Uncertainty grows as Trump delays a health care decision

Owen Stevens
May 24, 2017

The Trump administration asked on Monday that a major federal court case weighing the fate of the Obamacare cost-sharing subsidies be put on hold again, leaving billions of dollars in payments to insurers up in the air for 2017 and 2018. Without those subsidies, experts say, premiums could jump about 20 percent in 2018. "At a critical period when insurers are deciding premiums for next year, Republicans are pouring uncertainty into the health insurance marketplaces".

"The parties continue to discuss measures that would obviate the need for judicial determination of this appeal, including potential legislative action", lawyers for both the House of Representatives and the Trump administration wrote in the brief.

Insurers and medical groups which have pressed the administration to continue funding the payments, which amount to about $7 billion this year and help low-income consumers pay for out-of-pocket medical costs, reiterated their view on Monday after the court filing.

The biggest dips in support for Republicans were pegged to high-profile events related to the House GOP's American Health Care Act, its legislation to repeal and replace parts of President Barack Obama's signature 2010 health care law, the Affordable Care Act.

However, House Republicans previous year successfully challenged the legality of CSR reimbursements to insurers after a federal district court judge ruled that the Obama administration had been paying insurers without Congress appropriating the funds.

On Monday, a Trump administration senior official told CNBC the government would continue paying insurers the reimbursements for the next three months as officials decide whether to continue fighting the House's case or not. Many other White House officials are wary of that idea, and a poll from the Kaiser Family Foundation found that a majority of Americans would place most blame for healthcare problems - such as rising premiums - on Trump. "It's critical to ensuring overall affordability".

House Democratic Leader Nancy Pelosi's spokesman, Drew Hammill, said the House bill was becoming a liability for Republicans and "has no chance of success in the Senate, and now may even have to come back to the House to be amended".

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Democratic attorneys general and eight healthcare industry groups have voiced concerns in in the days leading up to Monday's deadline.

The case is on appeal after a lower court ruled that the government lacks constitutional authority to make the payments because Congress failed to specifically approve them in the Obama-era health overhaul legislation.

President Donald Trump reserves the right to unilaterally cut off the payments, made monthly by the Department of Health and Human Services, if he disagrees with a recommendation to do otherwise. Democrats argue that conclusion is based on a faulty reading of the law.

In an interview with The Economist on May 4, Trump weighed that option publicly, saying: "You know when people say, 'Oh, Obamacare is so wonderful, ' there is no Obamacare, it's dead. You know if I ever stop wanting to pay the subsidies, which I will".

The BlueCross BlueShield message may find a receptive home with Senate moderates in both parties, said industry analyst Sheryl Skolnick.

The case is known as House v. Price.

Information for this article was contributed by Ricardo Alonso-Zaldivar and Tom Murphy of The Associated Press and by Robert Pear of The New York Times.

Other reports by VgToday

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