Trump to Cut Cost-Sharing Reductions, Raising Premiums and Increasing Deficit

And in more cruel, vindictive chaos, Donald Trump plans to yank $7 billion in cost-sharing reductions that are helping seven million Americans afford health insurance.

“What it adds up to me is a gross dereliction of duty,” John Baackes, CEO of L.A. Care Health plan said of the decision. “The Affordable Care Act is still the law of the land and the cost-reduction subsidies are part of that. … Even if there’s a lawsuit about it, it should still be honored until the last appeal is exhausted. I thought they took oaths to uphold the law of the land. They’re just flaunting it now” [Josh Dawsey and Paul Demko, “Trump Will Scrap Critical Obamacare Subsidy,” Politico, 2017.10.12].

In August, the Congressional Budget Office reported that eliminating the cost-sharing reductions (CSR) would push premiums for ACA silver plans up 20% beyond previous baseline projections. But while Trump’s chaos might temporarily drive some insurers out of the ACA marketplaces and leave 5% of Americans living in areas with no individual market insurance vendors, the CBO says the increases in premiums would trigger increases in ACA premium tax credits:

Implementing the policy would increase the federal deficit, on net, by $194 billion from 2017 through 2026, CBO and JCT estimate. 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.

Because the tax credits would increase when premiums for silver plans rose, the agencies estimate that the average subsidy per person receiving premium tax credits to purchase nongroup health insurance would increase. Increases in those tax credits for people with income between 100 percent and 200 percent of the FPL would roughly offset the reductions in CSR payments. However, increases in premium tax credits for those with income between 200 percent and 400 percent of the FPL would substantially exceed the small reductions in CSR payments for this group [Congressional Budget Office, “The Effects of Terminating Payments for Cost-Sharing Reductions,” August 2017].

So Donald Trump may think he’s building on his legacy of erasing Barack Obama’s legacy (when all a President does is negate what his predecessor did, do we call that a negacy?), but according to the CBO, in this case he’s upsetting the markets, driving additional premium increases, and creating more costs for taxpayers.

The CBO report says that the increased premium tax credits won’t insulate silver-plan buyers from paying more. At the bottom of the income scale, net silver premiums for individuals making $18,900 a year go up 11%; individuals making $26,500 pay 9% more.

Democrats recognize Trump’s elimination of the CSR for what it is:

In a joint statement, the top Democrats in Congress, Senator Chuck Schumer of New York and Representative Nancy Pelosi of California, said Mr. Trump had “apparently decided to punish the American people for his inability to improve our health care system.”

“It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America,” they said. “Make no mistake about it, Trump will try to blame the Affordable Care Act, but this will fall on his back and he will pay the price for it” [Robert Pear, Maggie Haberman, and Reed Abelson, “Trump to Scrap Critical Health Care Subsidies, Hitting Obamacare Again,” New York Times, 2017.10.12].

Some Republicans, like Rep. Ileana Ros-Lehtinen, recognize this cut goes against Trump’s promise of “insurance for everybody” and “much less expensive” health care:

So let’s get clear, Representative Kristi Noem, Senator Mike Rounds, and Senator John Thune: if you want to keep the deficit from growing, and if you want to protect more than 27,000 South Dakotans from premium increases, you sit down with Democrats, make the Alexander/Murray compromise bill work, and save the cost-sharing reductions from Donald Trump’s blind flailings.

39 Responses to Trump to Cut Cost-Sharing Reductions, Raising Premiums and Increasing Deficit

  1. Richard Schriever

    He is an anger-driven, shallow, clueless, careless blustering oaf.

  2. Insurance companies have already factored it in and will be ready with new rates. Insureds will have to decide if it is worth it or not, just like we did before the ACA/Obamacare came into being. Now, we are all in the same situation that those who did not make enough to even qualify for a subsidy.

    Many people right now wait until they are 65 to have those surgery’s they have struggled with over the years. Now you can wait until open enrollment and pay the huge cost of insurance, stay with it for a couple of months and get the process done. Then drop it and move on. If you cannot pay the 6 to 10,000.00 out of pocket, including bankruptsy, declare yourself insolvent and away it goes.

    trump has solved the problem by showing people that bankruptcy can work, hell, he has shown that by doing so, you could even be prez. Soon, you will be seeing upgraded flyers on how to do it, count on that as the past is now the present. nice…

  3. With just one signature Trump undermined the government ACA that was forced upon a free people, allowing the formation of associations to acquire health insurance for their members at a much more affordable cost and stopped the unconstitutional Cost-Sharing Reduction Payments saving the American people billions of dollars all at the cost of one executive order.

    Sweet. . . Its like the man is a Genius.

