Thursday, Trump issued an Executive Order directing federal agencies to draft new regulations allowing employers to form insurance offerings across state lines. Many contend opening up the marketplace will allow more employer flexibility, greater choice, and as a result, lower premiums.
Before the ink had dried, a leaked report indicated Trump’s plans to throw another blow at Obamacare, this time, by way of subsidy.
Congress has yet to appropriate funds for subsidies given to health insurance providers that offer Obamacare plans. Failure to subsidize these plans spells the end of Obamacare as we know it.
BREAKING: White House says it cannot lawfully pay subsidies to health insurance companies under President Obama's health care law.
— The Associated Press (@AP) October 13, 2017
Politico reported:
The subsidies, which are worth an estimated $7 billion this year and are paid out in monthly installments, may stop almost immediately since Congress hasn’t appropriated funding for the program.
The decision, which leaked out only hours after Trump signed an executive order calling for new regulations to encourage cheap, loosely regulated health plans – delivered a double whammy to Obamacare after months of failed GOP efforts to repeal the law. With open enrollment for the 2018 plan year set to launch in two weeks, the moves seem aimed at dismantling the law through executive actions.
Press Secretary Sarah Huckabee Sanders confirmed the decision in a statement emailed to reporters at 10:47 p.m. Thursday.
“Based on guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare,” she said. “In light of this analysis, the Government cannot lawfully make the cost-sharing reduction payments. …The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system.”
About 7 million Americans receive a subsidy for their health insurance purchased through an Obamacare exchange.
Insurance companies participating in Obamacare exchanged have been losing copious amounts of cash, which is why exchanges have collapsed as insurers continue their mass exodus into more profitable ventures. Participating insurers have received bailout after bailout by way of subsidy from the federal government to offset loss incurred by selling Obamacare plans.
When Trump floated yanking subsidies last spring, speculation suggested insurers would pass that cost on to the rest of the insurance pool, effectively raising premiums across the board. So it makes sense that Trump would first create a mechanism for the market to find cheaper alternatives (Thursday’s Executive Order) before cutting insurers off the government dole.
Lost in the fear-mongering about sweeping premium increases is how much every tax payer has been involuntarily feeding participating insurers through these Obama-era federal bailouts.
From a post in The Weekly Standard in 2014; a bit lengthy but necessary:
Because insurance companies won’t bear the cost of their own losses—at least not more than about a quarter of them. The other three-quarters will be borne by American taxpayers.
For some reason, President Obama hasn’t talked about this particular feature of his signature legislation. Indeed, it’s bad enough that Obamacare is projected by the Congressional Budget Office to funnel $1,071,000,000,000.00 (that’s $1.071 trillion) over the next decade (2014 to 2023) from American taxpayers, through Washington, to health insurance companies. It’s even worse that Obamacare is trying to coerce Americans into buying those same insurers’ product (although there are escape routes). It’s almost unbelievable that it will also subsidize those same insurers’ losses.
But that’s exactly what it will do—unless Republicans take action. As Laszewski explains, Obamacare contains a “Reinsurance Program that caps big claim costs for insurers (individual plans only).” He writes that “in 2014, 80% of individual costs between $45,000 and $250,000 are paid by the government [read: by taxpayers], for example.”
In other words, insurance purchased through Obamacare’s government-run exchanges isn’t even full-fledged private insurance; rather, it’s a sort of private-public hybrid. Private insurance companies pay for costs below $45,000, then taxpayers generously pick up the tab—a tab that their president hasn’t ever bothered to tell them he has opened up on their behalf—for four-fifths of the next $200,000-plus worth of costs. In this way, and so many others, Obamacare takes a major step toward the government monopoly over American medicine (“single payer”) that liberals drool about in their sleep.
Laszewski adds, “The reinsurance program has done and will continue to do what it was intended to do; help attract and keep more carriers in Obamacare than might have otherwise come.” Thus, Obamacare is being aided by having taxpayers subsidize big insurance companies’ business expenses. (Who could ever have guessed that big government and big business might be natural allies?)
But, amazingly, it doesn’t stop there. Laszewski writes that Obamacare also contains a “Risk Corridor Program that limits overall losses for insurers.” So insurers not only don’t have to pay out all of their costs; they also don’t have to swallow all of their losses.
Laszewski explains that if an insurance company expects its costs in a given year to be X, and those costs end up being more than X plus 2 percent, taxpayers will come to that insurance company’s rescue—thanks to Obamacare. In fact, once an insurance company covers that initial 2 percent in unexpected costs, taxpayers will cover at least 80 percent of any additional costs the insurer accrues.
As mentioned above, every person contributing to the federal tax coffers is already paying to offset the loss of a failing market, artificially propped up by government stilts. Removing them will create temporary uncertainty as the market adjusts, but there’s no reason (aside from politicalization of the issue) to believe anyone will die or health insurance will be unaffordable because of Trump’s recent decisions. Quite the contrary.
