Popular vote loser Donald Trump has threatened to sabotage Obamacare to try to force Democrats to come to the table on his disastrous Zombie Trumpcare plan. It's not working because Democrats aren't stupid and are refusing to negotiate with a hostage-taker. At issue right now is continuing cost-sharing reduction payments to insurers who are subsidizing low-income Obamacare customers. House Republicans sued the Obama administration over these payments, saying they weren't explicitly included in the law and are thus unconstitutional, and they got one federal judge to agree with them, though that decision has been stayed. While the court case hangs in limbo, the Obama administration continued those payments. Trump, however, might stop them even though congressional Republicans have decided that maybe they should drop their opposition and fund them because without them, people could start losing their insurance and there's nothing in place to avert disaster. So here we are.
Democrats now have more material—a lot more—to support their fight. That's thanks to a new analysis from the Kaiser Family Foundation of what it would cost the federal government—taxpayers—if the payments go away and insurers stay in the markets.
Ceasing payments for the Affordable Care Act’s (ACA) cost-sharing reduction program could save $10 billion, but cost an additional $12.3 billion in premium tax credits – an estimated net increase of $2.3 billion, or 23 percent, in federal spending on marketplace subsidies – in 2018, if insurers continue to participate in ACA marketplaces, according to a new analysis from the Kaiser Family Foundation. […]
Without the payments, the analysis finds, the average ACA marketplace premium for silver plans would need to rise by 19 percent in 2018 for insurers to offset the lack of funding. Estimated premium changes vary for the 38 states that used healthcare.gov in 2016, ranging from 9 percent in North Dakota to 27 percent in Mississippi. […]
According to the analysis, the government would owe an estimated additional $12.3 billion in tax credits in 2018, if cost-sharing reduction payments end and if insurers choose to continue offering plans in ACA marketplaces. The government would save $10 billion from stopping the payments, resulting in a net increase in federal costs of $2.3 billion. Extrapolating to the 10-year budget window (2018-2027) using the Congressional Budget Office’s projections for cost-sharing reduction payments, the net increase in federal costs would be $31 billion.
The alternative is that insurers leave the marketplaces, the end result being lots of people losing their health insurance plans and probably not being able to replace them. That's not a particularly good look for Republicans, either. The other alternative is for Congress to do what regular Americans, the insurance companies, the healthcare providers and institutions, and the U.S. Chamber of Commerce want them to do—make the payments.
Republicans have totally backed themselves into a corner on this one, and now are at the whims of an unstable and unpredictable president who might just decide he wants the government to shut down over this or any other issue. It's no more than they deserved, but it sure does suck for the rest of the country.