Politico has published the transcript of the President’s remarks this afternoon from his impromptu question and answer with the press. I’d like to highlight this part before we get to the whole thing (emphasis mine):
REPORTER: Senator McCain defined them as the same group.
TRUMP: Okay, what about the alt-left that came charging at us – excuse me – what about the alt-left that came charging at the, as you say, the alt right? Do they have any semblance of guilt?
(Update at 6:2o PM EDT):
Politico has now updated their transcript, without further comment, notation, or explanation so that the section above now reads as:
REPORTER: Senator McCain defined them as the same group.
TRUMP: Okay, what about the alt-left that came charging at ’em – excuse me – what about the alt-left that came charging at the, as you say, the alt right? Do they have any semblance of guilt?
If they post an explanation, and I’m around, I’ll post it.
ETA at 6:10 PM EDT
Literally the easiest thing to do for an American politician or leader is to denounce NAZIs. The whole justification for American leadership in the global system is that we finally got our butts in gear in 1941 and defeated the purest, most unadulterated evil movement, NAZIism, during World War II. This us such a gimme it isn’t even the equivalent of a 3 inch put. The President’s inability to do this simple thing, while standing next to two two Jewish Americans (Gary Cohen and Stephen Mnuchin) and an Asian American (Elaine Chao) speaks volumes about him. The fact that none of those three didn’t resign immediately, even if they waited till they were all off camera so as not to make a scene, also speaks volumes about them.
The whole transcript after the jump updated at 6:20 PM EDT to reflect the revisions that Politico made to their transcript:
Full text: Trump’s comments on white supremacists, ‘alt-left’ in Charlottesville
The following is a transcript of President Donald Trump’s remarks at a news conference on infrastructure at Trump Tower on Aug. 15 and the Q&A with the media that followed.
PRESIDENT DONALD TRUMP: Hello, everybody. Great to be back in New York with all of our friends and some great friends outside the building, I must tell you. I want to thank all of our distinguished guests who are with us today, including the members of our cabinet: Treasury secretary Stephen Mnuchin and OMB Director Mick Mulvaney and the Transportation Secretary who is doing a fabulous job, Elaine Chao. Thank you all for doing a really incredible and creative job on what we’re going to be discussing today, which is infrastructure. We’ve just had a great set of briefings upstairs on our infrastructure agenda. My administration is working every day to deliver the world class infrastructure that our people deserve and frankly our country deserves. That’s why I just signed a new Executive Order to dramatically reform the nation’s badly broken infrastructure permitting process.
Just blocks away is the Empire State Building. It took 11 months to build the Empire State Building. But today it can take as long as a decade and much more than that. Many, many stories where it takes 20 and 25 years just to get approvals to start construction of a fairly routine highway. Highway builders must get up to 16 different approvals involving nine different federal agencies governed by 29 different statutes. One agency alone can stall a project for many, many years and even decades. Not only does this cost our economy billions of dollars, but it also denies our citizens the safe and modern infrastructure they deserve. This overregulated permitting process is a massive, self-inflicted wound on our country.
It’s disgraceful. Denying our people much needed investments in their community, and I just want to show you this, because it was just shown to me. I think I’m going to show it to the media – both real and fake media by the way. This is what it takes to get something approved today. Elaine, you see that? So this is what it takes, permitting process flow chart. That’s a flow chart. So that can go out to about 20 years, this shows about ten. But that can go out to about 20 years to get something approved. This is for a highway. I have seen a highway recently in a certain state – I won’t mention it’s name, it is 17 years. I could have built it for $4 million, $5 million without the permitting process. It costs hundreds of millions of dollars, but it took 17 years to get it approved and many, many, many, many pages of environmental impact studies. This is what we will bring it down to. This is less than two years. This is going to happen quickly, that’s what I’m signing today. This will be less than two years for a highway, so it’s going to be quick, it’s going to be a very streamlined process, and by the way, if it doesn’t meet environmental safeguards, we are not going to approve it – very simple. We’re not going to approve it. So this is – maybe this one will say, let’s throw the other one away. Would anybody like it from the media? Would anybody like that long, beautiful chart, you can have it.