This is far better a result than anything Congress has coughed up this year. Which means I fully expect the entire internet to light its hair on fire while Democrats launch full-scale lawfare.
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Comments
1) Neither party is paying attention to the real problem, which is the cost of health care.
2) Trump’s EO will help millions of people who run or work for small businesses.
3) Trump’s EO will probably result in my daughter losing her excellent, effective, and affordable health insurance policy because of her pre-existing conditions.
I feel for anybody who has a preexisting condition. I don’t know what it’s like to have a continuous medical ailment that is expensive. I’m not going to pretend I do. But why should someone with a known medical condition pay less for insurance than a healthy person? That’s backwards. We’ve got to find a way to cover sick people that couldn’t afford insurance otherwise prior to Obamacare, but it can’t come cheaper than other healthy people.
Is it only affordable because someone else is being forced to cover her costs (through the subsidy or some other back handed measure)? IF your daughter had to pay the proper price I doubt she would be able to claim that its affordable by any measure.
It’s not my responsibility to pay for your daughter’s healthcare. Go virtue signal with your own money.
Allow me to let you into a nasty little secret, medical insurance companies make a LOT of money, even though medical care charges are obscenely inflated.
The biggest problem that those with pre-existing conditions face is what providers charge, not what insurance companies pay. Take insulin dependent diabetics. The retail charge for a 1000 unit bottle of insulin ranges from $250 to $300. That is what the diabetic would pay out of pocket without insurance. However, with insurance and getting the insulin from a network pharmacy, the accepted charge is usually %50-$75, of which the patient pays $20-$40. The pharmacy will accept about 1/5 of the retail charge. If we assume that the pharmacy is still making some profit, this represents a mark-up which would be nothing less than price gouging, in any other industry. And, it is SOP across the entire medical profession.
It seems to me you don’t have a good grasp on how distorted the costs and charges (two different things) have become in the health care industry due entirely to government interference. Which began in the 1930s and has progressively gotten worse.
The left keeps breaking the system until they fix it. Job security in DC-speak. It’s almost comical? Medicare, Medicaid, the HMO Act of 1973 were sold as if they were somehow going to bring health care costs down. Quite predictably, they drove health care costs up since all of these were arrangements between third parties. The person actually being treated was cut out of the loop.
The Emergency Medical Treatment and Labor (???} Act of 1986 really drove costs into the stratosphere. Per the EMTLA all hospitals must provide emergency stabilizing care to anyone who shows up with an emergency medical condition regardless of ability to pay.
So it’s wrong to talk about “retail prices” for bottles of insulin or any such. There is no such thing. The bottom line is that hospitals have to keep their doors open despite the fact that nobody is actually paying for the true value of the care they receive. Most people don’t know this, but hospitals actually lose more money on Medicaid patients than they do on the uninsured. Medicaid reimbursement rates are ridiculously low. Which is why doctors who don’t have to take Medicaid patients usually don’t. Hospitals with emergency rooms have no choice. Somebody has to make up the shortfall. So they jack up the prices and gouge the insurance companies. They don’t care; they’ll just pass that along in the form of increased premiums.
What you understand as the retail price of a bottle of insulin, isn’t. It’s just a number on a page. Nobody pays that. If a diabetic has to pay out of pocket, they’re not going to pay anywhere near that.
I know. I’m not a diabetic, but I’ve been a cash customer for years and I get steep discounts. Back in 2007 I broke my leg. I had to go to the emergency room, get x-rays, have the leg set, pay for the soft cast and the crutches. The bill they gave me when they thought I had insurance was frightening. After all the discounts when I told them I’d be paying out of pocket it was something like $700. That’s the number that sticks in my mind but it was ten years ago; I do recall it was well under $1000 and I just put it on my credit card.
I recently had a medical episode which I don’t want to go into much detail about, except to say that just because I still work out like a beast at 55 y.o. I really need to eat more healthily. Again, I’m paying out of pocket for an overnight stay in the hospital.
How much is the bill you people with insurance would get for two chest x-rays, plus paying someone to read out the results?
I suspect it’s more than the $19.50 I just paid upon receipt of the bill. For the price of a large pepperoni pizza (which may be part of the problem) I got two chest x-rays. In a hospital, not one of those $99 neighborhood emergency clinics (which are not to be despised).
As I understand it the charges they present to cash customers more accurately reflect the actual cost of the services they provide. Nobody is subsidizing me; I pay my own way. But I honestly think that no one knows for sure anymore because the central planners have knocked the whole system completely off kilter.
Arminius
I agree 100% with your analysis. My daughter just got a $3,143 bill for an MRI. Insurance paid $449.11. Total insanity.
I’m just not optimistic that any of our leaders will be able to do anything helpful about it.
gibbie, I guess my question is when did it become the federal government’s responsibility to “do something” about your or anyone’s medical bills? Remember, the federal government’s money comes from us, taxpayers across this great nation. Why should I have to pay for your health care? I’m paying for my own, but why am I also responsible for paying for yours, too? Maybe I’m just stuck in ancient times, circa 2009.
