Kimberly Leonard of the Washington Examiner reported on Monday morning that President Trump has a draft Executive Order that would defang the individual mandate.
Trump cannot repeal the individual mandate through executive order, but he can broaden “hardship exemptions,” which under Obamacare are left to the discretion of the administration. The exemptions allow customers to have ways to get out of paying the fine for not having coverage, which is $695 per adult or 2.5 percent of income, whichever is higher….
This was telegraphed from the evening of the inauguration as that executive order hinted that hardship exemptions would be passed out like pacifiers at a rave. Some insurers have built morbidity adjustments into the 2018 rates to account for a sicker risk pool as some healthy people who normally would have bought insurance because they have a “taste for compliance“. If the messaging is that there is no mandate, the average person who buys insurance will be sicker and thus leads to higher premiums than in the counterfactual of a universe where everyone assumes the mandate will be enforced.
Pennsylvania estimated that the complete repeal of the individual mandate would have led to 2018 rates to increase by more than the CSR non-payment:
If the individual mandate is repealed, insurers estimate that they would seek a 23.3 percent rate increase statewide. If cost-sharing reductions are not paid to insurers, the companies would request a 20.3 percent rate increase statewide. If both changes occurred, insurers estimate they would seek an increase of 36.3 percent.
The executive order would not be a complete repeal so the 23.3% rate increase is a ceiling estimate. But it is a significant price hike.
However, much like CSR, the distributional consequences are uneven. Non-subsidized buyers will bear the entire cost increase. This will drive out healthier buyers because of the increased premiums.
Subsidized buyers will see the same impact as CSR Broad Load. All rates would increase at the same percentage bump. This makes the least expensive Silver and the lower cost Bronze plans comparatively cheaper as the gap increases from the Benchmark Silver. People who want to buy plans that are more expensive than the Benchmark plan will get even more expensive as the gap will increase.
Most of the sabotage attempts play out the same way. If someone is subsidized, they are not greatly harmed. As we have seen with CSR, there are numerous scenarios where numerous subisidized individuals are better off or could be better off in a sabotaged environment than in a business as normal counterfactual.
Non-subsidized individuals who tend to be older and making over 400% FPL ($48,080 for an individual, $98,400 for a family of 4) are brutalized. They got kicked hard with 20% incremental rate increases because of CSR payment termination. They would get kicked hard again with another 15% to 20% rate increase because of the mandate games.
It seems that the Republican political strategy is to punch their base voters in the face in order to mobilize them in anger against the ACA.
? ?? Goku (aka The Hope of the Universe) ? ?
That’s… really fucked up. And might just work. Hopefully the old rule of “the buck stops here” will ensure voters blame Trump and the GOP for this bullshit.
Major Major Major Major
@? ?? Goku (aka The Hope of the Universe) ? ?: that’s kind of always the republican strategy. Government can’t do anything right, elect us and we’ll prove it!
Chris
@? ?? Goku (aka The Hope of the Universe) ? ?:
It’ll totally work, on 80% of their voters at least. I’m already seeing plenty of people complaining about their premiums going up next year wailing “THANKS, OBAMA!!!” as if Trump spending the last year trying to monkey-wrench the program had nothing to do with it. The question is whether among the last 20%, there might be enough drop off (more in the “staying home” than “voting Democrat”) to change things…
? ?? Goku (aka The Hope of the Universe) ? ?
@Chris:
I was told people always blame the sitting party for problems happening on their watch.
Raoul
“It seems that the Republican political strategy is to punch their base voters in the face in order to mobilize them in anger against the ACA.”
The anger we mobilize will be to unseat Republicans. Quite a few, I hope!
Paul Ryan seems to have a real contender for 2018. Quite a few House stalwarts are retiring. Change is gonna come.
TenguPhule
Death Spirals. Oh joy. //
Who knew the Republican Death Panels would end up only having one person sitting on the final panel with very small hands.
TenguPhule
@? ?? Goku (aka The Hope of the Universe) ? ?: That rule only applies to Democrats.
See also, Iraq War II.
Major Major Major Major
@? ?? Goku (aka The Hope of the Universe) ? ?: Traditionally, 40% of the country will always vote for the D and 40% will always vote for the R. Now it’s more like 45/45. (Trump was truly bottom of the barrel and got 46%.)
For the people in the middle, who would be included in the 20% remainder that @Chris alluded to, they tend to apportion blame towards (not 100% to) the sitting party.
