Republicans, stoking insurer panic, cite uncertainty as a reason to pass health-care bill

After Senate Republicans wrapped up their health-care meeting with Vice President Pence, Sen. John Barrasso (R-Wyo.), one of the body’s few physicians, told reporters that the party got a new sense of urgency after Anthem, an insurer in Ohio’s Affordable Care Act exchange, announced that it was pulling out. Thousands of Ohioans, most in rural areas, could be left uninsured.

“We need to stabilize the markets right now,”  Barrasso said. “While we were in there, another company pulled out, which shows the continued collapse of the Obamacare market. I mean, it happened during the policy meeting.”

Quickly, a reporter pointed out the rest of the story — the reason for Anthem’s turnabout. In a statement, the insurer had blamed uncertainty over whether subsidies would continue to be paid out to people buying plans on the exchange, a problem created by President Trump’s decision to punt a decision on whether to support those subsidies.

“Planning and pricing for ACA-compliant health plans has become increasingly difficult due to the shrinking individual market as well as continual changes in federal operations, rules and guidance,” the insurer had said.

But just as quickly, Barrasso had an answer. “Even Robert Pear of the New York Times has written that this is Obama’s problem, because they made illegal payments,” he said. “The Obamacare market is collapsing.”

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The brief exchange, coming as Republicans struggled to come to a resolution on their health-care bill, demonstrated a strategy as brazen as anything in modern politics — undermining the current operation of the ACA, and arguing that the law, thus undermined, is falling apart. Despite the clear warnings of state insurance commissioners and of insurance companies themselves, Republicans continue to discuss premium increases and insurer pullouts as if the party fully in control of the government is a terrified observer.

The reference to Robert Pear — who was standing next to Barrasso — provided a concise example. Pear had not written that the confusion over “cost-sharing” was “Obama’s problem.” In a May 20 story, Pear had written that “in some ways, the Obama administration shares responsibility with the Trump administration for the current mess,” because it had paid out the cost-sharing subsidies after the Republican-controlled House (and later Senate) refused to appropriate them.

That led to a lawsuit which is working its slow way through the courts — but which the Trump White House could abandon at any time. Doing so would solve the problem that insurers, repeatedly, have cited for 2018 premium increases. It would do so more directly than even passage of the American Health Care Act, which would replace the subsidies with refundable tax credits scaled for the age of the buyer.

But since the first birth pangs of the AHCA, message-conscious Republicans have insisted that cost increases in the current system should be blamed on the Obama administration, not on them. In a tweet, Speaker of the House Paul D. Ryan (R-Wis.) said of the Ohio news that “the collapse of Obamacare continues.” At the start of Tuesday’s news conference, White House press secretary Sean Spicer cited the Ohio news as the reason to pass whatever health-care bill Republicans came up with.

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“The American people have been saddled with a bill for Washington’s inability to get this disaster taken care of,” he said. “And it’s simply not right for them to have to pay it any longer. It’s time for us to provide them with the choice and control that all Americans want over their own health care.”

Ryan and Spicer had used the same argument for months, to great effect among Republicans. In May, after a number of Iowa insurers made a similar case that uncertainty caused them to pull out of the state’s exchange, Ryan flipped two Iowa Republicans who had opposed the AHCA to yes.

Democrats, taken aback at the buck-passing, spent part of Tuesday insisting that the administration could stop the insurer panic whenever it wanted to.

“It’s holding cost-sharing hostage as a political tool,” said Sen. Charles E. Schumer, the Democratic leader. “The way to get companies to come back to these counties is to say you’re going to do cost-sharing permanently.”

Sen. Sherrod Brown (D-Ohio), who said he’d talked to an Anthem executive before the announcement, added that Republicans “own this health-care system and are making it worse every month.”

“It’s interesting that Trump does this Hamlet-like dance every month about whether to provide funding,” Brown said.

But asked how Democrats could respond, Brown said he was unsure. The last round of appropriations, seen as a win for Democrats — who among other things saved funding for Planned Parenthood — occurred as the Trump administration seemed ready to continue cost-sharing subsidies.

The next bite at the apple for forcing funding through Congress might come when the debt limit needs to be raised. Democrats have so far given little indication that they’d use that process to fix the administration’s “Hamlet” problem.

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