Now, if you want a donation for your daughter’s medical treatments, I will more than willingly chip in. Just don’t make me purchase a ridiculously expensive health care plan that includes prenatal care and sex change hormones and other random crap I will never ever need to fund your and your families’ medical treatments.
In a somewhat related aside, I was watching I Love Lucy the other night, and Lucy went to the hospital to have little Ricky. Ricky and Lucy spoke about paying for the birth-all of it, out of their own pocket. They didn’t wonder why other Americans weren’t footing their bill with useless high-premiums for conditions they could never have, high deductibles, and high co-pays. They didn’t expect the government to step in and pay their way.
As Arminus illustrates, self-pay patients pay far less for the same medical services that are billed and paid for by private or government insurance. This isn’t a government problem (except that anything that involves the government is instantly outrageously expensive), so the solution is not more government. It’s less.
Fuzzy: “I guess my question is when did it become the federal government’s responsibility to “do something” about your or anyone’s medical bills?”
Please find where I said that it was.
Sorry, gibbie, it seemed to me that you were looking for the feds to pay for healthcare. The feds’ money comes from taxpayers, i.e. me, so if you expect the feds to pay for your or your family members’ healthcare, you want me to pay for it. Via taxes, crazy health “benefits” I will never ever need, and various assorted means of “spreading the wealth.” You can’t divorce your call for cheap or free health insurance for pre-existing conditions from the people who will actually be paying for it.
Thank you for making my point for me.
I actually have a VERY GOOD grasp of why medical care charges are so high. I have clearly explained that in previous threads. Medical care costs are so high because of medical care insurance, most notably government funded care programs such as Medicare and Medicaid.
A cardiovascular surgeon bills $20,000 for bypass surgery, knowing that he will accept $3000 and make money. Why? Because the insurance company [or Medicare} will not pay more than that. But, to make it even better, the insurer only pays a percentage of the total charge less the patient’s deductible. So, to receive that $3000, the physician has to bill the patient for $20,000. If a person has no insurance, he is essentially on the hook for the full $20,000. And, in some states, a care provider must charge a uninsured patient the same rate that he charges an insured patient. So, what happens? Medical care is priced out of the reach of most people. This requires them to have insurance. And, the insurance company pays 1/3, 1/4 or even 1/5 of what the uninsured patient is charged.
But. let’s look at this another way. Would you pay $100 for a steak dinner, while the guy next to you pays $10 and his diner’s insurance company pays another $10 for the same meal? Not likely. And when was the last time that you negotiated the prices of a steak dinner, or a gallon of milk or even a pair of pants? The point is that people should not have to “negotiate” the cost of basic services, in this country. The prices should be posted and everyone should pay the same price.
Now, one thing to remember about major medical insurers, none of them is losing money. Even though they may say that they are, they are not. Insurance companies have been so solvent, over the decades, that they have billions, if not trillions, of dollars tied up in investments and real estate.
“Is it only affordable because someone else is being forced to cover her costs (through the subsidy or some other back handed measure)?”
You have just defined the word “insurance”.
But for insurance to work, they need to be able to take actuarial tables into account. And they do, in all other types of insurance. In car insurance, a 17-year-old boy will cost a shipload more to insure than a 40-year-old woman, because actuarially, the former is likely to cost them a shipload more in claims than the latter. In home insurance, a rider for wind damage/hurricane is going to cost someone living on a barrier island off the coast of Florida a shipload more than someone living in a Milwaukee suburb, because the former is much more likely to make big bucks claims than the latter. And it’s the same with health insurance — that, is, it used to be. “Community rating” as has been mandated under the ACA, if it were applied to other insurances, would see every single driver, no matter their age or driving record, charged the same for car insurance. If it were applied to home insurance, it would see every single homeowner, no matter the location or condition of their home, pay the same for home insurance. That’s not the way any other insurance market works — why should the health insurance market be any different?
“why should the health insurance market be any different?”
Because losing your life is more serious than losing your car or house.
There were not millions upon millions of Americans dying in the streets for lack of medical treatment prior to the ACA’s community ratings mandate.
“There were not millions upon millions of Americans dying in the streets for lack of medical treatment prior to the ACA’s community ratings mandate.”
I believe that the “hospitals must treat” mandate preceded the ACA.
When I say “losing your life” I include debilitating diseases and conditions as well as death. I think they qualify as being more important than losing your car or your house.
First we were talking about health insurance and the ACA (and specially, the mandated “community rating” under the ACA); now you’re talking about EMTALA. I’m not sure whether you’re deliberately obfuscating the issue or just having trouble focusing.
gibbie @October 13, 2017 @ 2:13 pm @:
“’why should the health insurance market be any different?’
Because losing your life is more serious than losing your car or house.”
So. What?
I don’t understand your thinking. Essentially you seem to be saying that since we’re dealing with issues of life and death we have to abandon all reason and adopt a business model so unsustainable it can only lead to quick disaster.
Actually, you’re not the first one to say it. The left has been saying it for decades. Hence the Obamacare death spiral.
