Trump Administration Not Alone in Attempts to Undermine Insurance Markets

In an unusual Saturday announcement, the Trump Administration took another swipe at the Affordable Care Act that is expected to increase premiums on middle-class consumers. The move would freeze protection payments to insurers with “sicker patients” from financial loss. Those payments are known as “risk adjustments.” This is the latest move to undermine the ACA and it will result in higher costs to consumers. Make no mistake, it is all being done for politics. The administration isn’t alone in their efforts.

After the Republican controlled Congress failed to “repeal and replace” the ACA, the administration has taken to withholding anticipated money from insurers. The first move in October of 2017 was to eliminate the cost-sharing reductions (CSR) that helped low-income individuals with out-of-pocket costs. Those payments went to insurers, not the consumers. It was an attempt to get insurers to leave the established marketplace. It worked in North Dakota, Medica left the marketplace because Insurance Commissioner Jon Godfread refused to allow companies to even consider rates without the CSR payments. The result was fewer insurance options in ND.

Then in December of 2017, Republicans in Congress passed a rushed tax reform bill. In it, they removed the individual mandate. Though unpopular, it was a mechanism of keeping rates down because more healthy individuals were in the market. With it gone, rates are likely to go up further than anticipated in 2019. Whatever tax reduction – if you received one at all – may be eaten up by higher premiums next year. When Kevin Cramer touts this rushed bill for campaign purposes, he neglects to mention that reality. The result is higher premiums in ND.

There is more. Last month, the Trump administration abandoned defending protections for people with preexisting conditions. They decided to no longer defend the provision in an on-going court case started by Texas. North Dakota’s Attorney General Wayne Stenehjem signed on to that lawsuit. What gave this court case stronger merit according to those pursuing it? The elimination of the individual mandate voted in place by Kevin Cramer and John Hoeven. The result may be the loss of protections for people with preexisting conditions in ND.

Donald Turmp and Kevin Cramer

Saturday’s announcement to freeze payments will have a further impact on insurance rates. The “risk adjustment” takes payments from insurers with healthier consumers and distributes it to companies with more sick consumers. No taxpayer subsidies are involved according to the Associated Press. The Blue Cross Blue Shield Association President Scott Serota said Trump’s move, “will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices.” The result yet again is higher premiums in ND.

After sixty “symbolic” votes to repeal ACA, as Cramer put it, they failed to succeed because they had no replacement that would work. Now the administration, without a health care policy of their own, is taking a sledgehammer to the current law. All of these decisions have had or have the strong potential to not only disrupt the market, put raise rates and result in people losing coverage.

Do you see the pattern? It isn’t just the Trump administration, it is being aided by people right here in ND. Because of Cramer and Hoeven’s December tax vote, Stenhjem signed onto another lawsuit against current law. This time regarding preexisting conditions. An insurance company dropped coverage in ND’s marketplace because payments were stopped and Godfread refused them flexibility. Yet, at every turn, you see these same politicians issue a boilerplate press release blaming ACA for insurance woes when some of it has been their own actions that have led to further rate hikes. Meanwhile, modest, workable, bipartisan fixes to the ACA have been rejected in Congress time and time again. It is all being done for politics.

Tyler Axness
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