Courts hammer Trump for sabotaging Obamacare, in rulings that could cost the Treasury billions

Greenbeard · Feb 19, 2019

The ACA requires insurers to lower deductibles, co-pays, and other out-of-pocket spending for low income people so that they can afford to use their insurance. In return, the feds are supposed to reimburse those insurers for those additional expenses.

When Trump reneged on making those reimbursements in late 2017 insurers responded by jacking up premiums to recoup the lost revenue--that's part of the mechanism by which Trump triggered the largest premium jump the marketplaces have yet experienced.

That made for some weird dynamics in the markets but the truly odd part is that insurers are now winning back in court the funds Trump reneged on--revenue those insurers already recouped, largely at Uncle Sam's expense, through the Trump-induced premium spike. Talk about double dipping!

Courts hammer Trump for sabotaging Obamacare, in rulings that could cost the Treasury billions

Legal experts thought that one of President Trump’s cruder attacks on the Affordable Care Act would come back to bite him once the courts took a crack at it.

Court rulings have flooded in over the last few weeks, and the experts are right. The cost to the government could be $12 billion a year, payable to health insurers who were cheated by Trump’s action. That’s not chump change. As Nicholas Bagley of the University of Michigan wrote this week, “Insurers could buy us a damn border wall every year with that money.”

Many experts predicted that this [canceling cost-sharing reduction reimbursements to insurers] wouldn’t work, since creditors armed with a government promise to pay could go to the Court of Federal Claims, which has the power to order the government to pay up even when Congress hasn’t appropriated the necessary funds. (The payments come from a separate Judgment Fund, a permanent, uncapped fund established for claims such as these.)

So far, more than 90 insurers, including scores brought into court as part of a class-action lawsuit, have won their cases before the Court of Claims. The rulings are coming from Wheeler and his bench colleagues Margaret M. Sweeney, who decided the class-action case on Feb. 15, and Elaine D. Kaplan, who ruled in a Montana case in September. As Bagley observed, “None of these judges bought the Justice Department’s rationale for refusing to pay. And good reason: it’s garbage.”

What’s most interesting about these rulings, the experts say, is that they apply to expenses that the insurers essentially worked their way around in 2018, through a maneuver known as “silver loading.”

Essentially, the insurers calculated their potential losses from the CSR suspension, then raised their premiums for benchmark silver ACA plans to cover the losses. This was done with the agreement of state regulators, including Covered California, which oversees ACA plans in that state.

Because the benchmark plan also sets the level of premium subsidies for all ACA plans, this turned out to be a boon to millions of ACA buyers — the subsidies increased to the point that they made higher-benefit gold and platinum plans cheaper and, in many cases, made lower-benefit bronze plans free for buyers. The U.S. Treasury ended up eating the higher cost.

As it happens, it may not be the insurers that reap the benefit, but their customers. That’s because the ACA sets limits of up to 20% on the gross profits that insurers can earn from the ACA plans and requires them to rebate the excess to the customers.

What a tangled web.

Captain Adverse · Feb 19, 2019

Greenbeard said:
The ACA requires insurers to lower deductibles, co-pays, and other out-of-pocket spending for low income people so that they can afford to use their insurance. In return, the feds are supposed to reimburse those insurers for those additional expenses.

What a tangled web.

You are correct, what a tangled piece of crap the ACA "web" was. IMO never should have been created, at least not using private insurers.

I would have preferred a modification of Medicare and Medicaid since we are all already taxed for that.

Helix · Feb 19, 2019

The ACA was the heritage foundation version of first world healthcare. However, the Trumpist party wasn't even confident enough in its position to let it fail on its own. It was sabotaged at every step. It's time for single payer, IMO.

jimbo · Feb 19, 2019

Helix said:
The ACA was the heritage foundation version of first world healthcare. However, the Trumpist party wasn't even confident enough in its position to let it fail on its own. It was sabotaged at every step. It's time for single payer, IMO.

As long as that single payer is you and not me, I'm fine with it.

Helix · Feb 19, 2019

jimbo said:
As long as that single payer is you and not me, I'm fine with it.

I'm good with bringing the get a horse crowd into it like Medicare. I'll be voting for that.

Tanngrisnir · Feb 19, 2019

Captain Adverse said:
You are correct, what a tangled piece of crap the ACA "web" was. IMO never should have been created, at least not using private insurers.

I would have preferred a modification of Medicare and Medicaid since we are all already taxed for that.

Yes, and all that's quite irrelevant to the fact that the plan was birthed by the loony, radical right and Trump is essentially human filth.

jimbo · Feb 19, 2019

Helix said:
I'm good with bringing the get a horse crowd into it like Medicare. I'll be voting for that.