Just how much in the way of actual health care services do you expect a bankrupt health insurance company to pay for? Or, for that matter, do you expect a bankrupt government to pay for?
Outside of my 20 years in the Navy most of my working life was spent in the restaurant business. Both as an employee and as an owner.
Quick quiz; when I owned the restaurant my goal was to:
A) Make sure as many people as possible had food regardless of their ability to pay.
B) Provide my employees with a “living wage.”
C) Make money.
Go ahead, guess.
Spoiler alert: my pockets aren’t so deep I can afford to run a charity or a make-work project. Which isn’t to say I don’t give to charities, including those that do their level best to make sure that people who can’t afford health care get it.
Jimmy Kimmel is an @$$. I’m glad his kid got the emergency surgeries he needed, but it was at Children’s hospital. Any child would have gotten the same care, whether the child of a Hollywood celebrity or a farm worker. The surgeon who operated on Kimmel’s kid does the same thing pro bono when the parents can’t pay.
Charity. Business. Government. Three separate things. Never confuse them.
Amy’s point is solid, you pay more for insurance if you are more likely to need it. If you didn’t, insurance companies would go bankrupt . . . or need trillion dollar taxpayer bailouts.
Taxpayers, then, are forced to reprioritize their family budgets, affecting their own standards of living and even the health and life of themselves and their families.. People who can’t pay their mortgages can be a bit stressed out, this leads to life-threatening high blood pressure and heart conditions, perhaps even addictions to other health-destroying habits like drinking alcohol to excess.
Is it okay to you that families lose their homes because they are now paying $30,000/yr in health insurance alone? Is that the price everyone else should pay for your life? What about the effects of this financial hit to their families and their families’ futures? So what? Who cares if we have a middle class as long as everyone pays for health insurance (not health care) they don’t need and will never ever use? Who cares if the people footing the bill suffer severe health repercussions due to their forced lower standard of living? Let them eat ramen noodles and hotdogs! As long as they pay for my health care, who cares how their life, family, or health is affected?
Irrelevant. Your life or death is your problem, not the insurer’s or anyone else’s. You have no more right to force an insurance company to pay the cost of your daughter’s life than you do to rob a bank for it, or to mug people on the street for it.
What you’re looking for is not insurance but charity, so go find some generous souls and beg them to save your daughter’s life. If nobody is willing to donate of their own free will what it costs, then your daughter should die. She has no right to live at the expense of unwilling donors. Human nature being what it is, though, that won’t happen. If the spare resources exist to save her life, someone will be willing to provide them. The poor will always be with us, and so will the generous. The scenario I laid out above, where the right thing is for her to die, is purely hypothetical, a point of moral philosophy, not relevant to practice.
I love Texas. Many people who live her don’t know the meaning of the word “fear.” Like Marcus and Morgan Luttrell.
Unfortunately far more don’t know the meaning of the words “yield to ramp.”
And I have no idea where this gibbie individual lives but he obviously doesn’t know the meaning of the words “risk pool.”
No, gibbie, wealth and income redistribution does not “define” insurance.
What a bizarre response! The very concept of insurance involves risk sharing and money distribution. The only question is what kind of risks and costs are going to be shared.
Couple of things…
First, those aren’t the ONLY questions… another is whether to buy insurance at all.
Second, as far as what the insurance covers… shouldn’t customers be allowed to have input on what they want covered?
It only seems bizarre to you because you have no idea how real insurance actually works. People buy insurance to cover the cost of an event that is unlikely to happen, but if it does happen it would be catastrophic financially.
It doesn’t matter if we are talking about homeowners insurance, auto insurance, or (if it were still insurance) health insurance.
Relatively speaking very few people lose their homes to a fire or a tornado. The vast majority of homeowners go their entire lives paying their premiums without losing their homes. That’s how an insurance company stays in business; they employ actuaries who assess the actual risks, and then charge people enough to make a profit even when a sizeable minority of policy holders make claims after losing everything.
Auto insurance is more akin to health insurance in that different people present different risks. Hence the term you clearly have never heard before, “Risk pool.”
Safe drivers are in one pool. Riskier drivers are placed in a separate pool. The highest risk drivers are placed in the assigned risk pool. The premiums each driver will pay goes up or down depending on how much risk they pose to the company. Assigned risk drivers are really drivers that no insurance company will voluntarily insure, but the states get involved and force insurers to cover them. But those assigned risk drivers will pay an arm and a leg for that insurance until their driving record allows them to get conventional insurance. Usually that takes three years, depending on the state.
Assigned risk drivers are the actuarial (but not moral) equivalents of health insurance customers with pre-existing conditions in that it is a virtual certainty that the company will be paying out massive claims.
With actual insurance, the insurance companies are permitted by law to act in a sane manner. They charge similar risks similarly. Higher risks pay more, lower risks pay less.
Under Obamacare these insurance companies aren’t allowed to behave rationally. All customers must be placed in the same pool, and risk has nothing to do with it. Everybody must pay premiums as if they’re the same risk even though they’re not.
