During an off-camera briefing on Monday, Press Secretary Sean Spicer signaled that the Trump administration is willing to use low-income Americans’ health insurance as a bargaining chip to persuade Congress to pass Trumpcare, which will result in tens of millions of Americans losing their health insurance.
Spicer detailed the administration’s position in response to a question about whether the Trump administration will cover next month’s cost-sharing reduction (CSR) payments for low-income people who purchase health insurance on the Obamacare exchanges. As ThinkProgress has previously detailed, the payments “partially subsidize deductibles and co-payments for more than 7 million low-income Americans, making it possible for many of them to afford their insurance. Cutting off the payments could potentially kick millions of people off the state exchanges, pushing some private insurers to withdraw as well. Premiums could shoot up across the board.”
Spicer made clear that the administration will do what it can to continue to destabilize Obamacare exchanges by only committing to the CSR payments one month at a time.
“We committed to making them last month, and that’s as far as we will go at this time,” Spicer said. “We’re not committing to them this month.”
But Spicer then signaled that the “dynamic” will change if the Senate passes a health care bill. The bill on the table — which was written in secret by Republican senators and hasn’t been subject to a hearing — is in some ways harsher than the House version that would result in 23 million Americans losing their health insurance. But unlike the House bill, the Senate version continues to temporarily provide tax subsidies for consumers to buy health insurance on exchanges, albeit ones that are much less generous than Obamacare.
“If we can pass health care overall, then that changes the dynamic,” Spicer said. “It will ultimately be up to the president to decide.”
Spicer then made an explicitly political case for why Trump won’t commit to making the CSR payments — an assurance that would undermine the administration’s ongoing effort to blow up Obamacare by encouraging insurance companies to continue to offer plans on the exchanges.
“If the president were to hypothetically say he’s going to make the payments in perpetuity or for a year, I think that continues to prop up a failed system and continues to do wrong by the American taxpayer and it also doesn’t lend itself to the expediency that I think we want to help get a new health care system in place,” he said.
Trump himself alluded to the chaos ending the CSR payments would sow in insurance markets in a tweet earlier Monday in which he threatened to let Obamacare “crash & burn!”
Republican Senators are working very hard to get there, with no help from the Democrats. Not easy! Perhaps just let OCare crash & burn!
— Donald J. Trump (@realDonaldTrump) June 26, 2017
In an interview with The Economist in May, Trump signaled he will eventually stop paying CSRs — the only question is when.
“[T]here is no Obamacare, it’s dead. Plus we’re subsidizing it and we don’t have to subsidize it. You know if I ever stop wanting to pay the subsidies, which I will,” Trump said. “Anytime I want.”
As The Weekly Standard detailed, the administration’s posture on CSRs “has already accelerated the collapse of health care exchanges as insurers move to limit their risk by raising prices or withdrawing from markets altogether.”