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Trump administration says it's ending ACA ‘sabotage,’ experts say it comes at great risk to patients

The average premium for the second lowest cost silver health insurance plans — the one used to determine final premium tax credits — will drop by a “historical” 1.5% for the first-time since the implementation of the federally-facilitated exchange in 2014, according to CMS.

However, experts told Healio Family Medicine that the agency’s actions put profit over patients and puts the well-being of many Americans at risk.

CMS claims

The average change in premium costs may not seem like a lot but is significant when put into historical context, Seema Verma, CMS administrator, said in a conference call with reporters.

“This is a very positive change from the double-digit increases we have seen over the past 2 years,” she said, noting that some states had seen increases of 200% and higher. The change in premiums was just one of the health insurance-related accomplishments under the Trump administration she lauded during the call.

According to Verma, states will soon be able to use waivers to increase their flexibility in sustaining their insurance markets. In addition, for the first time in several years, there will be an increase in insurance providers on the federal health insurance exchange market, she said. 

“While some have been accusing [the Trump administration] of sabotage, the reality is we have been doing everything we can to mitigate the damage caused by Obamacare,” Verma said.

Experts weigh in

Arthur Caplan, PhD, founding head of medical ethics at New York University School of Medicine, and Robert Greenwald, JD, faculty director, Center for Health Law and Policy Innovation at Harvard Law School said in interviews CMS should not be patting itself on the back.

“The idea that the Trump administration is trying to save patients is ludicrous,” Caplan said in an interview. “It has permitted lousy cheap coverage, cheap, almost worthless policies to be sold,”  adding that is the “real reason why” CMS can make an announcement like this one.  

“Putting this pig in a dress by claiming they’re helping people doesn’t make what they’re really trying to do — make the Affordable Care Act a footnote in history — go away. They’re putting money over people,” Caplan added.

“In no way does the Trump administration deserve credit for the state of the marketplace,” Greenwald agreed. “They have done everything in their power to destabilize it.”

According to Greenwald, states and insurance companies positively balanced the Trump administration’s actions by funding outreach and navigation efforts to promote the marketplace, adopting their own individual mandates to assure that there is diversity among marketplace applicants, passing laws that banned or limited the introduction of “junk” insurance plans, introducing a reinsurance system that results in lower premiums in their marketplaces, and allocating premium rate increases into silver-level plan premiums only.  

Greenwald added it is not too late for clinicians and others to make their thoughts about health insurance known.

“If the American people want to see a strong marketplace this year, and the years ahead, they need to voice their opposition to efforts to repeal the Affordable Care Act and the health insurance marketplace,” he told Healio Family Medicine. - by Janel Miller

Disclosures: Healio Family Medicine was unable to confirm relevant financial disclosures prior to publication.