• Menu
  • Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar

Before Header

  • About Us
  • Lexicon
  • Contact Us
  • Our Store
  • ↑
  • ↓
  • ←
  • →

Balloon Juice

Come for the politics, stay for the snark.

Come on, man.

You cannot shame the shameless.

Republicans are the party of chaos and catastrophe.

Hi god, it’s us. Thanks a heap, you’re having a great week and it’s only Thursday!

There are a lot more evil idiots than evil geniuses.

Give the craziest people you know everything they want and hope they don’t ask for more? Great plan.

No one could have predicted…

Republicans don’t trust women.

It’s easy to sit in safety and prescribe what other people should be doing.

Don’t expect peaches from an apple tree.

They love authoritarianism, but only when they get to be the authoritarians.

Somebody needs to explain to DeSantis that nobody needs to do anything to make him look bad.

Trump makes a mockery of the legal system and cowardly judges just sit back and let him.

Happy indictment week to all who celebrate!

There are some who say that there are too many strawmen arguments on this blog.

The Supreme Court cannot be allowed to become the ultimate, unaccountable arbiter of everything.

I’m pretty sure there’s only one Jack Smith.

Glad to see john eastman going through some things.

Trump’s legal defense is going to be a dumpster fire inside a clown car on a derailing train.

I was promised a recession.

There’s always a light at the end of the frog.

“woke” is the new caravan.

Pelosi: “He either is stupid, or he thinks the rest of us are.” Why not both?

Our job is not to persuade republicans but to defeat them.

Mobile Menu

  • Four Directions Montana
  • Donate with Venmo, Zelle & PayPal
  • Site Feedback
  • War in Ukraine
  • Submit Photos to On the Road
  • Politics
  • On The Road
  • Open Threads
  • Topics
  • COVID-19 Coronavirus
  • Authors
  • About Us
  • Contact Us
  • Lexicon
  • Our Store
  • Politics
  • Open Threads
  • 2024 Elections
  • Garden Chats
  • On The Road
  • Targeted Fundraising!
You are here: Home / Anderson On Health Insurance / Good news through the lack of bad news

Good news through the lack of bad news

by David Anderson|  February 1, 201711:24 am| 19 Comments

This post is in: Anderson On Health Insurance, C.R.E.A.M., All we want is life beyond the thunderdome, Bitter Despair is the New Black

FacebookTweetEmail

One of the first potential blow-up points for the ACA in the Trump Administration was today. Insurers are required to offer lower deductibles and cost-sharing to people who buy on-Exchange policies and who make less than 250% of the Federal Poverty Level. This is the Cost Sharing Reduction (CSR) subsidy. Insurers offer the better product and the Federal government pays the insurers on the back end for the increased value of the Silver plan.

There is a lawsuit (House v. Burwell which will be renamed) that the District court judge ruled that the House’s argument that the CSR subsidies were discretionary spending that had not been appropriated was correct instead of accepting the Obama administration’s argument that the spending was mandatory and thus automatically appropriated. It has been appealed by the Obama Administration and once the administrations changed, the Appeals Court granted a delay in the appeal as the Trump lawyers figure out what they want to do.

However, the current CSR system where money goes out the door to pay insurers is based on administrative interpretation of the law. At any point in time, the Administration could decide to re-interpret the law and agree with the House that the funding is discretionary and that there is no money available to legally pay the insurers.

As I outlined in early January, this would blow up the Exchanges:

CMS in their 2017 QHP contracts allowed carriers to pull products from the market if the CSR subsidies disappear and it looks like that would be the plan of CHC to pull their Silvers….Carriers have to offer Silver plans to participate on Exchange. If they yank all of their Silvers, they have to yank everything on Exchange.

And carriers will flee if CSR disappears as they will not eat a 30% revenue loss for a high cost population in a market that they don’t know if it will be around long enough to actually make money on.

So far there is no executive order or administrative re-interpretation of the CSR funds.

This is good news. The markets and the plans survive for another month.