I'm sure you will.

JasperL · Feb 19, 2019

Captain Adverse said:
You are correct, what a tangled piece of crap the ACA "web" was. IMO never should have been created, at least not using private insurers.

I would have preferred a modification of Medicare and Medicaid since we are all already taxed for that.

Lots of people would have preferred that but comparing the ACA to flying unicorns which also were a fantasy in that reality isn't very productive. And as Greenbeard has pointed out, in a state dedicated to make something like the ACA work, instead of the GOP working like heck to make it fail and be replaced with nothing, it does work, very well.

washunut · Feb 19, 2019

Helix said:
I'm good with bringing the get a horse crowd into it like Medicare. I'll be voting for that.

Not sure anyone working for a large corporation or the government (state,city,federal) would trade their insurance for medicare.

JasperL · Feb 20, 2019

washunut said:
Not sure anyone working for a large corporation or the government (state,city,federal) would trade their insurance for medicare.

It's tough to compare because the copays and shared insurance payments paid by employees varies widely between plans and employers and even classes of employees in some cases, but Medicare plus a decent supplement will be directly comparable for most if not the vast majority of people. I've not talked to anyone that finds Medicare with a supplement a big step down from their pre-Medicare coverage, and I'm getting to the age where i know people well who have done the switch. I also take care of healthcare for my mother in law, pay all her bills, and have found her coverage excellent so far, very comparable to my own.

Helix · Feb 20, 2019

washunut said:
Not sure anyone working for a large corporation or the government (state,city,federal) would trade their insurance for medicare.

Most of us do it eventually and are fine with it.

Common Sense 1 · Feb 20, 2019

Remember 3 things about Obamacare.

1. You can keep your Doctor if you like your Doctor. A lie!

2. You can kepp your healthcare insurance if you like it. A lie!

3. A middle class fsmily will save $2500.00 per year on their healthcare. A lie!

All 3 lies were spread by Obama time after time. Obamacare was a failure the first day it went into effect.

A very flawed program from the start.

AGENT J · Feb 20, 2019

Greenbeard said:
The ACA requires insurers to lower deductibles, co-pays, and other out-of-pocket spending for low income people so that they can afford to use their insurance. In return, the feds are supposed to reimburse those insurers for those additional expenses.

When Trump reneged on making those reimbursements in late 2017 insurers responded by jacking up premiums to recoup the lost revenue--that's part of the mechanism by which Trump triggered the largest premium jump the marketplaces have yet experienced.

That made for some weird dynamics in the markets but the truly odd part is that insurers are now winning back in court the funds Trump reneged on--revenue those insurers already recouped, largely at Uncle Sam's expense, through the Trump-induced premium spike. Talk about double dipping!

Courts hammer Trump for sabotaging Obamacare, in rulings that could cost the Treasury billions

What a tangled web.

i always found it funny how some people claim the ACA was so horrible while ignoring the fact people (in government) were letting the air out of the tires, draining it of gas, removing the spark plugs and blacking out the windshield and then claiming see its not working as they walk away whistling.

is it perfect? of course not, did it fix everything? of course not but it was a start and eventhough it has had success it could have even more. you keep building on it and fix the parts that dont work, you dont sabotage it with nothing to replace it thats just dumb and hateful and selfish while MORE Americans suffer.

AGENT J · Feb 20, 2019

Common Sense 1 said:
Remember 3 things about Obamacare.

1. You can keep your Doctor if you like your Doctor. A lie!

2. You can kepp your healthcare insurance if you like it. A lie!

3. A middle class fsmily will save $2500.00 per year on their healthcare. A lie!

All 3 lies were spread by Obama time after time. Obamacare was a failure the first day it went into effect.

A very flawed program from the start.

LMAO Please prove that the three things you called lies were factually lies . . . ready . . GO!

opcorn2:

Port & Starboard · Feb 20, 2019

Greenbeard said:
The ACA requires insurers to lower deductibles, co-pays, and other out-of-pocket spending for low income people so that they can afford to use their insurance. In return, the feds are supposed to reimburse those insurers for those additional expenses.

When Trump reneged on making those reimbursements in late 2017 insurers responded by jacking up premiums to recoup the lost revenue--that's part of the mechanism by which Trump triggered the largest premium jump the marketplaces have yet experienced.

That made for some weird dynamics in the markets but the truly odd part is that insurers are now winning back in court the funds Trump reneged on--revenue those insurers already recouped, largely at Uncle Sam's expense, through the Trump-induced premium spike. Talk about double dipping!