Forcing a health 27 y.o. into the same cost-sharing pool as a 65 y.o. with respiratory and heart conditions because of their 35 year four-pack-a-day smoking habit is insane. They’re both being charged as if they’re at equal risk of making a claim. And they aren’t.
So the healthy 27 y.o. makes the sane decision to pay the penalty and ditch Obamacare. Hence the death spiral. Obamacare isn’t insurance. It’s the kind of Ponzi scheme that put Bernie Madoff in prison for the rest of his natural life.
I understand a lot of people, you included, think it’s “bizarre” when I point this out. Most people can’t do math, let alone grasp basic economics. I can explain a futures market in three minutes to a six year old but after 12 years of Marxist indoctrination all I get from high school seniors are blank stares and the mindless stammering of words like “speculators.”
See “Obamanomics” for further examples of a grown man being more stupid than a six year old.
No, it doesn’t. It involves risk offsetting and hedging; in other words making intelligent bets. There is no difference between an insurer betting you that your house won’t burn down, or that you won’t need expensive surgery, and a bookie betting you that a specific horse won’t win. And there is no difference between forcing an insurer to take a bet it knows it’s going to lose and simply robbing him outright, or mugging a little old lady.
Bulldust. Insurance is a bet. The company bets you that your house will not burn down. They know exactly the odds that they will lose the bet, and they charge you more than enough to cover that contingency. If there is a 0.8% probability that your house will burn down, they charge you something like 0.9% of its value; if the probability is 100% they charge you perhaps 110% — or they refuse the bet. Nobody is forced to subsidize anyone, or to cover anyone else’s payout.
No. Unfortunately like most people you have no idea how pre-existing conditions affect health insurance coverage. Or, what constitutes a pre-existing condition.
A pre-existing condition doesn’t mean you can’t buy health insurance from a new insurer. It simply means that the new insurer will not cover the new client for that condition. Suppose a woman had breast cancer that is now in remission. That didn’t mean she couldn’t buy insurance. Just that the insurer wouldn’t cover expenses arising from her pre-existing condition. So she’d have to find some other way to pay for her treatment if the cancer returned. But if she broke her leg or her pancreas ruptured the insurance would cover that since they were unrelated to the pre-existing condition.
And then the insurer could only refuse to cover expenses arising from pre-existing conditions for a specific amount of time. After a certain amount of time, in my experience six months but maybe for some people upon the next annual policy renewal, insurance will cover those expenses.
Sorry about your daughter, but while she may like her coverage there are hundreds of others who lost theirs because of Obama. There were a lot of cancer patients who had achieved excellent results because they were able to use their insurance to assemble a network of specialists who could keep them alive. Like all communist projects, such as the People’s Republic of China which doesn’t belong to the people and isn’t a Republic but is geographically China or the Democratic People’s Republic of Korea which simply adds another false adjective to describe a brutal hereditary dictatorial concentration camp on the Korean Peninsula, the Affordable Care Act isn’t affordable and has nothing to do with providing care but like the other communists getting the geography correct our communists were correct about it being an act of Congress.
Obamacare policies were designed to redistribute wealth and income, nothing more. A drunken Max Baucus happily slurred his way through a speech on the Senate floor, triumphantly bragging how the American people had been taken to the cleaners. They had to lie about how you could keep your doctor if you liked your doctor and how you could keep your plan if you liked your plan because no health insurance plan prior to Obama was intended to steal from clients A and B to pay for client J’s more expensive costs. They all had to be replaced with health insurance plans that weren’t intended to provide coverage to the people paying the premiums but to provide coverage to people who weren’t paying the premiums that actually covered the cost of providing their own health care.
Like your daughter.
And now there are cancer patients who can’t keep their networks of care-givers together. Say they had three specialists. Now Blue Cross may have two of the three in their networks but not the third. And Kaiser will have one of those same doctors in its networks, and the third that Blue Cross didn’t include, but the second doctor that is in Blue Cross’ network isn’t in Kaiser’s.
I tend to be skeptical of stories like yours because for every one like it there are ten stories from people who are worse off under Obamacare. Or, maybe they aren’t worse off now because Obamacare has finally killed them. Which isn’t to say that some people haven’t benefited. But if they have it’s been at the expense of others. By definition, because as every economist knows all resources are scarce. Life is just a series of trade-offs.
At least in a market economy you, the health care consumer (or whatever market we’re talking about it) have a say in what kind of trade-off you’re willing to make. In a centrally planned economy, which is what Obamacare is no matter how much “free-market” lipstick they put on that pig, it’s entirely out of your hands. And don’t make any mistake; if your daughter benefited it isn’t because the nameless, faceless bureaucrats in DC care about her. Just as they had nothing personal against those cancer patients they screwed over. Like all leftists they don’t care. Since job security for many thousands of new federal hires (mostly IRS and HHS) depends on keeping the Obamacare gravy train rolling, if they had to screw over your daughter and to paraphrase Obama deny her a life saving surgery and instead give her a pain pill and send her home to die, they would.
