Trump Making Health Insurance Free for More Americans?!

Wait a minute—could Donald Trump be turning into Bernie Sanders and giving people “free” health care? Maybe!

As I reported when Il Duce nixed funding for the cost-sharing reductions, the Affordable Care Act’s premium tax subsidies will kick in to make up the difference and shield many lower-income policyholders from taking a hit from Trump’s higher premiums. The Kaiser Family Foundation finds that, in 1,540 counties, Trump’s move just made basic health insurance free:

The study found that in 1,540 counties a hypothetical 40-year-old making $25,000 a year can get a basic “bronze” plan under the ACA next year for zero monthly premium.

It’s partly as a result of administration actions that raised the underlying cost of insurance, leading to higher federal spending for premium subsidies.

The final number of counties with available free plans is certain to be higher because the Kaiser study only examined the 39 states using the federal HealthCare.gov website for sign-ups. In those states, nearly 60 percent of counties will have free bronze plans.

“Because of the way that premiums are set this year, people have to shop around to make sure they are getting a plan that makes sense for them,” said Gary Claxton, a co-author of the report. “Telling people that the choice is to pay a penalty (for being uninsured) or take a free plan, is a pretty attractive proposition” [Ricardo Alonso-Zaldivar, “‘Obamacare’ Curveball: Free Insurance in 1,500-Plus Counties,” AP, 2017.10.31].

Kaiser Family Foundation offers a handy clickable maps showing the counties where the bronze plan will cost less than the available premium tax credit and the percent post-subsidy cost change in various plans for various age groups by county. South Dakota doesn’t have any of the new Trump-freebie counties, but low-income folks can get a better deal on bronze plans, some paying as little as $12 a month.

According to KFF, pretty much every county in West River is seeing after-tax-credit costs for silver plans for 40-year-olds making $35K decrease 8%. In northeastern South Dakota, those net costs are staying the same or going down as much as 8%. Southeast South Dakota is a mixed bag, with Kaiser estimating 6% net cost increases in Lake and Moody counties but 4% decreases in Minnehaha and Lincoln.

So, heck, Trump didn’t mean it, and he probably doesn’t even know he’s doing it, but if we stay consistent from the blackface post, then we say intent and ignorance don’t matter. Good job, Donald! Keep it up! (And check in with Bernie Sanders for more good ideas for health coverage!)