Quick, ACA marketwatchers: what's wrong with the headlines below?
Trump didn't end the Cost Sharing Reduction benefit, of course, He didn't end government funding for CSR, either -- he just redirected it into a less efficient channel that will cost the Treasury hundreds of billions, hurt unsubsidized enrollees in states that don't make insurers price in CSR in the most efficient way, and provide a windfall for many more affluent subsidized enrollees in states that do concentrate the premium hike where it belongs, in on-exchange silver plans.
Those headlines did a real disservice. A lot of people in this country must be under the impression that a major ACA benefit has been stripped away. The ledes in many cases did not repair the damage.
Here's CNN's:
Washington (CNN)President Donald Trump plans to end a key set of Obamacare subsidies that helped lower-income enrollees pay for health care, the White House said Thursday, a dramatic move that raises questions about the law's future.Will the subsidies go away, CNN? No...as you'll learn if you get to paragraph #27:
The late-night announcement is part of Trump's aggressive push to dismantle aspects of his predecessor's signature health law after several failed attempts by Congress to repeal it earlier this year.
Insurers have already signed contracts committing them to participating in 2018 and setting their rates. They must continuing offering the reduced deductibles and co-pays to eligible enrollees, but they won't be paid for them. That's why many asked for such large rate hikes.Here's NPR's lede:
The Trump administration said Thursday that it would end the Affordable Care Act's cost-sharing reduction payments designed to help low-income Americans get health care. Not paying the subsidies, health care experts have warned, could send the health insurance exchanges into turmoil.This story never even gets around to mentioning that qualified enrollees will continue to get CSR -- nor does it explain what CSR does. Surprising, for NPR, which has great healthcare coverage.
The payments, which started under the Obama administration, had been continued by President Trump, despite his strong opposition to the ACA, also known as Obamacare. But the subsidies had never been funded by Congress, and the White House on Thursday said that because there was no appropriation for it, "the Government cannot lawfully make the cost-sharing reduction payments."
USA Today begins with wording that accurately describes what Trump did (headline to the contrary) -- but then also tells readers that the subsidies "end":
Shares of health insurers and other medical-related stocks took a sharp dive Friday as investors reacted to a White House move to end payments to Obamacare insurers that were used to offset the cost of coverage for low-income people.The story also never gets around to explaining that those who qualify for CSR will still get the benefit. While its focus is on the impact on healthcare stocks, it includes a quote that gets that wrong too. Gary Kaltbaum, president of money-management firm Kaltbaum Capital Management. is quoted as follows without correction:
The move by the Trump administration, announced late Thursday, to end so-called cost-sharing subsidies added to the chaos and instability in the nation's health-care system as the Trump team attempts to undo the 2010 Affordable Care Act.
"It's very simple, it is negative for insurance companies because these are payments to them as part as of the Affordable Care Act," he says. "It's also negative for hospitals because the payments help pay out-of-pocket costs for people with low incomes so hospitals will incur more costs. No more payments equals less profits, (so) stocks go down."The cutoff of CSR reimbursement could only affect hospitals insofar as fewer people buy coverage at all. That's not what's said here.
The Kaiser Family Foundation, which conducts regularly surveys probing Americans' perceptions of what's going on in the ACA marketplace and with the law in general, should ask people whether Trump has managed to take a major benefit away. The answers won't be encouraging.
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