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You are here: Home / Anderson On Health Insurance / CSR thoughts this morning

CSR thoughts this morning

by | 41 Comments

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Okay, I’m trying to process and think through the next week on Cost Sharing Reduction news. Here is what I am expecting:

    • Lawyers and lots of them doing lawyer things in a lot of court rooms
    • Well capitalized insurers in states that planned ahead for no CSR to practice their Scrooge McDuck dives

 

  • Every health plan actuary to report to the company health clinic to receive a central line for a caffeine drip
  • Talk about some insurers pulling out of the Exchange
    • I think the mechanics of not selling plans in 2018 are far easier legally than mid-year termination
  • Some states attempting emergency rate re-filings

 

Anyone who is telling you that they know for sure what will happen is either blowing smoke up your ass or disclosing insider information.

Reader Interactions

41Comments

  3. 3.

    clay

    @Cheryl Rofer:

    Hundreds of thousands of New York families rely on the Affordable Care Act’s subsidies for their health care – and again and again, President Trump has threatened to cut off these subsidies to undermine our healthcare system

    I wonder if people could sue Trump for emotional distress and damages?

  4. 4.

    Sloane Ranger

    Congrats on your new, well deserved fame.

    Lawyers can sue but this will go to the Supreme Court at some point. What are the chances of winning this once it gets there?

    Even if they get an Injunction how long can they keep it away from Roberts et al?

    And, if the Democrats somehow win majorities in both Houses in 2018, what is the likelihood of them being able to do a legislative fix?

  6. 6.

    dr. bloor

    @Sloane Ranger: There will be a ton of pressure on Congress to fund the CSRs immediately. I’m not holding my breath, but a bunch of Republicans who love the Real/Replace slogan are about to get real time feedback about the immediate consequences of the EO from their constituents.

  7. 7.

    MomSense

    I’m not sure what our AG will do as she is running for the Democratic nomination for Governor. This is usually the kind of thing she is all over so we’ll see.

    I’m going to call my Rep and Senators today and explain to them that we are looking for courage. Between the expiration of CHIP almost two weeks ago, the criminal and willful abandonment of Puerto Rico, the fact that trump is turning our word into mud with his handling of Iran, the jet setting cabinet members, and now this intentional harm being done to working people who rely on the ACA for their health coverage – I’m thinking I need to get the wet wheel out for my farm tools. My pitchfork is going to need serious sharpening.

  8. 8.

    Cheryl Rofer

    Susan Collins just announced that she will not be running for governor of Maine. Says she feels she is needed in the Senate. Seems to indicate that she will continue to oppose Trump.

  10. 10.

    Chris

    @clay:

    Oh, I have no doubt it would get tossed out of court, but it really should be allowed. The amount of stress this is putting on millions of people who go to bed every night not knowing if they’ll still have health insurance the next morning has to be taking a stupendous toll on people’s healths.

  12. 12.

    schrodingers_cat

    What should we do? Call our representatives?
    When I was studying for my citizenship exam, earlier this year, my study guide (courtesy: USCIS) said that the United States was a nation of laws. Dear lawyers, how is being governed by one man’s whims lawful? Did the mad King George do any thing that was half as worse as the current despot in the WH.

  13. 13.

    Millard Filmore

    The number of people that Repeal and Replace would kill was 20 to 25 thousand. How many will die per year from this?

  16. 16.

    ChrisH

    I heard a refreshing lack of both siderism this morning in regards to CSR. David Greene on morning edition had one of their correspondents on and the conversation was more or less “Trump is intentionally trying to sabotage the ACA to support his claims it is failing.” Hopefully this filters up into the cable discussions too

  17. 17.

    MomSense

    @eric:

    I think it says a lot about the situation on the ground. It is going to be interesting to see who jumps into the race now.

  18. 18.

    El Caganer

    @schrodingers_cat: It’s not just his whims. Somebody had to come up with this idea, and he’s too fucking ignorant and stupid to have done it himself. He’s a useful idiot for unseen creatures with dirty hands and no morals.

  20. 20.

    Suzanne

    Congrats to the blog’s real ombudsman! Published in the FTFNYT, you think yer so smaaaaaaht…..

    I truly wonder what the working-class sTrumpet voter will think of this. I mean, all that I see is tearing away some of the safety net without “something terrific”, without anything, to replace it. I fail to foresee why Trump could possibly think this is a good idea, if he games it out.

  23. 23.