So my Executive Order also requires agencies to work together efficiently by requiring one lead agency for each major infrastructure project. It also holds agencies accountable if they fail to streamline their review process, so each agency is accountable. We’re going to get infrastructure built quickly, inexpensively, relatively speaking and the permitting process will go very, very quickly. No longer will we tolerate one job killing delay after another. No longer will we accept a broken system that benefits consultants and lobbyists at the expense of hard working Americans. Now, I knew the process very well – probably better than anybody. I had to get permits for this building and many of the buildings I built. All of the buildings I built in Manhattan and many other places, and I will tell you that the consultants are rich people. They go around making it very difficult. They lobby congress, they lobby state government, city governments to make it very difficult so that you have to hire consultants and that you have to take years and pay them a fortune, so we’re streamlining the process, and we won’t be having so much of that anymore. No longer will we allow the infrastructure of our magnificent country to crumble and decay, while protecting the environment we will build gleaming new roads, bridges, railways, waterways, tunnels and highways.
We will rebuild our country with American workers, American iron, American aluminum, American steel. We will create millions of new jobs and make millions of American dreams come true. Our infrastructure will again be the best in the world. We used to have the greatest infrastructure anywhere in the world, and today, we are like a third-world country. We are literally like a third-world country. Our infrastructure will again be the best, and we will restore the pride in our communities, our nation. And all over the United States, we will be proud again, so I want to thank everybody for being here. God bless you, God bless the United States. If you have any questions, Mick, you could come up here, please. Come on up. Mick Mulvaney. If you have any questions, please feel free to ask.
REPORTER: Why are the CEOs leaving your manufacturing council?
TRUMP: Because they are not taking their job seriously as it pertains to this country. We want jobs, manufacturing in this country. If you look at some of those people that you are talking about, they are outside of the country. They are having a lot of their product made outside. If you look at Merck as an example, take a look where – excuse me, excuse me – take a look at where their product is made. It is made outside of our country. We want products made in the country, now I have to tell you, some of the folks that will leave, they’re leaving out of embarrassment, because they made their products outside, and I have been lecturing them, including the gentleman that you are referring to, about you have to bring it back to this country. You can’t do it necessarily in Ireland and all of these other places. You have to bring this work back to this country. That’s what I want. I want manufacturing to be back into the United States so that American workers can benefit.
REPORTER: Why did you wait so long to denounce neo-Nazis?
TRUMP: I didn’t wait long. I didn’t wait long. I didn’t wait long. I wanted to make sure, unlike most politicians, that what I said was correct, not make a quick statement. The statement I made on Saturday, the first statement, was a fine statement, but you don’t make statements that direct unless you know the fact. And it takes a little while to get the facts. You still don’t know the facts. And it is a very, very important process to me. It is a very important statement. So I don’t want to go quickly and just make a statement for the sake of making a political statement. I want to know the facts. If you go back to my statement, in fact I brought it. I brought it.
As I said on remember this, Saturday, we condemn in the strongest possible terms this egregious display of hatred, bigotry and violence. It has no place in America. And then I went on from there. Now here is the thing. Excuse me, excuse me. Take it nice and easy. Here is the thing, when I make a statement, I like to be correct. I want the facts. This event just happened. A lot of the event didn’t happen yet as we were speaking. This event just happened. Before I make a statement, I need the facts, so I don’t want to rush into a statement. So making the statement when I made it was excellent. In fact, the young woman who I hear is a fantastic young woman and it was on NBC, her mother wrote me and said through I guess Twitter, social media, the nicest things, and I very much appreciated that. I hear she was a fine, really actually an incredible young woman, but her mother on Twitter, thanked me for what I said. Honestly, if the press were not fake and if it was honest, the press would have said what I said was very nice. – excuse me – unlike you and unlike the media, before I make a statement, I like to know the facts.
REPORTERS YELLING INDISTINCTLY
TRUMP: They didn’t, they didn’t. They don’t.
REPORTERS CONTINUE YELLING INDISTINCTLY
TRUMP: How about, how about, how about a couple of infrastructure questions.
REPORTER: Was that terrorism?
TRUMP: Say it, what?
REPORTER: The CEO of Walmart said you missed a critical opportunity to help bring the country together. Did you?