  4. Yes, now trumpcare lives and you and your posse own it. With that one signature, the name has changed to trumpcare, complete with all the failures because of the lack of funding. trump has shown yet again what he thinks of the American people both on the mainland and in Puerto Rico and the Virgin Islands. Well done, donny boy. And a tip of the hat to NOem, Jackley, Thune and Rounds for being active participants. It is now up to the new owners to explain what is going on and why, hint… The wall that Mexico was supposed to build.

  5. There is no “Trumpcare” that is what is so marvelous about this! It doesn’t cost the American people one freaking dime! He didn’t start his own program. He returned control to the people. Obummercare is gone, caput, nada, forever out of our lives as it dies the slow death it deserves along with socialism, communism, fascism and all the other authoritarian enslavement programs of the leftist!

    Let the people sing “We are free, We are free at last!!!!”

  6. Oh, on your point about Puerto Rico: I talked to a Naval Officer there today, the restaurants are open, Walmart is busy, people are not starving, the homes have electricity and the SeaBees are searching for roads to clear without much luck.

  7. Here is what trumpcare will cost. “”Two months ago, the Congressional Budget Office estimated that individual health plan premiums would be 20 percent higher than originally projected if the [CSR] payments ceased. It also projected that premiums would be 25 percent higher than they otherwise would be by 2020, and that the federal deficit would be increased by almost $200 billion if the subsidies ended.” That was 2 months ago, and now with the timing, it will double

    Genius at spending other people’s money. 2020 is just two years away. 200 billion a year for starters and it just keeps going up the kazoo. With the trumpcare, money is not an issue

  8. trumpcare will suddenly make Medicare more expensive as well. Genius at work, ask the Wharton professor.

  9. Delighted to hear about the work in saving Americans in Puerto Rico. I am sure they will be surprised to hear that.

  10. What time was Ensign Charles Parker freed up with his duties with McHale’s Navy?

  11. “Congressional Budget Office estimated ” never been right in the past what makes you think they will be right this time?

  12. Did Ensign Charles Beaumont Parker have any trouble with the PT 73 bringing through the Panama Canal? What about Binghampton was he good with it? Ensign Charles Beaumont Parker reminds me of another genius, donald j trump. If you put hair on old Parkers melon, he and trump would be hard to distinguish. Take the IQ test and boom, still equal. See if I am correct

    See, two genius’s.

  13. Roger Cornelius


    Obamacare will forever be called ‘Odumbercare’

  14. But no more ACA that is for damned sure. The republican healthcare plan, die quickly, Thanks Grayson for that one. He was a pos, but he had that right.



  16. OHBTW, the ACA, best insurance coverage I’ve ever had. Saving my life.

    Old Sarge, have you ever heard of Mueller? Most of trump’s base hasn’t says a recent poll. NPR today

  17. Roger Cornelius

    Will Mike Rounds insurance company face insolvency as many health insurance companies fear?

  18. Roger Cornelius

    Sarah Palin’s fear of Death Panels has become a reality with Donald Trump as chairman.

  19. Rounds wouldn’t be in the senate if it wasn’t in the interest of his bottom line, and he is an apologist for Trump’s fouled FEMA “responses” comparing his disaster of his flooded home below Oahe and “blizzards that closed down the whole state”, likely a HUGE disaster. the early October blizzard “atles ” did kill a lot of cattle, but was prolly climate change induced. @Team Cavuto

    earlier Rounds said: ““It would be great if we could find a way to bring Dems into the discussion. But the reality is they’re enjoying watching us struggle with this like they did with Obamacare for seven years,” said Sen. Mike Rounds (R-S.D.). “They want us to feel the political heat.”

    ouch for all of us, huh mike?

  20. trump is unhinged, Corker says this ““You cannot publicly castrate your own secretary of state” without limiting the options for dealing with North Korea, Corker, chairman of the Senate Foreign Relations committee, told the Post.” Time to get the padded room ready for our liddle dictator. Bring on the 25th pronto. Friday the 13th and Freddy is on the loose with a nightmare at 1600 Pennsylvania Avenue, D.C.

  21. The question to Rounds, Thune and NOem should be, are you willing to throw South Dakota citizens under the bus to line your own pockets with this blood money? How much is enough for your greed?


