Trump kicks the CSR can down the road another 3 months...which does NOTHING to resolve carrier uncertainty.
2018 MIDTERM ELECTION
Time: D H M S
The House of Representatives and Department of Justice plan to ask the DC federal appeals court to keep on hold for another 90 days a lawsuit that questions the legality of cost-sharing subsidies in the Affordable Care Act, according to four people familiar with the matter.
The White House, during that time, will continue to make payments to insurers, according to a senior administration official.
OK, assuming they do indeed ask for this, and assuming the court grants a third 90-day extension, this means that CSR reimbursement payments can continue for another 3 months. That's the good news.
Insurers planning to offer plans on the exchanges in 2018 must submit their pricing in the coming days and weeks.
..."If the administration seeks a delay on Monday, presumably they would continue to pay the cost-sharing reductions but they don't have to actively defend the lawsuit in the short term," said Chiquita Brooks-Lasure, a managing director at Manatt Health.
The White House had told Congressional leaders it would make the monthly payment for May, which were due on May 19, but had stayed mum on payments thereafter. Next month's payment is due June 20.
Here's the bad news: That "presumably" caveat is critical, especially given that no pledges made by Trump mean a goddamned thing 5 seconds after they leave his mouth. He has zero credibility on this or any other issue. None. Zilch. The insurance carriers have absolutely no reason to feel any confidence that just because he made the May payment he'll make the next one in June, or in July or August.
Furthermore, the larger point here is that while Donald Trump could cut off CSR payments whenever he wishes, he's really not in any position to guarantee that they aren't cut off beyond a particular date. That issue is up to Congress and/or the federal Judge who made the ruling, Rosemary Collyer.
Collyer could deny the hold request, for instance...in which case I presume CSR payments would have to stop immediately even if Trump wants to keep making them.
As for the House Republicans, seeing how they're the ones who brought the lawsuit in the first place, they could resolve this whole mess by taking one of two actions:
- Drop the lawsuit altogether (which, for some surreal reasons which Nicholas Bagley explained, may not be possible at this stage even if they want to), or...
- PASS SIMPLE LEGISLATION AUTHORIZING CSR PAYMENTS, at least for a certain time period (say, through the end of 2018 or 2019 at least, since 2020 is when the AHCA would theoretically wipe out CSRs altogether anyway).
That's literally all they have to do, and the CSR case either dissolves completely or, I presume, would at least be made moot until that time period runs out (I'm sure Bagley can explain the details of how that would play out). A clean CSR authorization bill (i.e., one which doesn't include any poison pills like defunding Planned Parenthood or whatever) with GOP support would also get every single Democratic vote in both the House and Senate, I guarantee, which would mean a 2/3 majority in both, making it impossible for Trump to veto.
Ane yet...they won't do it.
The insurance carriers have also come to understand that relying on Trump is a) useless and b) doesn't resolve the larger issue anyway. Want proof? They say so flat-out in their latest letter to Congress from last week:
As providers of healthcare and coverage to hundreds of millions of Americans, we are writing again to you as leaders in Congress to express our serious concerns about the continued uncertainty around funding for cost-sharing reduction (CSR) payments. There now is clear evidence that this uncertainty is undermining the individual insurance market for 2018 and stands to negatively impact millions of people.
We urge Congress to take action now to guarantee a steady stream of CSR funding through 2018. Such action would represent a strong, positive step for all consumers who buy their own insurance by eliminating the single most destabilizing factor causing double-digit premium increases for 2018.
...Consumers who purchase their own insurance will have few, if any, coverage choices. As a result, millions of people will become uninsured.
With more uninsured, providers will experience more uncompensated care which will further strain their ability to meet the needs of their communities and will raise costs for everyone, including employers who sponsor group health plans for their employees.
Taxpayers will pay billions of extra dollars in costs due to higher premium subsidies—in fact, recent studies have found overall federal costs will be 23 percent higher.
Congress must take action now to fund CSR payments. At this point, only Congressional action can help consumers. We remain committed to working with you toward immediate stability and longer-term, effective, market-based solutions that best serve the American people.
"At this point, ONLY Congressional action can help consumers."
How much clearer can they be about this?