TRUMP: Not at all. I think the country — look, you take a look. I’ve created over a million jobs since I have been president. The country is booming, the stock market is setting record, we have the highest employment numbers we’ve ever had in the history of our country. We are doing record business. We have the highest levels of enthusiasm, so the head of Walmart, who I know, who’s a very nice guy, was making a political statement. I mean, I would do it the same way, you know why? Because I want to make sure when I make a statement that the statement is correct. And there was no way – no way – of making a correct statement that early. I had to see the facts, unlike a lot of reporters, unlike a lot of reporter.
I didn’t know David Duke was there. I wanted to see the facts. And the facts, as they started coming out, were very well-stated. In fact, everybody said his statement was beautiful. If he would have made it sooner, that would have been good. I couldn’t have made it sooner, because I didn’t know all of the facts. Frankly, people still don’t know all of the facts. It was very important – excuse me, excuse me. It was very important to me to get the facts out and correctly. Because if I would have made a fast statement and the first statement was made without knowing much other than what we were seeing. The second statement was made after it with knowledge, with great knowledge. There are still things – excuse me. There are still things that people don’t know. I want to make a statement with knowledge, I wanted to know the facts, okay.
REPORTER: Two questions: was this terrorism? And can you tell us how you are feeling about your Chief Strategist Steve Bannon?
TRUMP: I think the driver of the car is a disgrace to himself, his family and this country. And that is – you can call it terrorism, you can call it murder. You can call it whatever you want. I would just call it as the fastest one to come up with a good verdict. That’s what I’d call it. And there is a question. Is it murder? Is it terrorism? Then you get into legal semantics. The driver of the car is a murderer, and what he did was a horrible, horrible, inexcusable thing.
REPORTER: Can you tell us how you are feeling about your chief strategist, Mr. Bannon? Can you talk about that?
REPORTER: Steve Bannon —
TRUMP: I never spoke to Mr. Bannon about it.
REPORTER: Can you tell us broadly about – do you still have confidence in Steve?
TRUMP: Well, we’ll see. And look, look, I like Mr. Bannon. He is a friend of mine, but Mr. Bannon came on very late. You know that. I went through 17 senators, governors and I won all the primaries. Mr. Bannon came on very much later than that, and I like him. He is a good man. He is not a racist – I can tell you that. He is a good person, he actually gets very unfair press in that regard. We’ll see what happens with Mr. Bannon. He’s a good person, and I think the press treats him frankly very unfairly.
REPORTER: They have called on you to defend your national security adviser H.R. McMaster against these attacks.
TRUMP: I did that before. Senator McCain? Senator McCain. You mean the one that voted against Obamacare? Who is Senator McCain? You mean senator McCain who voted against us getting good health care?
REPORTER: Senator McCain said that the alt-right is behind these attacks, and he linked that same group to those that perpetrated the attack in Charlottesville.
TRUMP: Well, I don’t know. I can’t tell you. I’m sure Senator McCain must know what he is talking about, but when you say the alt-right, define alt-right to me. You define it. Go ahead. Define it for me, come on, let’s go.
REPORTER: Senator McCain defined them as the same group.
TRUMP: Okay, what about the alt-left that came charging at ’em – excuse me – what about the alt-left that came charging at the, as you say, the alt right? Do they have any semblance of guilt?
REPORTERS YELL INDISTINCTLY
TRUMP: What about this? What about the fact that they came charging – they came charging with clubs in their hands swinging clubs? Do they have any problem? I think they do.
REPORTERS YELL INDISTINCTLY
TRUMP: As far as I’m concerned, that was a horrible, horrible day. Wait a minute, I’m not finished. I’m not finished, fake news. That was a horrible day.
REPORTERS YELL INDISTINCTLY
TRUMP: I will tell you something. I watched those very closely, much more closely than you people watched it. And you had, you had a group on one side that was bad. And you had a group on the other side that was also very violent. And nobody wants to say that, but I’ll say it right now. You had a group – you had a group on the other side that came charging in without a permit, and they were very, very violent.
REPORTER: Do you think what you call the alt left is the same as neo-Nazis?