FacebookTweetEmail
Previous Post: « Preference Sensitive surgeries and ACA uncertainty
Next Post: Beauty and the Beast »

Reader Interactions

19Comments

  1. 1.

    Elizabelle

    February 1, 2017 at 11:46 am

    It’s early. But we will take good news, where we find it.

  2. 2.

    Raoul

    February 1, 2017 at 11:58 am

    Good.

    What I wonder in reading this is, if insurers offered and sold Silver subsidized plans with this structure in place, and now we are into month two of premium payments from the insured, what sort of unholy hell would be unleashed if the subsidies are administratively overruled in, say, March or April?

    Are insurers on the hook to keep the plans thru 12/31 at considerable losses, or are large numbers of people left high and dry mid-year?

  3. 3.

    rikyrah

    February 1, 2017 at 12:03 pm

    Thanks for the positive news, Mayhew.

  4. 4.

    MomSense

    February 1, 2017 at 12:04 pm

    I’m a donkey on the edge!

    Thanks, David for the info.

  5. 5.

    ArchTeryx

    February 1, 2017 at 12:10 pm

    What I wonder is why they DIDN’T blow it up. This crowd may be a bunch of evil clowns, but they have a certain animal cunning.

    So why didn’t they pull the trigger?

  6. 6.

    sukabi

    February 1, 2017 at 12:17 pm

    @ArchTeryx: a couple of possible reasons….1) they (Senate repubs and drumpf crew) are too busy installing incompetent, unqualified billionaire assholes in the administration for the heist of the millennium…
    2) haven’t gotten there yet.

  7. 7.

    Jerzy Russian

    February 1, 2017 at 12:18 pm

    @ArchTeryx:

    So why didn’t they pull the trigger?

    Perhaps sheer incompetence?

  8. 8.

    Ben Vernia

    February 1, 2017 at 12:19 pm

    Am I correct that the February 21 date for apprising the D.C. Circuit of the Administration’s intention in House v. Burwell is a key date (assuming it doesn’t get postponed)?

  9. 9.

    sukabi

    February 1, 2017 at 12:20 pm

    @Jerzy Russian: let’s hope that’s the reason…of course they could be like turkey farmers…gotta keep their product healthy long enough for the “big reveal”…

  10. 10.

    Chris

    February 1, 2017 at 12:29 pm

    @ArchTeryx:

    Give them time. It’s been a busy couple of weeks.

  11. 11.

    Villago Delenda Est

    February 1, 2017 at 12:33 pm

    So, the apocalypse has been delayed for a month. Wonderful!

  12. 12.

    Raven Onthill

    February 1, 2017 at 12:55 pm

    Likely enough the administration doesn’t know this. Also, the Trumpublicans are consolidating power and the shadowy figures advising Trump may not want to risk a yuge blow-up.

  13. 13.

    martian

    February 1, 2017 at 1:11 pm

    @Raoul: I second this question. What happens to policies already sold? Who eats the cost, customer or insurers? Or do the insurers have an out to abandon the policy holders because the government’s breach of the agreement voids them?

  14. 14.

    Richard Mayhew

    February 1, 2017 at 1:36 pm

    @Raoul: the insurers can cancel the contracts as soon as state law allows them to do so if CSR is yanked

  15. 15.

    David Anderson

    February 1, 2017 at 1:41 pm

    @ArchTeryx: Fingerprints on the murder weapon.

    Blowing up CSR leaves a lot of fingerprints. The GOP goal is to kill the ACA without getting blamed for it. That is why the 1/20/17 executive order tells HHS to use all discretion to waive as much as they can which really means issuing hardship exemptions to anyone who asks. That could kill the risk pool and drive insurers away in 2018 but the fingerprints are not bloody and they are not holding a smoking gun that everyone saw them fire.

    CSR is bloody obvious what they did and who did it. It assigns blame straight up.

  16. 16.

    StringOnAStick

    February 1, 2017 at 2:04 pm

    @David Anderson: Which path the rethuglicans take probably depends on how quickly they feel they are losing control over the situation.