Chris
@? ?? Goku (aka The Hope of the Universe) ? ?:
@Major Major Major Major:
Yeah… note that I was saying 80/20 percent of THEIR base voters, not the overall electorate (though I admit that’s just me guesstimating).
Yarrow
Republicans said they would fix healthcare but they didn’t. Make them own it.
Major Major Major Major
@Chris: I assumed you meant 80% of his voters period (which isn’t even at the traditional 40% line), rather than 80% of his base. I think it’s safe to say 10-20% of his voters are reachable or at least discourageable.
ETA and worded my original comment poorly.
Brachiator
@? ?? Goku (aka The Hope of the Universe) ? ?:
Trump promised repeal with replacement of something better. In Town Hall meetings, citizens clearly were not buying this bullshit. The Democrats and other interested parties need to hold the GOP’s feet to the fire. Clearly point out that these goons are keeping good insurance for themselves while pushing shitty plans onto everybody else. They are pushing a retreat, a return to the status quo, and their plans ultimately would see insurance companies having to put back old rules about pre-existing conditions in order to keep their profits.
Trump and the GOP are vulnerable on health care because even the dumbest Trump supporter can see when they are being screwed (even though they still might not care).
jl
@Major Major Major Major: Don’t have time to find a link now, but I’ve seen polling that two thirds of voters expect sitting party to improve health care and hold them responsible for not doing so.
So, to me, that means Democrats and a good chunk of independents holding GOP and Trump responsible. Maybe a few GOP voters, who may not change their voting preferences over the issue, but might sit out next couple of elections.
rk
@? ?? Goku (aka The Hope of the Universe) ? ?:
Not republican people. Not Trump voters. I saw someone on my FB page complain about how their premiums have gone up and some moronic older woman piped up with “well if only President Trump’s healthcare reform was allowed to pass we’d be seeing lower rates”. I don’t even know where to begin with these people. They’re profoundly stupid that there’s no solution. You can’t talk to them, you can’t reason with them and I can’t even laugh at them because it’s all becoming too painful. Hillary was being too kind when she called them deplorable. They’re just vile filth.
Chris
@Major Major Major Major:
No worries, so did I.
HumboldtBlue
@Brachiator:
They don’t give a fuck. I just received a letter from Anthem that my monthly premium will rise from about $180 per month to $918 per month. Fuck the GOP, fuck their cronies in the insurance racket and fuck this country.
Brachiator
@Yarrow:
Yep.
Major Major Major Major
@jl: I remember seeing that too, but accountability doesn’t often penetrate into the 40-45% base when it comes to voting behavior. Discouragement maybe, I remember that being a factor in 2008.
Brachiator
@HumboldtBlue:
They don’t care about you or me, but most of them care about their own sorry asses.
That’s insane. What part of the country are you in?
HumboldtBlue
@Brachiator:
California.
That’s why they’ve rigged the system, they know they are only vulnerable to an attack from the far right in a primary. Gerrymandering and the purge of voter rolls handles the rest.
jl
@Major Major Major Major: We’ll see how big the base really is starting in 2018. I think it is, tops, somewhat less than 40 percent of the voting public. So, for most of them, who cares about winning them over for the election? Beat them at the election. Some of them can be won over afterwards if they benefit from good policy. Some of the bigots and hard core authhoritarians will never be won over, and that is, or should be in a rational world, just too bad for them at election time. If they lose consistently, life for them will be much better between elections, apart from their woe stemming from their absurd and vicious prejudices.
Tenar Arha
I’m wondering how we can work against this. Call our Governors to pressure the WH? Call Congress & ask them to do ¯\_(ツ)_/¯?
Parfigliano
@rk: Fuck them they are hopeless
satby
@HumboldtBlue: I am so sorry. Try writing Anderson /Mayhew and asking him for some specific advice, he’s been suggesting some ideas to other jackals on his threads.
From Both Sides of the Pond
O/T – really bummed looking at marketplace plans in VA. Thanks to my lovely employer’s useless health care plan, we can’t afford to cover anyone in the family under my plan, but can’t apparently get any subsidies on the marketplace because my individual-only plan is below the threshold when just covering me. $1300 a month is not doable for the family. Now, if the open enrollment period for work’s plan has passed, could we qualify for subsidies as there’s no way she could get on the plan this year? Grasping at straws here.