Trump favoring cutting off ACA subsidies to insurers

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President Donald Trump is reportedly leaning towards ending cost-sharing reduction subsidies, or CSRs, to insurers offering coverage on the Affordable Care Act (ACA) exchanges, which could quickly destabilize the marketplace.

POLITICO reports Trump expressed his desire to end the payments in a May 16 meeting in the Oval Office. While others in the administration, including HHS Secretary Tom Price, MD, are wary of such a move because of the political consequences and how it would discourage insurers from participating in the exchanges, Trump feels the “bold move” would force Democrats in Congress to negotiate a replacement for the ACA, despite party members’ statements otherwise.  

Trump has been encouraged by groups outside the administration to preserve the subsidies. The National Association of Insurance Commissioners has said the ongoing uncertainty around the CSRs could lead many insurers to drop ACA participation in 2018. The attorneys general of 15 states have signed on to intervene in the lawsuit threatening the subsidies. If they are eliminated, a Kaiser Family Foundation study said federal healthcare spending would go up, not down.

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