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Trump administration ushers in changes to Obama health law


    Health and Human Services Secretary Tom Price, testifies on Capitol Hill in Washington. The Trump administration tooksteps intended to help calm jittery insurance companies and make tax compliance with former President Barack Obama’s health law less burdensome for some people.

WASHINGTON >> The Trump administration took steps Wednesday intended to calm jittery insurance companies and make tax compliance with former President Barack Obama’s health law less burdensome for some people.

But the changes could lead to policies with higher annual deductibles, according to the administration’s own proposal. That seems to undercut President Donald Trump’s assurance in a recent Washington Post interview that his plan would mean “lower numbers, much lower deductibles.”

The moves announced separately by the Health and Human Services Department and the IRS don’t amount to sweeping changes to the Affordable Care Act. That would fall to Congress, where Republicans are struggling to reach consensus over how to deliver on their promise to repeal and replace the health law. House Speaker Paul Ryan, R-Wis., is expected to present elements of a plan to GOP lawmakers Thursday morning.

But the administration actions do signal a change in direction. Recently confirmed HHS Secretary Tom Price called them “initial steps in advance of a broader effort to reverse the harmful effects of Obamacare.” Premiums are up sharply this year, while many communities were left with just one insurer.

For consumers, the proposed HHS rules mean tighter scrutiny of anyone trying to sign up for coverage outside of open enrollment by claiming a “special enrollment period” due to a change in life circumstances such as the birth of a child, marriage, or the loss of job-based insurance. Also, sign-up season will be 45 days, shortened from three months currently.

For insurers, the curbs on special enrollments are a big item. The industry claimed that some consumers were gaming the system by signing up when they needed expensive treatments, only to drop out later.

Insurers would also gain more flexibility to design low-premium plans tailored to younger people. But that flexibility could lead to higher deductibles, according to HHS.

“The proposed change … could reduce the value of coverage for consumers,” the administration proposal said. “However, in the longer run, providing (insurers) with additional flexibility could help stabilize premiums.”

Larry Levitt of the nonpartisan Kaiser Family Foundation said “this would allow insurers to offer plans with higher deductibles, which seems counter to President’s Trump promise to lower deductibles.” A deductible is the annual amount consumers pay for medical care before their insurance kicks in.

Democrats said the HHS changes would undermine consumer protections and make more people uninsured. Some called the move “sabotage.”

Separately, the IRS said it’s backing off from a tighter approach to enforcement that was in the works for this tax-filing season. The IRS said that’s in line with Trump’s executive order directing agencies to ease requirements of the health law.

Under the law, people are required to have health coverage or risk fines from the IRS — an unpopular provision. That underlying requirement remains on the books, and taxpayers are still legally obligated to comply, the IRS said.

But the agency is changing its approach to enforcement. Originally, the IRS had planned to start rejecting returns this year if a taxpayer failed to indicate whether he or she had coverage. Now the IRS says it will keep processing such returns, as it has in the past.

Administration officials said the HHS rules will help to stabilize the individual health insurance market for next year. That could buy time for Congress to make bigger changes.

The industry group America’s Health Insurance Plans commended the administration, but said more is needed. In particular, insurers want Trump and Congress to remove a legal cloud over billions of dollars in subsidies that the companies are obligated to pay to cover deductibles and copayments for low-income people.

It remained unclear if insurers would be swayed. Only Tuesday, Humana announced it will not participate in next year in the government-run marketplaces, where insurer exits have already diminished consumer choice.

“I don’t necessarily think these changes are enough to alter insurers’ decision-making about staying in the markets,” said Caroline Pearson of the consulting firm Avalere Health.

Pearson said consumer reviews may also be mixed. Healthy people may appreciate more affordable premiums. But people with health problems could see an erosion in coverage.

Separately, a government report Wednesday said the nation’s problem with rising health care spending is back and here to stay, regardless of what happens to the Obama health law.

Nonpartisan experts at HHS said health care spending will claim a growing share of national resources for the foreseeable future.

Health care will grow at an annual average of 5.6 percent from 2016-2025, outpacing expected economic growth. Now $3.5 trillion, the nation’s health care tab will increase to nearly $5.5 trillion in 2025, accounting for about one-fifth of the economy.

The unwelcome trend is due to fundamentals such as rising prices for treatments and services, as well as an aging population.


Murphy reported from Indianapolis.

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  • At least with President Trumps AmeriCare plan we will know whats in it before it goes into effect. Unlike Obamacare where it had to be passed before we see what was in it (straight from the Donkeys(a@#)mouth PELOZI) and you know what that got us,one big disaster. The Trump Train is moving full steam ahead, All the hatred coming from the Democratic party and its left wing radical supporters can not de-rail it the support is to strong.

  • Be prepared for more confusion and IMHO, higher medical payments.
    Lower premiums for younger people looks enticing. Reality is that age doesn’t matter when it comes to health. My nephew has had two surgeries and is needing another one. I’ve had one and I’m 30 years older that he.
    Lower premiums will probably mean much higher deductibles of certain services. I encourage you younger ones to review your insurance coverage and make sure you have a very good understanding if what you’re covered for. When the new stuff comes out, prepare for the shock.
    This administration has yet to address problems in their own administrative offices. How do you think they’ll address problems with something as complex as healthcare? The first step is you’ve got to recognize truthful facts at the reports and analysis you’re looking at.

  • There are some good and bad things with the ACA. Most know the good that more Americans now have health insurance. The bad: Between three to five million people lost their company-sponsored health care plans. ACA goes from a fee-for-service to a value-based payment. Instead of being paid for every test, exam and procedure, hospitals and doctors will be paid based on how well the patient does. Sounds okay unless you or a close one needed specialized care. Your doctor or PT will need to ask the insurance company if treatment will be covered instead of the doctor/PT requiring the treatment/test and with that ‘order’ the insurance company reimburses as appropriate. And yup, many major insurance companies have or will stop offering insurance. If the ‘new and improved’ version can return authority for our medical needs back to the medical community and make it cost effective for insurance companies to participate, while allowing those that are insured to continue to have that option, it’ll be an improvement. But it’s easier said than done unfortunately.

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