Wednesday, October 18, 2017

Trump gives mixed signals on ACA subsidy deal

"Yet another last-ditch effort to tackle the nation’s health-care system stalled within hours of its release by a bipartisan pair of senators Tuesday, with President Trump sending mixed signals and Republicans either declining to endorse the proposal or outright opposing it," The Washington Post reports.

Senators Lamar Alexander  (R-Tenn.) and Patty Murray (D-Wash.) reached a compromise yesterday that would authorize federal cost-sharing subsidies for the next two years while granting states more flexibility in regulating health coverage under the Patient Protection and Affordable Care Act. The subsidies help offset the cost to insurers of low-cost plans for lower- and moderate-income Americans. Because insurance companies are still required to offer those discounts even without the subsidies, critics say insurers will likely withdraw from poorer and rural areas where more people purchase low-cost plans with higher out-of-pocket costs. That could leave some counties, especially in rural areas, without any ACA insurers.

President Trump appeared to support the compromise yesterday, but in a tweet today said "I am supportive of Lamar as a person & also of the process, but I can never support bailing out ins. co's who have made a fortune w/ O'care." Actually, the payments reimburse insurers for the cost of the discounts.

"But that message may have been more of a caveat than a rejection," Robert Pear and Thomas Kaplan report for The New York Times. Alexander told the Times that the president called him today and wanted to be "encouraging" about the agreement. Trump, Alexander said, "intends to review it carefully to see if he wants to add anything to it" and "wants to reserve his options."

The deal did not get a rousing reception in the Senate or the House, but Sam Baker of Axios Vitals reports that both Democrats and Republicans interested in it "are claiming victory. That ultimately bodes well for the future of the package, which experts on both sides say is likely to help stabilize the individual market." For a more detailed roundup of the coverage, see this story on Kentucky Health News.

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