Trump is trying to kill Obamacare

Donald Trump is trying to convince everybody that the ACA is in a death spiral. It isn’t according to the CBO:

Although premiums have been rising under current law, most subsidized enrollees purchasing health insurance coverage in the nongroup market are largely insulated from increases in premiums because their out-of-pocket payments for premiums are based on a percentage of their income; the government pays the difference between that percentage and the premiums for a reference plan. The subsidies to purchase coverage, combined with the effects of the individual mandate, which requires most individuals to obtain insurance or pay a penalty, are anticipated to cause sufficient demand for insurance by enough people, including people with low health care expenditures, for the market to be stable in most areas.

Nevertheless, some areas of the country have limited participation by insurers in the nongroup market under current law. Several factors could lead insurers to withdraw from the market—including lack of profitability and substantial uncertainty about enforcement of the individual mandate and about future payments of the cost-sharing subsidies to reduce out-of-pocket payments for people who enroll in nongroup coverage through the marketplaces established by the ACA.

Pay attention to that last bit because the Trump administration is trying very hard to kill the ACA:

As the fate of the Affordable Care Act dangled dramatically in the Senate last month, the Trump administration abruptly canceled contracts with two companies that have helped thousands of Americans in 18 cities find health plans under the law.

The suspension of the $22 million contracts, which ends enrollment fairs and insurance sign-ups in public libraries, is one of the few public signs of how an administration eager to kill the law will run the ACA’s approaching fifth enrollment season.

President Trump continues to stage photo ops at the White House and on travels with people he terms “Obamacare victims.” The Department of Health and Human Services is issuing weekly maps showing the few dozen counties that might lack an ACA health plan for next year.

Officials provided no assurances at that meeting, however, about whether the administration would continue the government’s other usual enrollment activities or promotion. (In January, it had halted most advertising aimed at encouraging consumers to sign up in the final crucial days before the deadline for 2017 coverage.)

For now, the largest mystery looming over the upcoming enrollment season is whether the president will carry out his stated resolve to end payments made to insurers on behalf of about 7 million lower-income customers to help them afford their ACA plans’ deductibles and copays.

There are other unknowns that also will shape — or upend — the enrollment period when it begins Nov. 1: Will the government contact the roughly 10 million people with ACA coverage to alert them that sign-ups will last just 45 days, about half as long as in the past three years? Will HHS run call centers for consumers who need help as they look for plans? Will the computer system be adjusted to accommodate a possible crush of shoppers given the shorter time frame?

And how will automatic enrollment be handled? In previous years, notices have been sent out in mid-December, informing customers with coverage about price changes for their current health plan and urging them to shop around. This year, Dec. 15 is when enrollment will end.

If the rates go way up ( or if insurance companies drop out of many more parts of the country) it will be largely because insurance companies won’t know how much the government will subsidize people and they don’t know if the mandate will be enforced; if the number of people who sign up for the ACA goes way down it will be for the same reasons and because the Trump administration won’t advertise and won’t help anyone if they want to sign up.

The only reason the ACA will fail is if the Trump administration kills it.

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