The Trump executive order calls for broadening the definition of a “bona fide group or association” to allow a greater number of small employers that are members of local chambers of commerce or a national trade association to form fully insured “large group” or self-insured “group” association health plans.Association health plans are by definition required to provide adequate coverage, and additional federal protections apply, including fiduciary responsibilities, a rigorous appeals process, and prohibitions against basing premium rates on an individual participant’s health condition.

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Iowa is abandoning its quest to shed major elements of the Affordable Care Act, after federal health officials failed to approve the plan in time for the insurance-buying season that begins in just over a week. The state’s withdrawal comes two months after President Trump telephoned a top federal health official with instructions to reject Iowa’s proposal.

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Mr. Trump and congressional Republicans are hoping the Labor Department will identify a way to allow associations and small employers to create self-insured plans—or something similar. That change could allow them to adjust benefits and offer more affordable coverage to more people. Since the passage of ObamaCare, however, states are no longer the driving force behind most insurance mandates and regulations. Washington is. A more straightforward solution would be for Congress to change the law.

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At the core of Medicaid’s troubles is its provider reimbursement system, which is based on price controls. In general, it pays rates substantially less than those of private insurance and can even be less than the cost to deliver that care. According to a Kaiser Family Foundation analysis, in 2016, Medicaid reimbursed physicians across the country 72 percent of Medicare rates for all services and 66 percent of Medicare rates for primary care. In general, Medicare rates are already less than those of private insurance. With noncompetitive reimbursement and the administrative hassle of the program, many providers are reluctant to accept Medicaid patients.
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President Trump has defended his decision to end cost-sharing reduction (CSR) subsidies — an element of the Affordable Care Act that helped lower the cost of deductibles and co-pays for people making less than 250 percent of the federal poverty level — by pointing to the gain in stock prices for health-insurance companies.

Insurance companies do not make money through the cost-sharing provision, estimated to be worth about $7 billion in fiscal 2017. They’re being paid back for money they’ve already spent. If they do not get repaid for doing what is required under law, companies say they will raise premiums to make up the difference.

That in turn will raise the cost to taxpayers, because whatever savings result from eliminating the CSRs will be exceeded by additional costs for higher tax credits to defray the new premiums.
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Any agreement to restore funding for cost-sharing payments should be tied to provisions allowing families to opt out of ObamaCare and buy coverage that meets their individual needs. The compromise should also grant insurers the right to sell such plans independent of ObamaCare’s rules and its rigged risk pool.

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A majority of voters back a key component of President Trump’s executive order. Fifty-two percent of voters said they support Trump’s plan to make it easier for small businesses to band together in associations to sponsor low-cost, less comprehensive health care coverage across state lines, while 30 percent said they oppose the policy, according to a new Morning Consult/Politico poll. 39% believe the executive order will lead to lower insurance premiums and 36% said health insurance costs would be likely to rise.

By our deadline Friday the world had continued to spin without interruption-planes taking off and landing; men and women commuting home after another week at work-and if you’re reading this then you survived the ObamaCare subsidy apocalypse of 2017. We’re referring to the political meltdown over the Trump Administration’s decision to end extralegal payments to insurers.

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The changes Trump’s executive order envisions would not alter the constraints imposed by the ACA or other federal statutes. They would work within those constraints. These changes would allow many consumers to avoid the ACA exchanges and ObamaCare’s hidden taxes—but then again, so did President Obama when he created “grandmothered” plans. They would make the costs of community rating, essential health benefits, and other hidden taxes more transparent—but so did “grandmothered” plans, as well as the steps President Obama took with Congress to increase premium-assistance-tax-credit clawbacks and to limit risk-corridor subsidies.
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President Donald Trump plans to end a key set of Obamacare subsidies that helped lower-income enrollees pay for health care, the White House said Thursday, a dramatic move that raises questions about the law’s future.

The late-night announcement is part of Trump’s aggressive push to dismantle aspects of his predecessor’s signature health law after several failed attempts by Congress to repeal it earlier this year.
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