Courts hammer Trump for sabotaging Obamacare, in rulings that could cost the Treasury billions

What a tangled web.

While the middle class working people got hammered under the ACA and eventually became the new uninsured.

Yup.....a pure freaking liberal masterpiece!

washunut · Feb 20, 2019

Helix said:
Most of us do it eventually and are fine with it.

Most of us HAVE to do it. I currently have the choice as my spouse works. I will stay OFF Medicare until I have to. Cost goes way up under Medicare.

Greenbeard · Feb 20, 2019

Captain Adverse said:
You are correct, what a tangled piece of crap the ACA "web" was. IMO never should have been created, at least not using private insurers.

I would have preferred a modification of Medicare and Medicaid since we are all already taxed for that.

Medicaid almost entirely uses private insurers at this point, and about a third of Medicare does.

Greenbeard · Feb 20, 2019

RetiredUSN said:
While the middle class working people got hammered under the ACA and eventually became the new uninsured.

Yup.....a pure freaking liberal masterpiece!

The GOP has been working to jack up premiums for eight years. And every time they score a success in their deranged agenda they crow about how prescient they are. The absurd situation in the OP is just the latest example of their idiotic agenda in practice.

American · Feb 20, 2019

Helix said:
The ACA was the heritage foundation version of first world healthcare. However, the Trumpist party wasn't even confident enough in its position to let it fail on its own. It was sabotaged at every step. It's time for single payer, IMO.

Try not to break you neck blaming the Heritage Foundation. They have zero legislative power. This was TOTALLY AND COMPLETELY THE FAULT OF THE DEMOCRATIC PARTY AND BARACK OBAMA.

Greenbeard · Feb 20, 2019

American said:
This was TOTALLY AND COMPLETELY THE FAULT OF THE DEMOCRATIC PARTY AND BARACK OBAMA.

The situation in the OP is entirely the fault of Donald Trump and the GOP. They did this on purpose.

American · Feb 20, 2019

Greenbeard said:
The situation in the OP is entirely the fault of Donald Trump and the GOP. They did this on purpose.

No it isn't, the Democrats did this.

SenorXm/Sirius · Feb 20, 2019

Remember when Trump said this:

“We’re going to have insurance for everybody,” Trump said in an interview with The Washington Post. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”

1 of 9,354 lies he's told in the last 3 years.

Greenbeard · Feb 20, 2019

American said:
No it isn't, the Democrats did this.

Trump reneged on the CSRs (which, per these lawsuits, he was legally required to reimburse), triggering a huge premium spike in 2018. And yes, the Trump premium spike disproportionately hit those above the limit for premium tax credits, since the taxpayers largely bore the cost for the low-to-middle income families below it. All this out of spite.

American · Feb 20, 2019

Greenbeard said:
Trump reneged on the CSRs (which, per these lawsuits, he was legally required to reimburse), triggering a huge premium spike in 2018. And yes, the Trump premium spike disproportionately hit those above the limit for premium tax credits, since the taxpayers largely bore the cost for the low-to-middle income families below it. All this out of spite.

The premiums went up because young people aren't buying insurance. There's no mandate, which was the heart of Obamacare socialism.

Greenbeard · Feb 20, 2019

American said:
The premiums went up because young people aren't buying insurance. There's no mandate, which was the heart of Obamacare socialism.

They went up because Trump unilaterally pulled $12B a year out of the markets, which then had to be made up through premium hikes. He did it on purpose, and he got the result he wanted. The taxpayers and middle class families in the marketplaces suffered.

As for his attempts to further destabilize the market by eliminating the mandate, he's just piling on, isn't he? He really wants to get those premiums up.

Courts hammer Trump for sabotaging Obamacare, in rulings that could cost the Treasury billions

Greenbeard

Captain Adverse

Classical Liberal Sage

Helix

jimbo

Helix

Tanngrisnir

jimbo

JasperL

washunut

JasperL

Helix

Common Sense 1

AGENT J

"If you ain't first, you're last"

AGENT J

"If you ain't first, you're last"

Port & Starboard

washunut

Greenbeard

Greenbeard

American

Trump Grump Whisperer

Greenbeard

American

Trump Grump Whisperer

SenorXm/Sirius

Greenbeard

American

Trump Grump Whisperer

Greenbeard

Courts hammer Trump for sabotaging Obamacare, in rulings that could cost the Treasury billions

Classical Liberal Sage

"If you ain't first, you're last"

"If you ain't first, you're last"

Trump Grump Whisperer

Trump Grump Whisperer

Trump Grump Whisperer

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