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  • Obamacare is in a total death spiral.

  • My name is Sherry Glied, and from 2010 to 2012 I was the assistant secretary

  • for planning and evaluation at the department of Health and Human Services

  • in the Obama administration.

  • When you think about whether the Obamacare is collapsing,

  • I think you really have to sort of think about the current situation and the counterfactual.

  • Would it naturally collapse or is it collapsing in part because

  • the administration is causing it to collapse.

  • Premiums last year that is coming into this year's cycle,

  • increased quite a lot.

  • There are couple of things administration has done that may be contributing to

  • weak performance of exchanges.

  • The first thing is that

  • when almost the first thing that the Trump,

  • the president Trump did when he entered the office is to put out

  • an executive order saying that they would not be

  • strenuously enforcing the individual mandate.

  • So that likely led to some reduction in signups

  • He also turned off the marketing spigot a little bit earlier this year than had been done in prior years.

  • But the most important concern, I think,

  • in terms of stability and future of these markets is that

  • they are supposed to have stream of money come in

  • to pay for reductions in the cost sharing for low-income subscribers.

  • So, the way that the Affordable Care Act is set up,

  • if you are low-income person and you buy a health plan,

  • that health plan gets an extra subsidy so that

  • your deductibles, your cost sharing, what you have to pay when you go to the doctor, isn't too high.

  • There's been an argument between Republican congress and President Obama

  • when he was still in office about whether the money that was flowing

  • under that piece of the legislation had correctly followed Congressional rules.

  • But, President Trump has not been clear about whether he will let those payments flow or not.

  • If the payments don't flow,

  • insurers will be responsible for giving better coverage to low-income people,

  • but they won't be subsidized for that.

  • And they're building that into their premiums, and raising them accordingly.

Obamacare is in a total death spiral.

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How Trump could be contributing to Obamacare

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    jenny posted on 2017/07/18
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