TRUMP: Those people – all of those people, excuse me – I’ve condemned neo-Nazis. I’ve condemned many different groups, but not all of those people were neo-Nazis, believe me. Not all of those people were white supremacists by any stretch.
REPORTER: Well, white nationalists –
TRUMP: Those people were also there, because they wanted to protest the taking down of a statue Robert E. Lee. So – excuse me – and you take a look at some of the groups and you see, and you’d know it if you were honest reporters, which in many cases you’re not. Many of those people were there to protest the taking down of the statue of Robert E. Lee. So this week, it’s Robert E. Lee, I noticed that Stonewall Jackson’s coming down. I wonder, is it George Washington next week? And is it Thomas Jefferson the week after. You know, you really do have to ask yourself, where does it stop?
REPORTERS YELL INDISTINCTLY
TRUMP: But, they were there to protest – excuse me – you take a look the night before, they were there to protest the taking down of the statue of Robert E. Lee. Infrastructure question. Go ahead.
REPORTER: Does the statue of Robert E. Lee stay up?
TRUMP: I would say that’s up to a local town, community or the federal government, depending on where it is located.
REPORTER: Are you against the Confederacy?
REPORTER: On race relations in America, do you think things have gotten worse or better since you took office with regard to race relationships?
TRUMP: I think they’ve gotten better or the same – look – they have been frayed for a long time, and you can ask President Obama about that, because he’d make speeches about it. I believe that the fact that I brought in, it will be soon, millions of jobs, you see where companies are moving back into our country. I think that’s going to have a tremendous positive impact on race relations. We have companies coming back into our country. We have two car companies that just announced. We have Foxconn in Wisconsin just announced. We have many companies, I’d say, pouring back into the country. I think that’s going to have a huge, positive impact on race relations. You know why? It is jobs. What people want now, they want jobs. They want great jobs with good pay. And when they have that, you watch how race relations will be. And I’ll tell you, we’re spending a lot of money on the inner cities – we are fixing the inner cities – we are doing far more than anybody has done with respect to the inner cities. It is a priority for me, and it’s very important.
REPORTER: Mr. President, are you putting what you’re calling the alt-left and white supremacists on the same moral plane?
TRUMP: I am not putting anybody on a moral plane, what I’m saying is this: you had a group on one side and a group on the other, and they came at each other with clubs and it was vicious and horrible and it was a horrible thing to watch, but there is another side. There was a group on this side, you can call them the left. You’ve just called them the left, that came violently attacking the other group. So you can say what you want, but that’s the way it is.
REPORTER: You said there was hatred and violence on both sides?
TRUMP: I do think there is blame – yes, I think there is blame on both sides. You look at, you look at both sides. I think there’s blame on both sides, and I have no doubt about it, and you don’t have any doubt about it either. And, and, and, and if you reported it accurately, you would say.
REPORTER: The neo-Nazis started this thing. They showed up in Charlottesville.
TRUMP: Excuse me, they didn’t put themselves down as neo-Nazis, and you had some very bad people in that group. But you also had people that were very fine people on both sides. You had people in that group – excuse me, excuse me. I saw the same pictures as you did. You had people in that group that were there to protest the taking down, of to them, a very, very important statue and the renaming of a park from Robert E. Lee to another name.
REPORTER: George Washington and Robert E. Lee are not the same.
TRUMP: Oh no, George Washington was a slave owner. Was George Washington a slave owner? So will George Washington now lose his status? Are we going to take down – excuse me. Are we going to take down, are we going to take down statues to George Washington? How about Thomas Jefferson? What do you think of Thomas Jefferson? You like him? Okay, good. Are we going to take down his statue? He was a major slave owner. Are we going to take down his statue? You know what? It’s fine, you’re changing history, you’re changing culture, and you had people – and I’m not talking about the neo-Nazis and the white nationalists, because they should be condemned totally – but you had many people in that group other than neo-Nazis and white nationalists, okay? And the press has treated them absolutely unfairly. Now, in the other group also, you had some fine people, but you also had troublemakers and you see them come with the black outfits and with the helmets and with the baseball bats – you had a lot of bad people in the other group too.
REPORTER: I just didn’t understand what you were saying. You were saying the press has treated white nationalists unfairly?
