barack Obama.

Here’s what you need to know:

  • Cheaper plans—at a high cost: Trump executive order, signed on Thursday, allows insurers to offer plans with less coverage than allowed under the ACA. This means people who don’t feel they need full coverage can purchase cheaper plans, ThinkProgress reports. The problem is, this will likely result in higher premiums for people in other insurance categories—those who likely need the coverage most.
  • Low-income impact: By cutting off the subsidy payments, which are estimated to be $7 billion this year according to Politico, Trump will be affecting mostly lower-income Americans. The Washington Post reports that the marketplaces under the Affordable Care Act that receive the subsidies mostly cater to Americans who can’t afford other kinds of coverage. Essentially, the subsidies help keep out-of-pocket costs down.
  • Marketplace disruption: With open-enrollment for people to buy health insurance through the marketplaces set to begin in less than three weeks, Trump’s decision could damage the marketplaces, the Post reports.
  • Art of the deal: But this could just all be part of a ruse. On Friday morning, Trump tweeted that “Democrats should call me to fix!” the problem he created with ending the subsidies. This could be an attempt by Trump to get Democrats to the table to cut some sort of legislative deal.

  • Settling the score: The Congressional Budget Office, a nonpartisan group that “scores” potential legislation, said earlier this year that Trump’s (then-threat) to cut off the subsidies, or “cost-sharing reduction payments,” would cause premiums for people using the (now) affected marketplaces to jump 20 percent in 2018 and 25 percent by 2020.
  • The damage is done: It might not be as disastrous for the law as Trump hopes. Talking Points Memo reports that some insurers already set their premiums higher for 2018 anticipating such a move by Trump. In California, for instance, a 12.5 percent surcharge was added on “silver plans”–which would mean taxpayers pick up the cost.
  • Owning it: While Trump has said in the past that he was not “going to own” the collapse of the Affordable Care Act, his actions–such as no longer paying the subsidies–may make it hard for him to distance himself from a hypothetical collapse of the ACA.
  • See you in court: Trump’s plan to cut off the subsidies could be challenged in court. California Attorney General Xavier Becerra called Trump’s decision “sabotage,” according to the Post, and added that he was prepared to take Trump’s administration to court: “We’ve taken the Trump Administration to court before and won, and we’re ready to do it again if necessary.”
  • Crossing a line: All of this already comes on the heels of Trump using the “power of the pen” to begin his dismantling of the healthcare law. On Thursday, Trump signed an executive order that essentially allows some kinds of health insurance sold across state lines.
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*First Published: Oct 13, 2017, 11:24 am CDT