My contempt for the destruction of the nonpublic employee middle class is expressed by my heading. We were already conned by Obama and now, Trump's blustering has shown him equally mealy-mouthed, weak and impotent when it comes to policies protecting the physical and financial health of Americans in the event of illness.
There are two parts of health insurance, buying it and then being able to use it in terms of its coverage and the amount of money you'll have to spend in deductibles, copays and coinsurance to use it. This week's news illustrates the basic problem for nonpublic employee consumers and sadly shows that like President Obama, President Trump is willing to make both the purchasing of and utilization of health insurance more expensive still in order to satisfy insurance companies.
Be clear, the Affordable Care Act promoted this very policy through its bare minimum requires checkup coverages and its dramatic increases in the prices charged by insurers including those bare minimum coverages. For the fraction of American people, at its peak 11 million, who purchased their health insurance through healthcare exchanges, the federal government picked up some of the cost of GETTING insurance through premium credits AND helped some of those individuals USE their health insurance through COST-SHARING where the federal government picked up some or all of the tab for using health insurance in the form of deductibles, copays and coinsurance. The rest of the nonpublic employee America saw our costs for both GETTING and USING health insurance go up dramatically.
Trump has just made matters different but worse because he's signaled his administration's commitment to the dominance of the insurance company daddy empowered by Obama.
Interestingly, this week the news was unclear. First, you wouldn't know it from reports of Trump cutting cost-sharing subsidies, but this was NOT what his executive order was about. HHS, not Donald Trump, decided to stop those payments, which were already in the courts regarding the issue as to whether the federal government had agreed to pay those cost-sharing expenses, consumer use payments into infinity or whether they needed to be funded each year. It has NOTHING to do with premium assistance, the cost of getting insurance, which the federal government is still paying for for those 11 million or less exchange enrollees.
What the media has NOT covered is the fact that Trump's Executive Order is a bigger hit to a greater number of nonpublic employee middle class people because it signals the Trump Administration's continuation of the big lie that the President would use his authority to HELP the middle class. Trump's executive order is a policy statement to promote selling health insurance across state lines and specifically encourages Association Health Plans, Short-Term Limited Duration Insurance, short-term health plans, and health reimbursement arrangements, essentially the HSA plans for healthy-wealthy people that supposedly promote "savings accounts," in conjunction with high deductible plans. See Whitehouse.gov, Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States.
Remember, the issue for consumers is how much it will cost us to GET health insurance and how much it will cost us to USE it. The sheer stupidity of Trump's ideological executive order is perfectly clear when you consider this issue for consumers. Trump's Executive Order is actually an Obama style pro-insurance company policy that signals the continued dominance of insurance companies over their government partner.
Trump's executive order. There were already under Obamacare RISK pools, the idea of a single risk pool was a gigantic failure on health exchanges and the assertion of a single risk pool was a gigantic lie under Obamacare. First, because Obamacare itself created separate risk pools, tobacco users and older Americans. Second because healthier Americans or those who believed their medical needs would be less chose cheaper plans. And third, because ERISA rules were relaxed under Obama allowing employers to charge mountains more to people as surcharge if they didn't submit to employer-insurance company "wellness" screenings, leaving those protecting their privacy paying more because they wouldn't have the employer "WELLNESS" exam. Trump signals a continuation of insurance company dominance in using risk pools to essentially charge more to some for various reasons.
Regarding the wellness versus standard rate whereby insurers "examined" employees, insurance companies got around the law by saying they needed to know what the population's health was at a particular employer so that they could "craft" their policies (that means charge more). Like Obamacare, this risk pool info is ALWAYS for insurers, if you use or are likely to use the product you purchase, you'll be charged more for that product.
So, Association Health Plans are very Obama like and therefore, were not discussed by the media, because after all, our lawmakers agree…Screw the middle class. Similarly, the offering of Short-term insurance plans, which were, by the way a popular getaround under Obamacare until 2015 when Obama and HHS outlawed such plans in an effort to force more young-healthies onto exchanges, again, was about getting young people to get better coverage that they might not need by buying into plans that older or sicker Americans would. This change in Obamacare in 2015, illustrated the failure of trying to get a "single risk" pool even within the fantasy idea of Obamacare (fantasy because it never existed).
HRAs, the HSAs are the same thing, the healthy-wealthy plans that have been proven inadequate for decades for middle class people in terms of both "savings" potential AND health coverage. Obama and Trump have echoed a love of such plans in accordance with the wishes of insurers.
It's a sad day for the middle class moderates who voted for Trump who has this week reenergized the swamp of government, and ignored the public employees whose superior benefits (which cost them less to use because of better coverage) and which are paid for by taxpayers remain untouched. This was a glaring Obamacare betrayal when we realized the Dems had created a loophole for themselves to avoid being bound by the bad law (Obamacare) they intended for everyone else and remains an appalling sticking point listening to Obama's Republican counterparts like Paul Ryan advocating for trimming benefits for everyone but public employees.
Moving forward, since the media is so worried about the few million who will lose their cost-sharing, perhaps asking about those public employee benefits should be part of the conversation talking about the government slashing benefits for nonpublic employees. All the big mouths should be asking, "What about the swamp, Mr. President?" And now we've found out, it's alive and well.