See the Veterans’ Administration for further examples.
The situation is simple. Obama, in collusion with HHS Sec.Sibelius, Attorney General Holder, the IRS, the Democrat Congress and others left out of the the ACA, the appropriation for subsidies to compensate insurance company losses. It may have been to game the CBO computations for the cost of the ACA, or perhaps because of the stupidity of Democrat lawmakers and plan architects like Professor Jon Gruber, but the appropriation was left out. Obama and his minions, listed above, conspired to rob the U.S. Treasury (taxpayers) of billions of dollars by illegally paying the subsidies anyway, without any congressional appropriation as constitutionally required. Now the Trump administration is stopping the illegal payments. It’s that simple. Article 1, section 9 says “No money shall be drawn from the Treasury, but in consequence of appropriations made by law.” That appropriation was never made as part of ACA or otherwise. Obama and others created a false interpretation of ACA that has been struck down by a Federal district judge, and Trump is following that judgement. To reinstate payments, the U.S. Congress will need to appropriate the payments and the president will need to sign the law appropriating the funds. Our government is not a one man dictatorship ruled by a person with a phone, a pen and bad intentions or good intentions. Thank you, President Trump, for removing this illegal theft from the Treasury.
“but there’s no reason (aside from politicalization of the issue) to believe anyone will die or health insurance will be unaffordable because of Trump’s recent decisions. Quite the contrary.”
You completely neglect the issue of pre-existing conditions. I suspect some provision will eventually be made, but there is nothing in the EO which would provide one. And I doubt such a provision could be made by EO.
Before Obamacare killed them, at least 34 states already had high-risk pools for people with pre-existing conditions who couldn’t get health insurance on the private market. I know – I have a pre-existing condition and was in Florida’s high-risk pool. For me, it was more expensive than an “ordinary” plan would have been, but I believe there were subsidies for lower-income folks.
The advent of the ACA wiped these plans out with the stroke of a pen.
What state are you in, Gibbie, and how was your daughter insured prior to the ACA?
FL, and she couldn’t get health insurance because she had a pre-existing condition.
That’s a shame. All I needed was to have been either turned down for normal health insurance, or only offered policies which specifically excluded anything having to do with my pre-existing condition, by three companies.
Now people like me (and your daughter presumably) really will be left out in the cold if the Trump administration removes the requirement for health insurance companies to cover anyone and everyone before some provision, either state-based or federal, is made for some sort of high-risk pool of the type Obamacare killed. So I understand that fear of yours. But hopefully they won’t do that.
I assume your daughter now has private health insurance currently? If I were you I’d advise her to stay on it and keep her premiums paid. I’m fairly sure that if you have an insurance policy, they can’t kick you off it (unless you stop paying, or are found to have lied or something). Even before the ACA, it’s only when you’re applying for a new policy that they can take pre-existing conditions into account.
Your daughter’s pre-existing condition was covered under your insurance from your employer until adulthood, after which time your daughter was covered by her employer’s health insurance. I’ve never seen one of those that disallowed pre-existing conditions. If they did nobody would have health insurance. If your daughter is unable to work because of her condition then she will be covered under Medicaid or Medicare.
The entire population of the US should not be forced into this abomination of a “health care plan” that provides neither low cost insurance or health care because of a minority of the population.
At any rate, neither of the actions that President Trump has taken – allowing insurance across state lines and ending the massive subsidies to the insurance companies – eliminates the provision of the law that requires insurance companies to provide insurance for those with pre-existing conditions.
Granny, you’re working under the assumption that everyone has employer-provided health insurance. That’s not true. Some of us pay for it ourselves, just as we do our home & contents insurance and car insurance.
The idea of your boss being expected to arrange your health insurance is an obsolete hangover from WWII-era attempts to get around wage controls, and hopefully in the not-too-distant future that loophole will go away. It will take a lot of the distortions out of the market.
As an individual that at one point had a per-existing condition (Hodgkin’s Disease Cancer) which I have been in remission long enough that it no longer qualifies as a per-existing condition, I was VERY cognizant of health insurance requirements.
There were very specific things that I looked for in employment prior to becoming an attorney, and my wife and I had a very, very specific set of agreements when I got my law degree and opened my own law practice: When I was working, anywhere I worked had to offer an “unlimited” policy plan (a plan with an unlimited lifetime benefit). Yes, it limited where I chose to apply for work, but that was the trade-off in exchange for being eligible for coverage that would accommodate my particular health needs.
Alternatively, so long as I am operating my own law practice, the agreement I have with my wife is that anywhere SHE works MUST offer health insurance (the requirement regarding lifetime maximum benefit has been removed by legislation).
People need to understand that there ARE rules. One of the mantras I have installed in my son is “Just because we want something” and he replies “doesn’t mean we can have it.” Health Insurance is no different than any other rational market, and the fact that we have abused it into a “guarantee” is a travesty, which is largely why the costs have spiraled the way they have. Others have better described exactly WHY individual costs are what they are due to insurance billing manipulating numbers based on “negotiated” payments and cross-referencing Medicaid/Medicare reimbursement rates.
