The God-King will sabotage Obamacare again…. (More)
“Millions of Americans rely on these benefits to afford their coverage and care”
President Trump is throwing a bomb into the insurance marketplaces created under the Affordable Care Act, choosing to end critical payments to health insurers that help millions of lower-income Americans afford coverage. The decision coincides with an executive order on Thursday to allow alternative health plans that skirt the law’s requirements.
The White House confirmed late Thursday that it would halt federal payments for cost-sharing reductions, although a statement did not specify when. Another statement a short time later by top officials at the Health and Human Services Department said the cutoff would be immediate. The subsidies total about $7 billion this year.
The Affordable Care Act provides two kinds of subsidies to help low- and middle-income people pay for insurance on the exchanges. Premium subsidies defray the cost of premiums for people making less than four times the poverty level. For those who make less than that, cost-sharing reductions help cover the costs of deductibles and other out-of-pocket spending.
Although they serve similar goals, the two subsidies function in different ways. The premium subsidies are refundable tax credits that go to individuals: They are administered through the tax code. For cost-sharing reductions, the ACA requires insurers to cut their lowest-income customers a break on their out-of-pocket spending. In turn, the statute says the federal government will, reimburse insurers for doing so.
The problem is that Congress never included these payments in an appropriations bill, and conservatives claim that makes them “illegal.” But they were part of the original Obamacare bill and refusing to fund them in later appropriations bills does not make the original law vanish, as Bagley explains this morning:
So what happens now? Lawsuits, lawsuits, and more lawsuits. Right out of the gate, I’d put dimes to dollars that that the 16 states that have intervened in the ongoing litigation will seek an immediate injunction from the D.C. Circuit to keep the cost-sharing payments flowing. The states may also file a separate lawsuit in district court seeking the same relief. I don’t know if either gambit will work, but the states will try.
If the Trump administration successfully brushes back those efforts, I explained what comes next in an article for the Penn Law Review:
Even without an appropriation, the ACA creates an entitlement to cost-sharing reductions. Health plans can vindicate that entitlement before the Court of Federal Claims. Payment would then come from the Judgment Fund – a permanently appropriated fund to pay court judgments where “payment is not otherwise provided for.” The question is thus not whether the government will pay, but when.
Bagley suspects Republicans will try to duck that with an amendment to the next appropriations bill, to the effect that no Judgement Fund money can be used to pay claims from Obamacare. However, that would default on a statutory debt … with all of the Full Faith and Credit Clause implications.
And legal challenges are already in motion, as New York Magazine’s Jonathan Chait reports:
What’s more, by withholding payments promised in law, the administration is exposing itself to a lawsuit it could very well lose. (New York Attorney General Eric Schneiderman has already announced his intention to sue.) Premiums are going to rise in the meantime, because insurers are subjected to greater uncertainty and the now-demonstrated knowledge that the administration is deliberately sabotaging the law they are operating under.
Most of that damage will be done before a federal court can hear a challenge and declare that the government must pay its bills. Chait tries to offer a hopeful conclusion:
Congress is not going to repeal and replace Obamacare. The Medicaid expansion, which accounts for a majority of the law’s coverage gains, remains in place and is not vulnerable to administrative sabotage. Individual consumers are going to experience a lot of financial pain as a result of Trump’s action. As premiums rise in response to the sabotage, the main public recourse will be to replace the Republican-led government with one capable of passing a workable and humane health care law.
Alas, again, the damage will also be done before the 2018 midterms, let alone the 2020 presidential election.
Oh, and this….
“I will tell you, you cannot disrespect our country, our flag, our anthem. You cannot do that.”
On Wednesday evening, Donald Trump taped an interview with Sean Hannity at Harrisburg, Pennsylvania’s Air National Guard base. During the taping, the daily “Retreat Ceremony” began.
The ceremony serves two purposes – to signal the end of the duty day and pay respect to the nation’s flag.
Once the bugle sounds, all personnel driving on the installation should stop. Service members and government civilian personnel are encouraged to turn off their vehicles, and, if safe to do so, exit to render the appropriate honors.
Individuals outside of buildings will also render the appropriate honors to the flag during the ceremony.
Instead, the God-King joked that the solemn bugle call was for Hannity’s ratings. Yes, really:
TRUMP: What a nice sound that is. Are they playing that for you or for me? They’re playing that in honor of his ratings. Did you see how good his ratings are? He’s beating everybody.
HANNITY: I think they’ll be higher tonight. I’m just guessing.
They should’ve taken a page from the late Robin Williams:
That, ladies and gentlemen, is how you “respect the flag.”
Photo Credit: Brendan Smialowski (AFP/Getty Images)
Good day and good nuts