Timing of White House actions unrolling parts of ACA 'couldn't be worse,' states say

[DonViejo]

By Amy Goldstein October 14 at 7:46 PM

After threatening for months to end billions of dollars in payments promised to health insurers, President Trump finally dropped the ax with timing that could inflict maximal disruption on the Affordable Care Act enrollment season scheduled to begin in two weeks.

The most immediate upheaval is playing out in a set of states where regulators had ignored the risk that the president might carry out his threat and told insurers not to include any cushion in their 2018 rates for ACA health plans. Officials in at least three states are now debating whether to delay the Nov. 1 start of enrollment as they rush to consider higher premiums to make up for the abrupt loss of federal money.

But even in states that prepared for a possible cutoff of the “cost-sharing reduction” payments, Trump’s action so close to the fifth year’s sign-up period is sowing widespread confusion among consumers, according to leaders of insurance exchanges and ­enrollment-assistance organizations around the country. Along with other steps the White House has taken since late summer to undercut the ACA marketplaces, they predict this latest move is almost certain to suppress the number of Americans insured under the law next year.

“The timing couldn’t be worse,” said Allison O’Toole, chief executive officer of ­MNsure, the marketplace Minnesota created under the ACA. Hundreds more consumers than usual have phoned its call center in recent days, uncertain whether they can still get and afford health plans.

“Will the [president’s] drumbeat of ‘it’s a failing marketplace’ affect enrollment? Absolutely,” said Peter V. Lee, executive director of Covered California, which calculates that the payments’ end will cost its 11 marketplace insurers $188 million for the last three months of 2017 — more than the small profits many were anticipating for the year.

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https://www.washingtonpost.com/national/health-science/timing-of-white-house-actions-unrolling-parts-of-aca-couldnt-be-worse-states-say/2017/10/14/bab688bc-b0f0-11e7-9e58-e6288544af98_story.html

[dalton99a]

1. Arsonists like to work when people are asleep

[kacekwl]

2. Fuck it. My wife finally is on Medicare and

after many years with no health insurance when the ACA passed I thankfully got covered . Now this fool is screwing with this. So as long as spouse is covered it's back to the ER for me . I will tell them trump sent me , get you $$$ from him.

[Igel]

3. People don't listen.

They just don't.

Trump says something, they run around like crazy people because he said something. Much of what he says is inflated, hyperbolic, over-the-top. He does not measure his words. That means you have to look at stuff that's not written, intonation and style, and pay closer attention not just to what we perceive the context to be but what *he* perceives the context to be. His style is not decontextualized and academic, and to treat it as such may score narrow, petty political points but at the cost of communication and understanding.

Take the wall. (Please.) He'd like to build it. It's not going to happen, at least not the way he said it would. Various other things fall into this category--he speaks, but it's unclear how it would be implemented or why it would be implemented.

The "Muslim travel ban," for all of it's all-encompassing and racist nature, resembles a sieve more than a container and bans travel by a small minority of Muslims. It's rather like boycotting the US by not doing business with North Carolina, or being a vegan by not eating just pork. For this and a lot of issues, there's this giant hyperbole storm whipped up on both sides.

At the same time, his words often still do have meaning. When he says he doesn't see how the insurance funding scheme worked out by Obama to administratively repair a legislative flaw holds water, so therefore he doesn't see how he could continue the funding, people at first ran around like crazy people then decided this was over-the-top and meaningless blather when he didn't cut funding at once. However, what people keep missing is that the Congressionally authorized funding allocated for insurance-company reimbursement had not run out when Trump was speaking. If he cut funding, he'd be denying funding Congress authorized. But when the funding ran out, he cut funding because at that point not only could he, but he argues that the funding allocated by Congress for one purpose shouldn't be moved to another budget category. This is a familiar argument (when it suits the arguer). The argument for moving the money is weaker now than it was when the ACA was first implemented because when Obama first did this Congress had simply failed to think it through, to put it charitably. They needed 51 votes for legislation that wasn't being handled by "regular orders" and would be decided on a strict partisan vote, except that coalition kept unraveling only to get cobbled together again when somebody else was again finally pleased. Making it "good" wasn't an option, since "good" was a matter of opinion and opinions varied a lot. But now the argument could be made that Congress had been funding it and therefore discontinuation of the funding was a decision, an act of legislative will. It's in Congress' court.