TRUMP: No, no. There were people in that rally, and I looked the night before. If you look, they were people protesting very quietly, the taking down the statue of Robert E. Lee. I’m sure in that group there were some bad ones. The following day, it looked like they had some rough, bad people, neo-Nazis, white nationalists, whatever you want to call ‘em. But you had a lot of people in that group that were there to innocently protest and very legally protest, because you know, I don’t know if you know, but they had a permit. The other group didn’t have a permit. So I only tell you this: there are two sides to a story. I thought what took place was a horrible moment for our country, a horrible moment. But there are two sides to the country. Does anybody have a final – does anybody have a final question? You have an infrastructure question.
REPORTER: What makes you think you can get an infrastructure bill? You didn’t get healthcare, you didn’t get tax –
TRUMP: Well, let me tell you. We came very close with health care. Unfortunately, John McCain decided to vote against it at the last minute. You’ll have to ask him why he did that. We came very close to health care. We will end up getting health care. But we’ll get the infrastructure, and actually, infrastructure’s something I think we’ll have bipartisan support on. I actually think – I actually think Democrats will go along with the infrastructure.
REPORTER: Mr. President, have you spoken to the family of the victim of the car attack?
TRUMP: No. I will be reaching out, I’ll be reaching out.
REPORTER: When will you be reaching out?
TRUMP: I thought that the statement put out, the mother’s statement I thought was a beautiful statement. I’ll tell you – it was something that I really appreciated. I thought it was terrific. And really under the kind of stress that she’s under and the heartache she’s under, I thought putting out that statement to me was really something I won’t forget. Thank you all very much. Thank you.
REPORTER: Do you plan to go to Charlottesville, Mr. President?
TRUMP: Did you know I own a house? It’s in Charlottesville, oh boy. It’s in Charlottesville, you’ll see.
REPORTER: Is that the winery or something?
TRUMP: It’s a, it’s a, it is the winery.REPORTERS YELL INDISTINCTLY.TRUMP: I mean, I know a lot about Charlottesville. Charlottesville is a great place that’s been very badly hurt over the last couple of days. I own – I own actually one of the largest wineries in the United States. It’s in charlottesville.
REPORTER: What do you think needs to overcome the racial divides?
TRUMP: Well, I really think jobs are going to have a big impact. If we continue to create jobs – over a million – substantially more than a million, and you see just the other day, the car companies come in with Foxconn, I think if we continue to create jobs at levels that I’m creating jobs, I think that’s going to have a tremendous impact – positive impact – on race relations.
REPORTER: And what you said today, how do you think that will impact?
TRUMP: Because the people are going to be working and making a lot of money, much more than they ever thought possible. That’s going to happen. And the other thing, very important, I believe wages will start going up. They haven’t gone up for a long time. I believe wages now, because the economy is doing so well, with respect to employment and unemployment, I believe wages will start to go up. I think that’ll have a tremendously positive impact on race relations. Thank you.
Trump is the consummate bullshitter. Verbally, he’s all over the map when discussing most issues, catering to what he thinks his audience wants to hear, and listening to the last person who leaves the room. Healthcare is a good example. He would have signed any bill–tiny, incremental piece of shit, or major sweeping reform–as long as it was perceived as a “winning” Obamacare repeal.
One (maybe the only) thing he won’t bullshit about is race. He could jettison these fucking nazis in a second without any ill effect. Yet he stubbornly and persistently refuses to make any significant, long-term criticism of white nationalists.
The only reasonable conclusion is that he really believes in white nationalism. Today, again, we’ve seen the core belief of a man who is otherwise has the moral clarity of a carnival barker.
Update:
Thank you President Trump for your honesty & courage to tell the truth about #Charlottesville & condemn the leftist terrorists in BLM/Antifa https://t.co/tTESdV4LP0
on health care why do we always have to pre-negotiate with ourselves and have ourselves primed to accept half a loaf? I am so tired of being sensible when there is no gorram reward. If loudly shouting the most extreme thing we want gets us even half what the republicans have gotten out of it why the hell not??
I want to raise an empirical point and then a broader political/policy point that explains my thought process.
First, empirically, what has “shouting the most extreme thing” gotten Republicans?
It has gotten them power.