  17. 17.

    feckless

    February 1, 2017 at 2:13 pm

    Prophecy:

    They will keep sending subsidy checks to the Insurance companies, long after the exchanges have been obliterated.

  18. 18.

    ProudGradofCatLadyAcademy

    February 1, 2017 at 3:04 pm

    Dave:

    What are the chances that the Insurers will not stand for the CSR being shredded and send in the lobbyists? I am thinking UHC will never stand for shenanigans of this sort for this year. We submit next year’s plans, rates and so forth pretty early in the current year to the states and the federal government. Our projected revenues would be so skewed for 2017 if they got rid of the CSR now. In 2018, that’s a different story.

    @ Feckless funny you should mention that, without disclosing too much, let’s just say we got our hands slapped for constantly fixing APTCs for 2014 and 2015. Mostly because our billing systems and adequately trained agents leaves a lot to be desired. I shouldn’t complain because our failures in billing is exactly why I have a job, but I wish that it didn’t and our billing systems actually worked.

  19. 19.

    Graeme Murray

    February 1, 2017 at 7:14 pm

    Here’s my healthcare story. I’m 71. I had a massive heart attack in 2008 and a 9 hour open heart surgery to replace valves in 2012, both with long hospital stays and rehabilitation. I have a pacemaker/ defibrillator. I see my family doctor every month and my cardiologist twice a year My family doctor sends me to specialists as required. I take 6 expensive little pills every day. I can get home care if needed. All this costs me nothing because I live in Canada and paid slightly higher taxes during my working life.

Comments are closed.

Primary Sidebar

Recent Comments

  • Soprano2 on Humpty Trumpty (Open Thread) (Apr 17, 2024 @ 8:51pm)
  • artem1s on Arizona In The Crosshairs (Apr 17, 2024 @ 8:48pm)
  • Bex on Humpty Trumpty (Open Thread) (Apr 17, 2024 @ 8:45pm)
  • Matt McIrvin on Humpty Trumpty (Open Thread) (Apr 17, 2024 @ 8:43pm)
  • BretH on Humpty Trumpty (Open Thread) (Apr 17, 2024 @ 8:42pm)

🎈Keep Balloon Juice Ad Free

Become a Balloon Juice Patreon
Donate with Venmo, Zelle or PayPal

Balloon Juice Posts

View by Topic
View by Author
View by Month & Year
View by Past Author

Balloon Juice Meetups!

All Meetups
Talk of Meetups – Meetup Planning
Proposed BJ meetups list from frosty

Fundraising 2023-24

Wis*Dems Supreme Court + SD-8
Virginia House Races
Four Directions – Montana
Worker Power AZ
Four Directions – Arizona
Four Directions – Nevada

Featuring

Medium Cool
Artists in Our Midst
Authors in Our Midst
Positive Climate News
War in Ukraine
Cole’s “Stories from the Road”
Classified Documents Primer

Calling All Jackals

Site Feedback
Nominate a Rotating Tag
Submit Photos to On the Road
Balloon Juice Mailing List Signup
Balloon Juice Anniversary (All Links)
Balloon Juice Anniversary (All Posts)

Fix Nyms with Apostrophes

Balloon Juice for Ukraine

Donate

Twitter / Spoutible

Balloon Juice (Spoutible)
WaterGirl (Spoutible)
TaMara (Spoutible)
John Cole
DougJ (aka NYT Pitchbot)
Betty Cracker
Tom Levenson
David Anderson
Major Major Major Major
ActualCitizensUnited

Political Action 2024

Postcard Writing Information

Balloon Juice for Four Directions AZ

Donate

Balloon Juice for Four Directions NV

Donate

Site Footer

Come for the politics, stay for the snark.

  • Facebook
  • RSS
  • Twitter
  • YouTube
  • Comment Policy
  • Our Authors
  • Blogroll
  • Our Artists
  • Privacy Policy

Copyright © 2024 Dev Balloon Juice · All Rights Reserved · Powered by BizBudding Inc

Share this ArticleLike this article? Email it to a friend!

Email sent!