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You are here: Home / Anderson On Health Insurance / The politics of no CSR funding

The politics of no CSR funding

by | 13 Comments

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I don’t think Cost Sharing Reduction (CSR) subsidies will ever be appropriated.  I have a hard time lining up the policy and political incentives in a way that have 60 Senators agreeing to vote on it.  I think the politics don’t line up as the policy foundations are changing.

If there is no CSR deal by December, then the expectation of what the baseline subsidized Exchange plans should look like and what the cheaper/inferior versions should cost will change. And those changes are not occurring just in Blue States. The changes are happening in Red States. The changes are happening in big cities. The changes are happening in little hamlets.

The fundamental expectations of what the ACA delivers is changing now because CSR has not been appropriated. That reality will proceed as the politics catch up to it.

Reader Interactions

13Comments

  1. 1.

    scottinnj

    So basically through his incompetence, DJT is providing middle class Americans with better, cheaper, healthcare?

    Senious and not snarky question – if it was this easy why didn’t Hillary run on this idea? “I will lower your premiums and your deductibles’ is not a bad campaign line?

  3. 3.

    David Anderson

    @scottinnj:

    1) she did. Her plan was far less dumb and more cost efficient than this “plan”

    2) yes this is dumb and an incompetence exploit

  4. 4.

    NobodySpecial

    @scottinnj: For better or worse, she tied herself to being Obama’s third term, and she had bad memories about the last time she tried to improve health care.

  5. 5.

    clay

    @David Anderson: Given all this, is it possible Trump will campaign in 2020 by claiming he ‘fixed’ Obamacare?

    Actually, of course he’ll claim it; lemme rephrase. Is it possible that Trump will campaign for re-election on fixing Obamacare, and actually be able to make a serious, truthful argument? What are the downsides to this new reality, to changing the “fundamental expectations of what the ACA delivers”?

  6. 6.

    David Anderson

    @clay: Yes, he can claim to have delivered better insurance with lower cost-sharing and lower premiums to more people in 2020 without breaking the Polifact meter.

    And guess what, that is how programs get embedded;. when their ideological opponents claim credit for actual improvements.

    And as states submit more waivers for reinsurance and high cost carve-outs to Medicaid (tomorrow’s post on Idaho), the ACA will get better for people making more than 400% FPL.

  7. 7.

    MomSense

    What are the odds the Congress will reauthorized CHIP? I’m not feeling very optimistic at this point. I keep calling and emailing my congress critters. Only King writes back that he is furious about this as well.

    Also, too why did Collins vote against all the various repeal and go fuck your self plans only to then vote to cut 1.5 trillion out of Medicare and Medicaid?

  8. 8.

    Ohio Mom

    @MomSense: I am also concerned about the cuts to Medicaid and Medicare if anything like the proposed budget passes. Seems like a back door dismantling.

    Of course there are plenty of other things to be in fear of in the budget proposal.

  9. 9.

    Victor Matheson

    I thought Mayhew might be channeling MLK…

    “And if America is to be a great nation this must become true. So let CSR changes ring from the prodigious hilltops of New Hampshire. Let CSR changes ring from the mighty mountains of New York. Let CSR changes ring from the heightening Alleghenies of Pennsylvania! Let CSR changes ring from the snowcapped Rockies of Colorado! Let CSR changes ring from the curvaceous slopes of California! But not only that; let CSR changes ring from Stone Mountain of Georgia! Let CSR changes ring from Lookout Mountain of Tennessee! Let CSR changes ring from every hill and molehill of Mississippi. From every mountainside, let CSR changes ring!”

  10. 10.

    MomSense

    @Ohio Mom:

    It’s so infuriating especially when they are simultaneously giving huge tax breaks to millionaires and billionaires. They really are a bunch of sociopaths.

  11. 11.

    Fair Economist

    There is one reason. Restoring CSR will get 100 billion or so for the Republicans to use for tax cuts

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