The House Rules Committee introduced a new amendment to the AHCA this morning. What does it do and does it matter?
SEC. 2205. FEDERAL INVISIBLE RISK SHARING PROGRAM.
(a) IN GENERAL.—There is established within the Patient and State Stability Fund a Federal Invisible Risk Sharing Program (in this section referred to as the ‘Program’), to be administered by the Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services (in this section referred to as the ‘Administrator’), to provide payments to health insurance issuers with respect to claims for eligible individuals for the purpose of lowering premiums for health insurance coverage offered in the individual market.(b) FUNDING.—
(1) APPROPRIATION.—For the purpose of providing funding for the Program there is appropriated, out of any money in the Treasury not other- wise appropriated $15,000,000,000 for the period beginning on January 1, 2018, and ending with December 31, 2026.
These two paragraphs are the meat of the four page amendment.
So what does it do. First it renames reinsurance to “Invisible Risk Sharing Program.” Secondly, it authorizes HHS/CMS to inject $15 billion dollars of non-premium dollars into the claims payment of the individual market over nine years.
Renaming reinsurance to Invisible Risk Sharing Program is a nothingburger. The key is the injection of money from outside of the premium pool into claims payment. Assuming that HHS elects to use this money as if it is reinsurance, that means HHS will use general revenue to pay some portion of very high cost claims. Since the money is coming from outside of the premium pool, it will lower the premiums paid as the premiums no longer to have to cover full claims expenses.
The question is by how much?
Not much is the answer. The appropriation is $1.67 billion dollars per year. In 2015, the ACA spent $7.8 billion dollar on reinsurance. This was approximately 10% of the total premiums collected so reinsurance under the ACA reduced premiums by 10% in 2015 compared to what they otherwise would have been. So a very rough guess is a $1.67 billion dollar externally funded reinsurance pool would lead to a 2% reduction in premiums.
So we get a rebranding of a basic insurance concept and a 2% reduction in premiums. This is a nothingburger.
Cermet
So the small handed liar in chief can now sell this new plan as just as good as the ACA but will lower insurance costs …lol.
Chris
So… does that bring in more congressional Repubs?
David Anderson
@Chris: I doubt it
ArchTeryx
They’re just not going to stop fucking this chicken, are they?
Seriously. It’s like you took a pile of offal, coated it with catnip, and threw it to a bunch of cats. They’ll keep right on going to it, get stoned, and then forget why they were there. They can’t stay away from it, nor will they actually start taking bites out of it.
I wonder what the plan is when the insurance companies look at this perpetual cathouse shitshow, go “screw this, I’m outta here” and abandon the exchanges en masse. Medicaid will rapidly become the only servicer on many of the exchanges.
Then what?
Yarrow
@David Anderson: Is this something we need to be calling our Reps about?
Goku
@ArchTeryx: I mean they really are autocrats. None of the public opposition they have faced has deterred them. All they care about is destroying the negroid usurper’s legacy and killing the poor and marginalized while lining their pockets as well as their donor’s.
Tom Levenson
Full of sound and fury…signifying, in the case of the Republican crime family, either nothing or active harm.
David Anderson
@Yarrow: We should call our reps about the AHCA on general principal. But on this particular, not really as it improves a very bad bill to only slightly better than very bad.
Mike J
Here’s some hilarity.How HHS uses the money isn’t spelt out by statute. Part of the Republican idea that vagueness and fog are good government because bills can be read in 10 minutes rather than an entire evening.
At the same, they rave about the administrative state, that is, rule making done by executive branch departments rather than by congress.
Any law introduced by Republicans that doesn’t specify exactly how the money should be spent is probably just a slush fund.
rikyrah
Thanks for the explanations, Mayhew.
John Revolta
Head of the Freedom Caucus says the new bill is okay with them.
Groucho48
Is that a 2% reduction from ACA premiums? Or, a 2% reduction in what Trumpcare premiums would be without the reinsurance?