What have they done with it so far? In 2009, Democrats at this point had a smaller functional majority in the Senate and a slightly larger majority in the House than the Republicans have today. Democrats had passed and signed into law the stimulus, CHIP re-authorization, Lily Ledbetter, and the Dodd-Frank CARD ACT by now. They were grinding their way through what would become the ACA.
What have the Republicans accomplished as of today?
They got a Supreme Court justice at the cost of allowing liberals to nominate liberals in the future. And they named a bunch of post offices. What else have they gotten at the legislative level? And they also got a President who is at 34% who is leading to massive swings against the GOP. Those swings are large enough to endanger the gerrymandered House GOP majority even if they do nothing.
That is my pragmatic point. Being howler monkeys may be a successful strategy to gain power but it has not been a successful strategy to exercise power.
leading lights of the conservative “health wonk” community is peddling bullshit that is technically true if you parse it correctly but designed to mislead anyone but a hyper technical reader.
Last year open enrollment started on November 15th. The 6th week of open enrollment would have been the first week of January.
This year, open enrollment started on November 1st. The 6th week of open enrollment just wrapped up.
Yes, at the six week mark of open enrollment, 2014 enrollment is running higher than 2015 enrollment. However there is one massive fact that will show 2015 open enrollment 7th week selections running ahead of 2014 7th week selections. Sometime at the end of this week, Healthcare.gov and most of the state based exchanges will conduct a massive automatic renewal of plans.
And next year, when Obamacare does not collapse in on itself like a neutron star of fail, the same opinion leaders and expert validaters will trot out the same story.
The Republican base has been promised a lot and their party can’t deliver on those goals. The elites don’t have legitimacy because their bullshit has been marked to market so new entries with new, creatively destructive forms of bullshit have a niches that they can fill and a willing mass audience that wants to believe that this time the new guy can deliver on their promises while ignoring the elites who have no credibility.
I want to avoid that cycle. I would rather under-promise and over deliver than over promise and under deliver.
I also believe that the details matter and an accurate assessment of the current state and a reasonable approximation of future states is critical in doing anything well. I can be accused of having that bias for professional and financial reasons as I am a health policy wonk and figuring out complex systems pays the mortgage. I don’t think that is what drives me, but I will acknowledge that possibility.
I want a political and policy program that has two realistic chances. The first is that it needs a realistic chance of passing Congress and being signed into law. The second is that once it is law, it needs to have a realistic chance of actually working and doing what it intends to do without surprising consequences in type or scale.
From these preferences, that means identifying things that imperil those two chances. Great politics don’t always means great policy as we see with the risk pool damage that the Under-26 provision of the ACA creates by pulling out healthy young people from the market. Needed policy is not always great politics as we see with the individual mandate. Sometimes a bad is needed to be accepted on one side of the equation to allow the other side to work but those bads should be minimized to the essentials for passage or functionality. And that means being disciplined in our thinking.
The valuation of “bad” will vary. It is a combination of projection and a value judgement as to what trade-offs are acceptable. Having that discussion now and hopefully coming to some type of consensus or at least a clear understanding of different valuations is a good thing as there is time to tweak and rejigger plans.
I must say, Team Trump has really tightened up their messaging strategy now that John Kelly is running the show:
Pres. Trump on Charlottesville: "Not all of those people were neo-Nazis, believe me, not all of those people were white supremacists.” pic.twitter.com/quf2s7sYGB
Our President retweeted a conspiracy theorist and a violent cartoon that seemed to support the terrorist car attack in Charlottesville this morning and then deleted them. But lots of people know to take screenshots. Other than that and a birther reference, he hasn’t done much today.
It’s feeling like a lazy day for me and the kittehs anyway. You?
the primary agenda for Democrats is obvious: appropriate funding for Cost Sharing Reduction payments and for some kind of reinsurance program to replace the program that expired in 2017…. To have any real hope of getting these measures passed in a Republican Congress, however, Democrats are going to have to face up to the question: What pound of flesh will they let Republicans extract as payment for these essential, common-sense fixes?
He envisions a negotiating environment where Democrats must concede significant waiver flexibility in return for Cost Sharing Reduction subsidies. This model of leverage is wrong.
