Low-income Americans can actually find free insurance plans on Obamacare’s exchanges, analysts said, scrambling a key attack line from Democrats who say the Trump administration’s antipathy has ruined the health law.
Mr. Trump’s decision to cut “cost-sharing” payments to insurance companies has sown chaos, raising the price of midtier plans. But that has cut the cost of lower-tier “bronze” plans, which may be more attractive to younger, healthier consumers.
Avalere Health, a D.C.-based consultancy, said nearly every county that uses the federal HealthCare.gov portal will have a zero-premium plan in 2018, once taxpayer subsidies for low-income Americans are counted.
The analysis underscores the fallout from Mr. Trump’s decision to cancel the cost-sharing payments, which reimburse insurers who lose money on low-income customers’ costs.
Insurers jacked up rates to recoup the money, yet many states loaded those costs onto midtier “benchmark” plans that determine the amount of subsidy. That created a taxpayer-funded boon for many customers, who by choosing less-expensive — and less expansive — plans, can essentially get covered for free.
Democrats have blamed Mr. Trump for destabilizing the markets, but are also urging consumers to take advantage of the high subsidies, hoping more people will enroll and help stabilize the law’s economic underpinnings.
“There is a bit of a tension in messaging among ACA supporters between the political message that the Trump administration is to blame for big premium hikes and the consumer message that many people eligible for subsidies could actually pay less for health insurance,” said Larry Levitt, senior vice president at the nonpartisan Kaiser Family Foundation.
He said the essentially free bronze plans may be a boon for the program, but he said consumers also have to be able to learn about them — and Mr. Trump’s cuts to outreach funding will make that more difficult.
Analysts such as S&P Global, a credit-ratings agency, say they still expect a year-over-year decrease in sign-ups, citing a shorter enrollment period, less advertising under Mr. Trump and higher costs for unsubsidized customers.
A federal judge in California said Democrats should consider whether they’re undercutting their own law, which desperately needs an influx of young and healthy customers. Sign-ups began Wednesday and will last until Dec. 15 in most states.
“If the states are so concerned that people will be scared away from the exchanges by the thought of higher premiums, perhaps they should stop yelling about higher premiums,” U.S. District Court Judge Vince Chhabria wrote earlier this month, denying a request from Democratic attorneys general to force Mr. Trump to resume cost-sharing payments.
“With open enrollment just days away,” he said, “perhaps the states should focus instead on communicating the message that they have devised a response to the [cost-sharing] payment termination that will prevent harm to the large majority of people while in fact allowing millions of lower-income people to get a better deal on health insurance in 2018.”
Avalere, the consultancy, said highly subsidized consumers can find free silver plans in 18 percent of Healthcare.gov counties, while 10 percent will offer free gold plans to individuals making $18,090, or 150 percent of the poverty level.
Andy Slavitt, who oversaw federal insurance programs under Mr. Obama, said Obamacare supporters are sending mixed messages because they’re dealing with two distinct audiences — policymakers, who will eat up taxpayer dollars and hurt competition in Mr. Obama’s program if they don’t restore the cost-sharing payments, and consumers, who must contend with what’s in front of them.
“The ACA, by design, was written such a way as to protect consumers from price shocks. This isn’t the type of price shock that was anticipated but it’s critical that low-income people can afford coverage, both for policy goals, but also to keep the risk pool working,” he said.
Capitol Hill Democrats say Mr. Trump is still hurting the law overall, despite the unforeseen benefits.
“If you qualify for a tax credit, then [exchange coverage] still the most affordable option on the market for you. But there are lots of people who rely on the exchanges who don’t get a tax credit, and Trump’s actions are dramatically increasing their premiums and costs. It’s the ’Trump Bump,’” said Sen. Chris Van Hollen, Maryland Democrat.
A bipartisan plan in the Senate would restore the cost-sharing payments for 2018 and 2019, although conservatives don’t want anything to do with propping up Obamacare.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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