How Trump insurance changes could affect coverage next year

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Is this complicated gambit on health care really more important to Trump than defunding Planned Parenthood or getting money for a border wall? Without these fixes, Obamacare will continue to face challenges that will nearly certainly keep it from thriving.

The Affordable Care Act enabled 20 million Americans to gain insurance, mostly through the individual insurance markets set up by the law or through an expansion of Medicaid, the government health insurance program for the poor and disabled. So the only real change that's been made so far is that the IRS has said that they wouldn't send your return back if you didn't check that box saying whether or not you had health insurance. The focus has shifted to ideas from President Donald Trump and GOP lawmakers in Congress, and most people dont like what they see.

The move follows the withdrawal by Trump and House Republicans late last month of a bill to repeal and replace the legislation better known as Obamacare, after Trump and House Speaker Paul Ryan failed to secure the necessary votes in the Republican-controlled House. So the administration is trying to keep the existing system going temporarily as it pursues a total remake. When the for-profits lured the most desirable customers away from the nonprofit Blues, the Blues had no alternative but to mimic the big insurers.

But here's the one thing you need to know: it was the defining feature of the very first health insurance plans sold in this country.

On Wednesday, Trump said he was considering withholding cost-sharing reduction subsidies slated to go to health insurers to help cover out-of-pocket medical expenses for low-income Americans in a move to force Democrats to negotiate on a new healthcare bill. Insurers and medical groups penned a letter to Mr Trump urging him to remain funding the subsidies, which amount to around $7 billion a year and are paid directly to insurers.

The president insisted that he does not want people to lose coverage.

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"The president's comments on stopping the Cost Sharing Reduction payments will increase costs, is a threat to the good health of the American people and a threat to keeping government open", an aide to House Democratic leader Nancy Pelosi told The Hill. In response, Democrats are planning to tie that money to the government funding bill that needs to pass at the end of the month.

The Obama administration was sued in 2014 by House Republicans, who argued that the federal government was making these cost-sharing payments without authorization from Congress.

Customers will have 45 days to shop for 2018 coverage, starting November 1 and ending December 15. Health insurance buyers who fail to enroll during this time will confront more stringent documentation requirements for a special enrollment period should they choose to buy Obamacare insurance before the next annual enrollment period. Insurers claim these have allowed some people to sign up only when they need costly treatment.

Giving insurers greater flexibility to create low-premium plans that would appeal to healthy young adults.

"The bottom line is that while the final rule addresses some of the challenges in the market, I think the reaction will be that it doesn't go far enough", said Cara Kelly, a vice president at the consulting firm Avalere Health. Or if you filed for bankruptcy or if the cheapest health plan available to you would cost more than 8 percent of your income - and there are lot more exemptions. This year alone, premiums for ACA plans rose by an average of 25 percent. A recent Congressional Budget Office analysis found the markets would "probably be stable in most areas" under the current law, but if billions of dollars in payments made under current law are discontinued - or even at risk of disappearing - it could scare off insurers.

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