Democrats have no reason to trade CSR funding for policies that they don’t prefer. Inaction gives them an incredible policy victory. Conservatives are the ones who need to make concessions to fully fund CSR.
The Congressional Budget Office projects that most states will allow insurers over the long run to load the cost of their obligated but not reimbursed CSR obligations to only their Silver plans. This will have an incredible change in the dynamics of the market.
Total federal subsidies for health insurance in the nongroup market—in particular, the sum of the premium tax credits and the CSR payments—would increase for two reasons: The average amount of subsidy per person would be greater, and more people would receive subsidies in most years….
By CBO and JCT’s estimates, the number of people receiving subsidies for nongroup health insurance would increase under the policy in most years. In particular, because tax credits would increase and gross premiums for plans other than silver plans in the marketplaces would not change substantially, many people with income between 200 percent and 400 percent of the FPL would, compared with outcomes under the baseline, be able to pay lower net premiums for insurance that pays for the same share (or an even greater share) of covered benefits….reducing the number of uninsured people, on net, in most years.
Insurers are increasingly explicit that they are loading the full cost of the uncertainty onto only the Silver plans. This is in states as ranging in size from Idaho to California. Bronze, Gold and Platinum plans will be priced on the basis of changes in medical costs, changes in enrollment and other normal insurance industry factors. Silver plans will be priced on those basis and then there will be a significant second price increase on top of the baseline increase.
The Center for Medicare and Medicaid Services (CMS) issued a guidance letter on August 10th to states contemplating loading CSR costs onto Silver plans only. This letter states that for risk adjustment purposes, Silver load only plans will be treated as if they are Platinum plans.
For the risk adjustment transfer formula, we intend to propose considering the 87 percent and 94 percent silver plan variants (as well as the limited cost-sharing and zero cost-sharing variants) to have plan metal level actuarial values of 0.9 in order to account for the higher relative actuarial risk associated with these plans
From a mechanical point of view, this is good guidance and a reasonable solution to the problem of running risk adjustment where Silver plans cost more than Gold plans. It is an incredible admission of a massive policy change regarding the sufficiency of the subsidy.
Subsidies in the ACA are calculated by taking the difference from the second lowest premium Silver plan and an individual’s expected contribution. The individual expected contribution is a function of their income. Any premium that is not covered by the expected individual contribution for the benchmark Silver is covered by the federal premium subsidy.
The ACA designated Silver plans as having 70% actuarial value (AV) with allowed minimal variation. In 2018, this means Silver plans will range from 66% AV to 72% AV. In most competitive markets, the benchmark Silver plan will be close to 66% AV. However in states that load the cost of CSR onto only Silver plans , the Silver plans will have an AV of 90% and this is what the subsidies will be calculated from.
The ACA exchanges have had difficulty in signing people up who make more than 200% FPL because the cost of the post-subsidy premiums rise too quickly in comparison to perceived value. Silver, if it is priced at 90% AV, will lead to incredibly lower prices for individuals making between 200% and 400% FPL. Most people making just under 400% FPL will be able to buy Bronze plans for no out of pocket premius. Gold plans with $1,500 deductibles will be significantly more affordable in this scenario than Silver plans with $3,000 deductibles are today to individuals and families earning more than 200% FPL.
Liberals will have achieved an incredible policy victory in the states that force insurers to load the cost of CSR onto only Silver plans. In these states, the benchmark plans will be sufficient to buy 90% actuarial value coverage. That is better than Medicare. That is an incredible improvement over the ACA as plans will become more affordable to many more people as premiums and deductibles will decrease and the risk pool will get healthier as the value proposition gets better.
Since it is an incredible policy victory that will be cemented into place by inaction, giving it up for short term funding of a secondary set of subsidies would be counterproductive.
Now let’s hope that they Silver Gap instead of Silver Spam themselves so that more people can get good deals.
There are two counties, one each in Wisconsin and Ohio, where there are no announced insurers for the Exchange. I am betting with no inside knowledge that someone will take these orphans on. They should be able to monopoly price with almost no pushback from the state insurance commissioner and choose their own risk pool by product offering choices.
This is what happens when state regulators give a damn. Good work Centene. Good work Gov. Sandoval.