The Executive Order attempts to unwind the law through Administration action, since Americans and Congress rejected legislative repeal efforts. The order will allow insurance companies to sell cheaper, “junk” plans that are exempt from Obamacare requirements. These changes could expand coverage options for healthy customers, but would raise costs for individuals who need more comprehensive coverage, or potentially leave them without coverage options at all. The Order would allow insurance companies to sell short-term health plans and association plans for small businesses, and in some cases, individuals. Association plans exist today but the Executive Order would exclude them from ACA regulations that require all plans meet a minimum standard and cover essential health benefits.
The Executive Order, much like the ACA repeal bills that Congress considered this year, would be terrible for Americans with pre-existing conditions and leave millions with insurance policies that do not cover essential services like prescription drugs, hospital visits, or critical treatments. The new, less regulated insurance plans would be attractive to healthy people, while at the same time making it difficult for individuals with pre-existing conditions to find comprehensive health care coverage. This Order would be harmful to the 1.7 million Americans diagnosed with cancer this year and the millions who will be diagnosed in the future. As the 16 million Americans living with cancer well know, we are all only temporarily healthy.
Later in the day, President Trump took another action that would disrupt the marketplace and make it more difficult for low-income Americans to purchase health insurance through the exchanges. The administration announced it will immediately halt cost-sharing reduction (CSR) payments. The $7 billion in annual subsidies help around 7 million low-income Americans to afford their deductibles and co-pays. While the Administration has called the CSR payments a “bailout,” this characterization is inaccurate. The payments are made to insurance companies, who then pass them along to medical providers.
The Congressional Budget Office says that ending CSR payments will result in 1 million more Americans uninsured, premiums will rise by 20% and the deficit would rise by $194 billion. As the Washington Post reports, the uncertainty about what Trump would do has already driven premium prices higher for 2018 – in some states, increases topping 50 percent. Now it’s going to get worse. And NPR reports that pulling CSR payments not only hurts the low income Americans who depend on the subsidies, the decision will also hurt middle-class individuals who earn too much to qualify for help paying their premiums.
To be clear, these actions will have a combined effect of “sabotaging” the Affordable Care Act. The replacement will be “Trumpcare,” a system that will not offer adequate health care to Americans and that will instead put many at risk. The National Coalition for Cancer Survivorship (NCCS) strongly opposes the decision to pull CSR payments and the Executive Order to allow substandard health plans and we will be an active and aggressive participant in the regulatory process, to make sure that the needs of those with cancer and other serious illnesses are reflected and that their access to affordable and adequate health insurance is protected.
Follow NCCS on Twitter to stay updated on developments: @CancerAdvocacy.