Issue Report ● Health Care
For Immediate Release: 
October 13, 2017
Contact Info: 
Mariel Saez 202-225-3130
President Trump is sabotaging the Affordable Care Act, raising health care costs and destabilizing the health insurance markets. His latest effort to sabotage the law came last night when he announced that he has decided to halt cost-sharing reduction payments. This followed an executive order he signed yesterday to undermine the law. Providers, insurers, and patient advocates, and others have issued statements strongly opposing the President’s efforts. Here’s a look at what they have to say:  
A group of six patient organizations including the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Congress of Obstetricians and Gynecologists, American Osteopathic Association and American Psychiatric Association, which represent more than 560,000 physicians and medical students nationwide released statements opposing the President’s actions:
“[President Trump’s executive order] proposes that individuals be able to purchase bare-bones policies for an extended period of time that, under current law and regulation, can only be used as a bridge toward buying coverage that meets current law essential benefit requirements. This will also destabilize the marketplace by incentivizing younger, healthier people to purchase cheaper bare-bones policies, leaving sicker individuals in an increasingly expensive market.” [Statement, 10/12/17]
“This decision is not consistent with the Administration’s pledge to provide individuals and families with more options to secure affordable health care coverage.  Elimination of CSR payments makes that goal harder, if not impossible, to achieve...” [Statement, 10/13/17]
American Diabetes Association, American Heart Association, American Lung Association, Arthritis Foundation,  Crohn’s and Colitis Foundation, Cystic Fibrosis Foundation, Epilepsy Foundation, National Health Council, National Multiple Sclerosis Society, United Way Worldwide, Volunteers of America, WomenHeart: The National Coalition for Women with Heart Disease: “The Trump Administration’s abrupt, late-night termination of critical CSR payments will jeopardize coverage for Americans who rely on the insurance exchanges and could throw an already fragile market into chaos. Our organizations, representing millions of Americans with chronic and serious diseases, are deeply disappointed by this decision, which shows a clear disregard for patients, providers and their families….The fallout for the health and wellbeing of all Americans, especially those with chronic or serious illnesses, could be catastrophic.” [Statement, 10/13/17]
America’s Health Insurance Plans and Blue Cross Blue Shield Association:  “Millions of hard-working Americans with modest incomes depend on cost-sharing reduction (CSR) benefits to get access to medical care. These benefits help real people every day, and if they are ended, there will be real consequences… We need constructive solutions that increase consumer choice, lower consumer costs, and stabilize local markets. Terminating this critical program will do just the opposite. This action will make it harder for patients to access the care they need. Costs will go up and choices will be restricted.” [Joint Statement, 10/13/17]
David O. Barbe, M.D., President of the American Medical Association: The AMA is deeply discouraged by the Administration’s decision last night to end the cost sharing reduction (CSR) payments to insurers, which are used to reduce deductibles and co-payments for low-income enrollees in the marketplace plans created under the Affordable Care Act (ACA)…. 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.  Our patients will ultimately pay the price.” [Statement, 10/13/17]
Alliance of Community Health Plans: “We are deeply disappointed in the Administration’s actions this week to undermine access to affordable coverage for millions of Americans…The CSRs have been a bargaining chip for too long. Making on average about $19,000 a year, millions of working Americans depend on this support to afford deductibles and copayments–and they deserve to know if that help will be there when they need it most.” [Statement, 10/13/17]
Chris Hansen, President of the American Cancer Society Cancer Action Network: “Today’s executive order jeopardizes the ability of millions of cancer patients, survivors and those at risk for the disease from being able to access or afford meaningful health insurance.” [Statement, 10/12/17]

Senior Vice President Bill Hoagland and Health Policy Director Katherine Hayes of the Bipartisan Policy Center: “The decision by President Trump to immediately stop payment of the cost-sharing subsidies provided through the Affordable Care Act is very short-sighted. It will hurt millions of low-income Americans and destabilize the individual insurance market…. When 2018 ACA marketplace rates were finalized last month, we saw double digit increases by health insurers all around the country explicitly due to uncertainty surrounding continued payment of these subsidies. Absent congressional action, this administration’s decision to end the payments assures the higher premiums will be in effect for 2018 and beyond.” [Statement, 10/13/17]
Young Invincibles: “The Trump Administration’s decision to no longer make CSR payments is a slap in the face to hardworking Americans who will see their premiums go up an extra 20 percent next year and in some cases lose their health insurance altogether. Republicans in Congress must make clear that it is unacceptable for the President of the United States to intentionally sow chaos in the health care system by passing a clean mandatory appropriation of CSR funding through FY2019. These payments are already built into the federal budget baseline and would not require additional spending. Now it is up to Congress to demonstrate it has the will to get this done and work on behalf of the American people, not the President.” [Statement, 10/13/17]
In addition, press reports are not mincing words when it comes to President Trump’s actions and how they will increase costs and undermine access to health coverage for Americans:
ABC News: The Note: Trump takes a chainsaw to health care
“President Trump is once again the bull in the china shop, telling Congress, ‘I broke it, you buy it.’ Within 24 hours, he will make two statements that could wreak havoc on systems in place expecting lawmakers to pick up the pieces. First, the monumental decision to end subsidies the federal government pays to insurers to keep out-of-pocket health care costs down for lower-income Americans. The Department of Health of Human Services says the payments will stop immediately, and it is possible health insurance companies could pull out of certain markets by next year.”
NBC News: Trump Deliberately Tries to Break Obamacare. Does He Own It Now?
