Washington — President Donald Trump’s move to stop paying a major “Obamacare” subsidy will raise costs for many consumers who buy their own health insurance, and make an already complicated system more challenging for just about everybody.
Experts say the consequences will vary depending on how much money you earn, the state you live in, and other factors.
Overall, Trump’s decision will make coverage under the Affordable Care Act less secure, because more insurers may head for the exits as their financial losses mount.
All of this is happening with the Nov. 1 start of sign-up season a couple of weeks away.
Here are some questions and answers as state regulators, insurance executives, consumer groups, and number crunchers try to analyze the potential impacts:
Q: How many people benefit from these subsidies?
A: About 60 percent of the estimated 9 million to 10 million people signed up for coverage through the health law’s insurance markets qualify for reduced copays and deductibles, which are available to individuals making up to about $30,000.
Q: Does this mean they’ll get no help?
A: No. Insurers are legally obligated to provide the discounts, and if the government doesn’t reimburse them, the companies are expected to raise premiums.
In some states regulators have allowed insurers to increase premiums preemptively for 2018 because of the uncertainty over what Trump would do. Other states have contingency plans.
And there’s another wrinkle: “Obamacare” also subsidizes monthly premiums, not just copays and deductibles.
So people getting premium subsidies will be shielded from those increases, for the most part.
Q: What about people who buy individual health insurance policies outside the “Obamacare” market and don’t get help under the ACA?
A: Many of these “off marketplace” customers are solid middle-class and don’t qualify for financial assistance, so potentially they could face a big hit.
It depends on where they live, said Larry Levitt of the nonpartisan Kaiser Family Foundation.
In some states, regulators directed insurance companies to limit potential rate increases only to plans sold on the ACA markets. Unsubsidized customers would be protected in those states.
In other states, however, they might be in for a shock.
Q: Trump says this money is a bailout. What’s the impact for insurance companies?
A: The National Association of Insurance Commissioners estimates that Trump’s immediate cancellation of monthly payments will cost insurers about $1 billion they would have been owed for the remainder of the year. There’s no way to raise premiums now for a few months to try to recoup of any of that.
The nonpartisan organization representing state regulators says Trump’s order will only add more disruptions to already shaky markets.
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