Last week, President Trump issued an executive order eliminating what are known as cost-sharing reductions, a key aspect of the Affordable Care Act.
The CSRs, which amount to about $7 billion a year, are payments made to insurance companies to reimburse them for subsidizing out-of-pocket health care costs for those earning between 100 percent and 250 percent of the federal poverty level, which the ACA requires insurance companies to do. As of last week, however, the federal government simply won’t pay them back.
Ostensibly, this was a legal decision. Because of a dispute over whether these payments are considered mandatory spending or need to be specifically allocated by Congress, the fate of the CSRs was making its way through the courts. The White House’s argument is that these payments are illegal, so the government’s hands are tied.
That might be more persuasive had former Trump adviser Steve Bannon not given the game away this weekend, telling the Values Voters Summit that Trump ended the CSRs to “blow those exchanges up.”
Of course he did. There’s no easier way to sow chaos into the Obamacare marketplace, and that’s what Trump wanted to do.