“Well, consider the actions that the Trump administration has taken, including over the last 24 hours:
  • Then Thursday morning, Trump signed an executive order that could allow some Americans to purchase cheaper insurance plans, which would reduce the ranks of healthy, younger people in the Obamacare markets
  • And then last night, the White House announced it was ending key Obamacare subsidies that help pay out-of-pocket costs for low-income Americans.”
“Any one of these moves, by itself, could be considered neglect. But taken together, they make a strong case that the Trump administration is deliberately trying to break Obamacare. After all, if fewer people enroll in the marketplaces, premiums will go up and fewer insurers will participate.”
“Republicans might think the law is already broken. But why make it worse? Can anyone say — with a straight face — that these actions, together, improve the law?”
“So who gets blamed if premiums go higher than they currently are? And who’s at fault if more insurers bolt the Obamacare markets?”
“Back in April, a Kaiser Family Foundation poll found 64 percent of Americans saying that Trump and Republicans control the government, and they are responsible for any problems with the health-care law going forward, versus just 28 percent who said they’d point the finger at Barack Obama and congressional Democrats for passing the law.”
Washington Post: The Daily 202: Throwing a bomb into the insurance markets, Trump now owns the broken health-care system
“The administration announced late last night that he will immediately halt cost-sharing reductions. These $7 billion in annual subsidies to health insurers allow around 7 million low-income Americans to afford coverage.”
“Earlier in the day, the president signed a far-reaching executive order that makes it easier for individuals and small businesses to buy alternative types of health insurance with lower prices, fewer benefits and weaker government protections.”
This is not ‘letting’ Obamacare fail. Many nonpartisan experts believe that these active measures are likely to undermine the pillars of the 2010 law and hasten the collapse of the marketplaces.”
“The uncertainty about what Trump would do has already driven premium prices higher for 2018. Now it’s going to get worse.”
Axios: ​Trump takes a sledgehammer to the ACA
“President Trump left little doubt yesterday that he intends to do as much damage as he can to the Affordable Care Act's insurance markets. And he can do a lot.”
“His decision to halt the law's cost-sharing subsidies will blow up those markets in the short term. And his administration has taken a slew of other steps to undermine enrollment. There's one constant here — to wound the ACA as badly as possible.”
“The ACA sought to flatten out the disparate experiences of the healthy and the sick. Trump would begin to resegregate them.
Bloomberg: Trump Cuts Off Health-Insurer Subsidy, Threatening Obamacare Chaos
“President Donald Trump’s administration took its most drastic step yet to roll back the Affordable Care Act, cutting off a subsidy to insurers hours after issuing an executive order designed to draw people away from the health law’s markets.”
“The moves -- which critics call deliberate attempts to sabotage the law -- come just weeks before Americans will be able to start signing up for coverage for 2018. They follow other steps the Trump administration has taken, such as slashing advertising and outreach budgets to bolster enrollment in Obamacare plans, as well as planning outages of the website where people can sign up.”
The effect is ‘likely to be profoundly destabilizing, disruptive and potentially materially damaging to hospitals and those exchanges plans who are still required to offer benefits,’ Mizuho analyst Sheryl Skolnick wrote in a note to investors.”
“The result of that action and others is likely to be higher premiums and fewer people covered. The executive order, in particular, will give people in the law’s markets several alternative forms of coverage. They will likely be cheaper, though not as comprehensive.”
Vox: Trump will pull Obamacare subsidies in another attack on health law
“The Trump administration has decided to cut off crucial Obamacare subsidies that help reduce health care costs for lower-income Americans, a serious attack on the stability of the health care law’s insurance markets.”
“President Donald Trump has been threatening to end the payments — know as cost-sharing reduction subsidies or CSRs — for months, but is finally following through after Republicans in Congress once again failed to repeal and replace Obamacare late last month.”
“The White House announced late Thursday that the administration would stop the payments. The move comes as the Trump administration is also cutting funding for Obamacare outreach and pursuing new regulations to blow holes in the law, changes that collectively threaten a program through which millions of Americans purchase insurance.”
“Even without the CSR payments, insurers would still be required to reduce cost sharing, but they would now have to do it without the government’s help. They have said they will raise premiums dramatically to make up the lost revenue.”
VICE News: Trump just made healthcare more expensive for millions of people
“Donald Trump announced Thursday the White House will scrap a key component of Obamacare legislation that helps low-income families to pay for healthcare — a move likely to destabilize insurance markets and send premiums soaring.”
“Congress has failed to find a replacement for the Affordable Care Act in recent months, so Trump is looking to fulfill a key campaign promise to repeal and replace Obamacare by sabotage.”
New York Times: Trump to Scrap Critical Health Care Subsidies, Hitting Obamacare Again
“President Trump will scrap subsidies to health insurance companies that help pay out-of-pocket costs of low-income people, the White House said late Thursday. His plans were disclosed hours after the president ordered potentially sweeping changes in the nation’s insurance system, including sales of cheaper policies with fewer benefits and fewer protections for consumers.”
The twin hits to the Affordable Care Act could unravel President Barack Obama’s signature domestic achievement, sending insurance premiums soaring and insurance companies fleeing from the health law’s online marketplaces. After Republicans failed to repeal the health law in Congress, Mr. Trump appears determined to dismantle it on his own.”
“Chris Hansen, the president of the lobbying arm of the American Cancer Society, said the order ‘could leave millions of cancer patients and survivors unable to access meaningful coverage.’”

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