Clean up those artificial influences, and Medical Care becomes reasonably priced again.
Aren’t pre-existing conditions a narrow problem that only needs a narrow solution?
The ACA is like the exterminator burning a building down to make sure he kills the roaches. Isn’t it far less expensive to just focus on the roaches?
The ACA was/is not about health care or health insurance: It was about moving the totalitarian control forward.
Totally agree!
Absolutely. As I often pointed out in the run-up to the ACA, the number of Americans with pre-existing conditions who could not find any health insurance at all, either through the ordinary market (albeit paying a bit more, to reflect the higher risk), through a special high-risk pool, through an employee pool, or through the government (Medicare/Medicaid), was probably a pretty low number. It would have made far more sense to work something out for this small minority of “special cases” than to completely up-end the system for everyone else and take over 1/6th of the American economy.
“Hey guys, let’s design the most fragile health care system imaginable, one guaranteed to collapse as soon as I leave office!”
Heckuv a legacy you got there, Omaba!
One more of his legacies looks about to be consigned to the dust bin of history today as well.
Darken getting sick of all this winning people! HAHAHAHAHAHAHA
Obama was funding these bailouts illegally through slush funds. Democrats can complain all they like, but they can’t force Trump to do something illegal that he clearly doesn’t want to do anyway.
This will cause chaos at the very least to the Obamacare structure. If insurers can safely predict there will be no bailouts in the future, there will be a mass exodus from the market and that will be the end of the ACA in practice.
Ted Cruz was on Fox News this morning (10/13) and said that the Health Insurance Companies PROFITS had Doubled from 2007 to 2015 ,,, 8 Billion to 16 Billion ,, so tell me again how much the cost of health care is the fault of the hospitals & doctors ??
Good…up to the point you, too, conflated “health care” with “health insurance”.
Just to be very clear, I don’t fault “doctors and hospitals” for the cost of health care. The blame for that lies in the manifold market distortions that swirl around the issue.
In my own case, when I see my private doc, I pay for the visit, and it’s a modest cost.
“manifold market distortions that swirl around the issue”
There are so many of them it’s difficult to get a comprehensive picture.
My favorite is that hospitals have to treat anyone who shows up and needs treatment regardless of their ability to pay for it. This may or may not be a good thing, but it is definitely a huge market distortion. I’m not sure what is the point of getting rid of Obamacare and retaining the hospital mandate.
Just to be accurate: you mean “stabilize.”
You keep saying “treat” but that’s not what is actually happening.
“Treatment” would mean addressing the underlying condition. That is most assuredly NOT what the hospitals are doing. They are treating the immediate emergency, and sending the individual on their way and billing them (and attaching assets for recovery).
I hate it when that happens.
All together people:
HEALTH INSURANCE IS NOT HEALTH CARE!
Good call Ragspierre
Dems in my state (Wa) are foaming at the mouth, so it must be good.
I was thinking about the buying across state lines- and love it because it cuts crony politicians off at the knees who have mandated that we pay for happy ending massages, sex changes, and other stuff that drive up costs in exchange for lobby money. MY BET THAT IS THE REAL REASON THE SIMPLE SOLUTION OF BUYING ACROSSS STATE LINES HAS BEEN IMPOSSIBLE FOR SO LONG.
As an aside- an inlaw was in a terrible car accident and had to airlifted to the hospital. After months of recovery the total bill was close to 350k. The amount actually paid was 50k. Hell- they could have paid that out of pocket. If we took away this shell game where everything. It’s like the cost of aspirin if you buy it from the pharmacy is $100, but if you have insurance, the pharmacy gets $1. Just charge me the $1 and all of this political crap goes away.
From what I understood, this fund was (or at least was *sold* as) a leveling mechanism by which insurance companies would lose some money on insuring poor people and gain some money by overcharging rich people, and in the end, the fund was supposed to waver back and forth as it paid/was paid money back and forth to the insurance companies.
Anybody who believed that honestly, has never done business with an insurance company.
Instead, the companies happily sent in bills for the ‘shorts’ while keeping every penny of the ‘longs’ as long as they could keep their heads above water and as long as the Dems kept writing them checks. About right?
Once all of Obama’s actions are eliminated we can then remove Obama from our listings of Presidents.
Should his Nobel Prize be taken away since he didn’t do anything to get it?
He should be removed from the list of presidents since he never was eligible for the presidency anyway.
Well, he hadn’t done anything to earn it when was nominated for it, and that hasn’t changed… it wouldn’t be fair to take it away now.
1. No actions are necessary for him to have been president. In fact a president who did nothing at all would be one of the best presidents on record!
2. And that would make him different from all the other Peace (or Literature) Prize winners how?
“It’s not my responsibility to pay for your daughter’s healthcare. Go virtue signal with your own money.”
