President Donald Trump’s health policy is hurting U.S. citizens, says Senator Susan Collins (R-ME), “by affecting the ability of vulnerable people to receive health care right now.” On CNN’s State of the Union, Collins blasted the Trump administration’s decision to stop paying insurance companies for subsidizing health plans on the Affordable Care Act (ACA) marketplace.
Collins is not the first Republican to criticize Trump for undercutting the ACA marketplace, where nearly 22 million people get insurance. And the criticism doesn’t end there. Insurers, doctors, hospitals, and even the U.S. Chamber of Congress think the federal government needs to pay insurers for a subsidy known as cost sharing reductions (CSR). (CSRs help people — who make up to 250 percent of the federal poverty line (FPL) — afford deductibles and copayments.) They’ve asked Congress to make these payments, since the president refuses to.
The Senate is purportedly writing legislation to appropriate these funds for at least one year. This bipartisan effort to pay insurers and further stabilize the marketplace was curtailed when the G.O.P. produced a new ACA repeal and replace bill in mid September. Collins supported the bipartisan effort — headed by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA), and has consistently criticized Republicans for producing legislation that will hurt people with modest incomes.
She added to those criticisms on Sunday:
JAKE TAPPER: Not to put too fine a point on it, senator, but you’re saying President Trump is taking actions that will hurt American citizens.
SUSAN COLLINS: I do believe that. I’m very concerned about what the impact is going to be for people who make under 250% of the federal poverty level because the funding that is available under the cost-sharing reductions is used to subsidize their out-of-pocket costs. And if they can’t afford their deductible, then their insurance is pretty much useless.
See full exchange below:
Trump’s move garnered criticism because ending CSR payments costs the federal government a great deal of money without accomplishing much.
First and foremost, the 58 percent of people who receive CSRs on the marketplace will continue to receive subsidized care. By law, insurance companies need to continue to subsidize people’s health care. To make up for CSR cuts, insurers and insurance commissioners in 36 states tacked on potential losses onto premiums. About 85 percent of people receive premium tax credits, which safeguards consumers from steep rates.
According to the Kaiser Family Foundation, the federal government will see a 23% increase in costs with higher premium tax credits than paying CSRs. So, by not paying CSRs, the government actually wind up spending more money in the end.
Former White House Chief Strategist Steve Bannon told a conservative crowd at the Values Voter Summit Saturday that Trump’s decision to end CSR payments is a long game to “blow up” the ACA. Though, Trump’s decision hasn’t blown up the marketplace yet. Most ACA enrollees will not feel the effects of Trump’s decision this open enrollment season, which begins November 1st; although, premium hikes do hurt people the 6.7 million people who do not qualify for subsidies.
Additionally, the move — if Congress is unable to act — will likely produce major lawsuits. Already 18 attorneys general have said they’d sue the federal government. “We’re about to see witness of the largest lawsuits, dollar-wise, in United States history,” said health expert Nicholas Bagley at the University of Michigan Law School. “What a stupid, profligate, and unnecessary mess.”
The article has been updated to revise the number of attorneys general suing to block Trump’s CSR cuts.