    Rounds and thune chimed in. today noem mumbled something about a death spiral or failing Obamacare. gee, wonder why. Sabotaging a a health care law has got to be against the law. vast right wing conspiracy

  23. Billie Sutton is the only one of the bunch that would be of help to South Dakotan’s with this grand theft. NOem and Jackley are complicit in the theft, so either one would be a disaster for healthcare in our state. Both of them have had their hand out as well to the special interests that have been doing their best to keep Medicaid expansion and what used to be the ACA from working here. Now they have trumpcare and the only one who would not put up with that fiasco is Billie Sutton

  24. It’s actually a Civics lesson. Trump’s oath of office requires that he (as leader of the Executive Branch) shall ‘faithfully execute’ the law. He hasn’t yet grasped this separation-of-powers idea – he still thinks this is an absolute monarchy. One of his wives, children, lawyers, generals – anyone who recalls some of the basic concepts of American gov’t – should diagram it for him. Courts determine whether laws are properly written. Duh, right?

  25. “OHBTW, the ACA, best insurance coverage I’ve ever had. Saving my life.” insurance cannot save your life but, in addition, ACA is not insurance. ACA is a program much like a FHA home loan guarantee. ACA did nothing for you but provide you assistance, in the form of welfare, providing you money that was taken from other people so you could benefit off of their sacrifice. Instead of worshiping some obscure failed program you should write letters of appreciation to the waitresses, farmers, police officers and teachers that all cut back on providing their own families with healthcare to pay for yours.

  26. mike from iowa

    OldFogey’s beans sure work up a blow. Bet he gets paid to be so obtuse.

  27. mike from iowa

    This must be where OldBucketmouth gets his ACA propaganda from.

  28. trumpcare will make it so the insurers will pay the subsidies. trump is a professional at crooking contractors as this is how he has treated all his contractors over the years in his failed business attempts. What will happen next year regarding healthcare, is anyone’s guess, my guess’s are either Bob Mueller or the 25th or impeachment.

    In South Dakota, because of the mental illness of trump, the two insurance companies that deal with the new republican trumpcare, had already submitted two sets of rates to the Division of Insurance. One set was to be a rate increase before trumpcare and now will use the double increase to cover the new trumpcare. The consumers who did not receive any kind of subsidy will get the 40% with no help to offset their increase. While those that did receive the CSR in the past, will still receive it only through the fantastic insurance companies in South Dakota, Avera and Sanford. Call potential governor NOem and thank her for trumpcare and also call potential governor Jackley and do the same, thank them for allowing you to pay double without raising your taxes.

  29. How NOem,Thune,Rounds/trumpcare screws the middle class and always the poor.

    “Now, to be clear, it doesn’t change much for people receiving Obamacare subsidies — those earning up to 400 percent of the federal poverty level, which works out to about $48,000 for an individual. That’s because Obamacare puts a cap on how much those people can pay.

    It does hurt people who are buying their coverage on the exchange and don’t get any subsidies. Some insurance companies have already adjusted their premium prices on these largely middle-income Americans to offset the federal payments they won’t receive.”

    Now, to be clear, there are only two insurance companies that sell individual health insurance in South Dakota. So you see that those that are not getting subsidies will be hurt the most. Only seems fair in the eyes of the republican congressional delegation…the same ones that want to be governor of the people they are screwing. Middle income folks, forget about that vacation trip or that remodel job, trim it back or forget about it. Next year will be double again. Goodwill has some great prices on used furniture and call the couch the NOem lounger.

  30. Francis Schaffer

    As an oaf, I am not sure I like being grouped with President Trump. He does not come to the meetings and hasn’t paid his dues, he is not a member.
    Okay I hear talk about ‘subsidies’, cost sharing and I wonder when I will have to declare my employer provide health insurance as income? It seems that is a subsidy too.

  31. That’s a good point of which to remind us, Francis. Folks lucky enough to get group coverage through the boss get a great benefit tax free. Folks buying their own health insurance only get to deduct their premiums, copays, deductibles, etc. once they add up to more than 10% of their income.

  32. If you are self employed, you can deduct the entire premium amount. The group pays your insurance, you must declare that as income. So if you are working for an employer and they pay you and your family insurance and it is like it is, about $1,500.00 to $2,000.00 a month, that could be as much as $24,000.00 in income. The whole system is screwed up and that is why folks like Bernie Sanders wanted to go universal.

  33. Maybe this will help you Francis.

  34. Francis Schaffer

    The link you provided indicates health benefits are excluded from taxes.

  35. mike from iowa Too true and funny, too.

  36. Adult day care in the White House. The Washington Post has a good article up about life in the adult day care with Baby Huey

    We have a couple of senators that are playmates of this big old loon, called Rounds and Thune and liddle NOem too.

  37. trumpcare at work with the lead doctor for trump.

    America’s healthcare will now be in Bornstein’s office practice…in his car.

  38. Earned Income Tax Credit attacked. More pain for the poor and a defeat for Ronald Reagan’s achievement, is NOem’s target. Not only beat hell out of the poor with the deny of healthcare, but do further damage to the economy and the poor with this. trumpers are a clear and present danger to democracy