    El Caganer

    @schrodingers_cat: I totally agree that he’s responsible. I kind of doubt that POTUS can get away with an ignorance defense; that doesn’t even work for us little people who don’t have the best minds, the highest IQ’s, etc., etc.

  24. 24.

    But her emails!!!

    @eric:

    Well, shit. She actually voted no on principle. This totally shatters the view I had constructed of her.

  25. 25.

    Frankensteinbeck

    @El Caganer:
    He’s not just responsible in a ‘buck stops here’ sense. He doesn’t have to understand the real ramifications. Understanding ‘This will fuck over everyone’s insurance’ is well within his moron limits, and fits Trump’s known motivations. Either someone slid a paper in front of him and told him it would do that, or he asked for an order that would do it. Either way, this is deliberate.

  26. 26.

    schrodingers_cat

    @Frankensteinbeck: Sounds like an impeachable offense to me. Deliberately jeopardizing our right to life, liberty and pursuit of happiness. This and his lack of action in PR.

    ETA: If he can pick and choose what laws to follow, that means he is not accountable and above the law, which violates the principle that we are a nation of laws.

  27. 27.

    Shell

    Meanwhile, Trump is speaking to the Value Voters group. Throwing out the usual gobs of platitudes. Apparently, venerating the flag fixes everything.

  28. 28.

    Frankensteinbeck

    @dr. bloor:
    If a bill gets to the floor, I am pretty sure it would pass both chambers. McConnell and Ryan, world class sadistic assholes, are the big stumbling blocks. I’m leaning a little over 50% Trump would sign it. The man has zero spine. He’ll bluster from a safe distance, but oppose someone in his face? Absolutely terrifies him.

  30. 30.

    hedgehog the occasional commenter

    So, um, tinfoil hat question–how many Americans are going to become medical refugees? Is there such a thing? With the lack of help for Puerto Rico (agree with rikryah, looks like genocide) and now the CSR removal–Dolt is really trying to kill us. (adjusts hat) Have I lost my mind?

  31. 31.

    ken

    Interestingly, Art V(b) of the 2017 and 2018 ‘general’ QHP Agreements expressly provides that insurers “could have cause” to terminate their participation in the event premium tax credits or CSRs cease to be available (that is pretty squirrelly language–why not just say ‘may’ or ‘have a right to’ terminate–but I digress). However, the distinct 2018 QHP Agmt for AR, KY, NM, NV, and OR does NOT include this termination provision. I suppose this means insurers in those states cannot use the end of CSRs as a pretext for getting out of their agreements for 2018. And the squirrelly-ness of the general 2017-2018 language means there will be decent lawsuits against insurers if insurers terminate due to ending of CSRs. https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Plan-Year-2017-QHP-Issuer-Agreement.pdf https://www.qhpcertification.cms.gov/s/QHP%20Agreement (follow links)

  32. 32.

    Frankensteinbeck

    @Shell:
    Hating black people fixes everything, for him and evangelicals. Venerating the flag is a buzzword right now solely because a black man protested racist police brutality. No other meaning.

  35. 35.

    gvg

    i am really upset at the non action on PR. I feel that I can’t see a way to help. they must think we don’t care too.
    Congress needs to act. Trump is not a leader. he can be persuded to go along with things if someone else does the work and gets it all organized. He’ll try to take credit of course.

  37. 37.

    Ruckus

    @El Caganer:
    He’s not nearly smart enough to come up any of the “justification” used in the EO or write the thing but he is more than stupid and asinine enough to come up with the idea to fuck over millions because of racism and ego.

  38. 38.

    satby

    @hedgehog the occasional commenter: I may become one if my low level but chronic asthma worsens.

    Edited to add: not to mention there are many countries where my SS income would allow me a higher standard of living than in my own country. As long as that’s coming, who knows how safe that will be?

  41. 41.

    Citizen Scientist

    Hi David:

    Meant to ask this in the open enrollment thread a few days ago, but got super busy with work that I didn’t want to look at a screen of any kind once I got home. For plan year 18, my co-pays for some things are going up, as well as, the amount I contribute annually for insurance through my employer (there goes probably at least half of whatever raise I might get in January). I’d like to call my plan admin and snarkily ask if this is because of sabotage from the current Administration. However, I thought I’d ask you: do you think all these shenanigans are affecting employer plans at this point for 2018 and 2019? i.e., leading to a greater financial hit to those with employer-provided insurance?

    Thanks for all the informative threads of late!

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