When Aetna, the health insurance giant, announced this month that it was pulling out of the Affordable Care Act’s insurance exchange in Virginia in 2018, President Trump responded on Twitter: “Death spiral!”
When Humana announced plans to leave all the health law’s marketplaces next year, the president chimed in, “Obamacare continues to fail.”
Left unremarked on was a big reason for the instability: The Trump administration and Congress are rattling the markets.
The administration’s refusal to guarantee payment of subsidies to health insurance companies, the murky outlook for the Affordable Care Act in Congress and doubts about enforcement of the mandate for most people to have insurance are driving up insurance prices for 2018, insurers say in rate requests filed with state officials. Continue reading the main story The Trump White House The historic moments, head-spinning developments and inside-the-White House intrigue.
Opponents of President Barack Obama’s signature legislative achievement have made what may be a self-fulfilling prophecy: They repeatedly forecast the collapse of the health law, and then push it along.
Frustrated state officials have ideas for stabilizing the individual insurance market, but they say they cannot figure out where to make their case because they have been bounced from one agency to another in the Trump administration.
“We have trouble discerning who has decision-making authority,” said Julie Mix McPeak, the Tennessee insurance commissioner and president-elect of the National Association of Insurance Commissioners, which represents state officials. “We reached out to the Department of Health and Human Services. They referred us to the Office of Management and Budget, which referred us to the Department of Justice. We reached out to the White House Office of Intergovernmental Affairs.”
The Trump administration has sent mixed signals, reflecting an internal debate about whether to stabilize insurance markets or let them deteriorate further. Mr. Trump has said he could cut off the subsidies at any time if he wanted to.
The government may clarify its plans in a legal brief to be filed on Monday with the United States Court of Appeals for the District of Columbia Circuit. Or it could simply ask the court for a three-month extension, prolonging the uncertainty.
State insurance commissioners have joined insurers, hospitals and congressional Democrats in urging the administration to pay “cost-sharing” subsidies, and federal health officials initially indicated that they would do so. But Mr. Trump countermanded them, refusing to make any long-term commitment.
On Thursday, 15 Democratic state attorneys general, led by Xavier Becerra of California and Eric T. Schneiderman of New York, filed a motion to intervene in the case, demanding that the payments continue.
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