The confusion the White House has sown guarantees that Americans looking for Obamacare will face high premiums and less choice-the very things Trump hammered the ACA for doing. People will suffer and they will die.
The subsidies were first challenged by a lawsuit from congressional Republicans in 2014. Even the legality of the payments was doubtful. And we're joined now by Julie Rovner, who's been covering this for Kaiser Health News.
MARTIN: That's Julie Rovner.
Ullmann said he has a hard time seeing the uninsured rate dropping in Florida as a effect, even an unintended one, of the president's decision to cancel the cost-sharing subsidies.
And that's because they're not cheap - they've cost the US Government about $US7 billion ($8.9 billion) so far this year. On October 12th Mr Trump kicked off a deregulatory process to permit widespread formation of so-called Association Health Plans (AHPs), insurance policies run by groups of small firms.
ROVNER: So the insurers have a couple of options. Those are the people who are getting help with their premiums.
The federal cost-sharing payments cover almost 95 percent of her deductible and co-pay costs.
JUDY WOODRUFF: So, let's talk about the potential impact here.
Both measures stand to return more Americans to the ranks of the actually or effectively uninsured, which is the problem that precipitated health care reform.
The White House announced on Thursday that it was stopping subsidies that were provided by the federal government to help provide medical insurance for low income Americans.
So it's money that's owed.
The president and other administration officials have described Trump's move as a way to put pressure on Congress to agree to some of Trump's priorities. Insurance companies can leave the marketplace, with notice. Pursuing ever-lower premiums, every association would likely incorporate in the most Wild-West-like state around, in the way that credit card companies tend to domicile in South Dakota. Remember, open enrollment starts in about two-and-a-half weeks - they have built in not getting these subsidies. And they might be able to get it.
ROVNER: Well, we're talking about 20 million people total.
JULIE ROVNER: Well, there is a lot of confusion about this. They may be early retirees who are not yet eligible for Medicare or they are people who are self-employed. Who are the newly insured?
To recap: Trump is enacting a policy where the government spends billions more to insure fewer people. Smaller shares - about four in ten - say that they are exhausted of the debate and think the country should focus more on other issues.
This year, the CSR payments will cost the federal government about $7 billion, according to the nonpartisan Congressional Budget Office. In many cases, they attributed those jumps partly to the uncertainty surrounding cost-sharing reduction subsidies. But as regulators will tell you, that criterion is not easy to enforce, which is why the hot potato of association "bona fides" is regularly tossed back and forth among states, insurers and the Labor Department.
The Congressional Budget Office estimated in January that the cost-sharing subsidies would total $7 billion in fiscal 2017, which ended September 30, and $10 billion in fiscal 2018. By 2020, premiums would increase 25 percent due to this change.
So people who are getting help won't see these increases. Those people may be asked to suddenly pay tens of thousands of dollars more. These are sometimes called min-med or "buffalo plans", because they pay out pretty much only if you're trampled by a herd of buffalo.
Welcome to Trumpcare. Or, more accurately, "No Care At All". One-third (34%) say their actions are not having much impact on the way the marketplaces are working.
JULIE ROVNER: Well, this - it's a relatively small piece. But individual-market customers might not know exactly how this executive order would affect them before then.
But even people who represent employer plans were complaining today that this could end up affecting them. So people who might not have been too sick to get insurance but still couldn't afford it could now afford it. A 2013 IRS Notice prevented employers from using HRA dollars to fund employees' individual health insurance premiums-because the Obama Administration anxious that doing so would encourage employers to drop coverage.
JUDY WOODRUFF: And, finally, the president's done this.
However, AHPs accomplish this goal not through Congress' Commerce Clause power-i.e., explicitly allowing, for instance, an individual in Maryland to buy a policy regulated in Virginia-but instead through federal pre-emption-individuals in Maryland and Virginia buying policies regulated by Washington, albeit in a less onerous manner than Obamacare's Exchange plans.
All Congress needs to do is appropriate the money. That is more than twice the share (30%) who say it is more important for the administration and Congress to continue repeal and replace efforts than to stabilize the markets. "After a thorough legal review by HHS, Treasury, OMB, and an opinion from the attorney general, we believe that the last administration overstepped the legal boundaries drawn by our Constitution".