If you ever need a heart transplant (which it appears you do), pay for it out of your own pocket.
It ain’t my responsibility, but if your daughter ever needs help, post it up here.
I’ll do what I can, and others will, too.
Thank you for your kind offer.
If you need charity, ask for it. Nobody has to give it to you. If someone has genuine insurance, then of course the insurer has to pay, just as it does when any insured-against event happens, whether it’s a ship sinking or Martians invading.
I use to have no problems paying for private health insurance. But now the premiums have increased in access of 100% and this year are going up another 20%. What just a few years ago cost 900 a month now cost over 2000 and the deductible has went from 2000 a year to 7500. I also now have a pre-existing condition and need a lung transplant. What will my monthly premium be. I really don’t want anyone to pay my health insurance. I’ve been paying into health insurance for 50 years with extremely low usage until last year. I earn a good living. So forcing me into disability is the right answer?
Health insurance should work like life insurance; if you’ve been paying your premiums they can’t kick you out just because you got older and sicker.
Arminius: “Suppose a woman had breast cancer that is now in remission. That didn’t mean she couldn’t buy insurance. Just that the insurer wouldn’t cover expenses arising from her pre-existing condition. So she’d have to find some other way to pay for her treatment if the cancer returned.”
I hope this doesn’t happen to anyone you care about.
The health care issue is quite a pickle. There are several questions here.
Did she have insurance when she had her first bout of cancer? Did she drop it when she recovered? Did the insurance company cancel her policy because she was costing them too much?
Do you think that churches and other organization should step up and cover their members’, and perhaps others’ health expenses if they can’t afford to themselves? Do you think that’s likely to happen?
Do you think that people should be required to carry at least catastrophic health insurance? I realize it’s unconstitutional, but at some point foolish people cease to deserve their freedoms.
Do you think it’s better for society if the relapsed cancer patient has to declare bankruptcy than if an insurer is required to issue her a policy which distributes the cost of her care? Bankruptcy also distributes the cost of her care.
Do you think Medicaid should be abolished? How about Medicare?
BTW, I agree that single-payer government healthcare in the US would have horrible consequences. It would lower the standard of health care for the entire planet.
“Impatience with the messiness of human existence is the mark of the true totalitarian.” (Victor Ferkes) This is the essence of leftism. Let’s not let it infect us too.
“…Do you think that people should be required to carry at least catastrophic health insurance? I realize it’s unconstitutional, but at some point foolish people cease to deserve their freedoms…”
Again, I have trouble coming close to comprehending your thinking. Why should I be required to buy anything including health insurance? Why should anyone be required to provide me with anything I can’t or choose not to pay for, including health care?
Personally I would love to have the option of paying a small monthly fee for concierge health care supplemented by catastrophic health care insurance but thanks to our Soviet central planners it’s not an option.
So I choose to pay cash. And I do pay my bills.
Please explain why I am “foolish” for not having insurance. If you scroll up you’ll see I a have to pay a bill for a recent September night’s stay in a hospital. Certain vendors are not employees of the hospital, so I’ve already paid in full for the services of the radiologists and pathologists. Since I’m paying cash I get discounts; the last bill I have to pay is for the hospital itself but I’m awaiting the revised bill that reflects the 45% cash discount.
Why would I have been so stupid as to pay the premiums for a useless insurance policy when I would have had to pay everything that was less than the deductible? And that would have been the full bill, with no cash discounts. As I understand it, had I had insurance I would have been charged twice what I am being charged now. In the hope that eventually, if I filed enough claims, eventually my high-deductible “Obamacare” policy would have kicked in and paid for something.
It’s October. It’s never going to happen. So rather than throw money down the toilet paying useless Bolshevik-designed premiums I just save the money and pay my actual bills.
How am I foolish? What freedoms do I deserve to lose? Discuss.
P.S. The only people who deserve to lose their freedom are the leftists who designed this craptastic system.
I think it’s foolish to not have at least catastrophic health insurance. Perhaps you could afford to pay the cash discount for a liver transplant, but the vast majority of people could not. And it’s madness that Obamacare made catastrophic coverage impossible.
I didn’t know that there was such a thing as “cash discounts”. It sounds subversive, so I’m surprised it’s allowed. I hope you get your “revised bill”.
I’m actually starting to feel sorry for you. Yes, thanks to Obamacare I can’t get anywhere near close to the coverage I want.
And, no, I couldn’t afford to pay for the organ transplant out of pocket. But I could pay for the hospice care.
Again, why should I be forced to pay for something I don’t want? Why should anybody else pay for something I didn’t want to pay for or can’t pay for?
About the subsidies. Some states are filing suit to keep the CSR payment appeal going. I’m not sure how they would have standing here. This is a federal program that congress has decided not to fund. The original suit was between the House and HHS. So how do the states get a say in court over this?
They seem to be saying that this will cause their citizens hardship via higher insurance premiums but if this is grounds then any state that wanted to stage a tax revolt could sue over increased taxes causing their citizens hardship. I doubt that would fly.