President Donald Trump delivered a one-two punch to the Affordable Care Act on Thursday, and industry leaders are calling it an all-out assault on consumer protections and a threat to quality patient care.
First, Trump issued an executive order yesterday that includes three primary directives to federal agencies: consider ways to expand association healthcare plans, expand coverage through short-term plans and adjust health reimbursement arrangements.
Later that night, the administration announced it would "immediately" halt cost-sharing reduction payments to insurers, which help subsidize the cost of health insurance for low-income Americans. Industry leaders say those subsidies are critical in the fight to stabilize the ACA's individual markets and that, without them, premiums will rise and more payers could exit the individual insurance markets.
Following multiple failures in Congress to repeal the ACA, Trump suggested he would instead take aim at the law through the "power of the pen."
ObamaCare is a broken mess. Piece by piece we will now begin the process of giving America the great HealthCare it deserves!— Donald J. Trump (@realDonaldTrump) October 13, 2017
Pamela F. Cipriano, Ph.D., R.N., president of the American Nurses Association, said in a statement that the group strongly opposes the White House's first order, saying it "sabotages Americans' healthcare."
"Patients could be sold insurance plans that do not cover essential health services, like contraception, mental-health care and addiction treatment; patients with pre-existing conditions may not be able to afford coverage and the healthcare markets could be destabilized, leaving consumers with fewer—if any—options for affordable, quality health coverage," Cipriano said.
David O. Barbe, M.D., president of the American Medical Association, said in a statement that with the decision to end CSR payments, "our patients will ultimately pay the price."
"This most recent action by the administration creates still more uncertainty in the ACA marketplace just as the abbreviated open enrollment period is about to begin, further undermining the law and threatening access to meaningful health insurance coverage for millions of Americans," Barbe said.
Tom Nickels, the American Hospital Association's executive vice president for government relations and public policy, echoed the sentiment. In a statement, Nickels said the president's executive order could "put patients at risk when care is needed the most" as it would allow insurers to offer plans with fewer benefits.
"The AHA is committed to ensuring that individuals and small businesses have affordable, comprehensive healthcare coverage options, and we encourage the administration to achieve this goal without sacrificing critical consumer protections by stabilizing the individual and small group markets," Nickels said.
The Senate Health, Education, Labor and Pensions Committee has spearheaded a bipartisan effort to stabilize the ACA's markets and lower premiums for patients who buy insurance in the exchanges. Healthcare industry groups have called for a focus on these efforts in the wake of several stalled GOP attempts to roll back the healthcare law. Funding CSRs, at least in the short term, is among the provisions the HELP committee is mulling in its ACA stabilization plan.
Chip Kahn, president of the Federation of American Hospitals, said in a statement emailed to FierceHealthcare that it's "critically important" for Congress to act quickly to fund these payments.
"Millions of working American families depend on the subsidization of their cost sharing to ensure them access to the healthcare they need," Kahn said. "Unfortunately, a decision has been made to stop federal payments for the cost sharing. This action will jeopardize the healthcare coverage on which so many Americans depend."
'Americans deserve 2 have access 2 high quality, affordable care that enables them 2 effectively manage health & covers treatment they need' https://t.co/Y3TmfDWF2c— AmHeart Advocacy (@AmHeartAdvocacy) October 13, 2017