Tim Jost: What Has Happened — and Not Happened — to the Affordable Care Act Under the Trump Administration?
President Trump has made numerous statements critical of the Affordable Care Act (ACA) and has issued executive orders that have undermined parts of the law. His administration has terminated cost-sharing reimbursement payments to insurers, greatly scaled back funding for navigators who help people sign up for coverage, encouraged the proliferation of non-ACA-compliant policies, and, in general, worked to reduce the federal role in maintaining the law’s provisions.
In a new To the Point post, Timothy Stoltzfus Jost says that while the above may be true, the administration has continued to implement other ACA programs, some of which stabilize and support the individual market. The Centers for Medicare and Medicaid Services (CMS) has granted seven state innovation waivers to allow reinsurance programs that have reduced individual market premiums and steadied ACA enrollment. CMS has also thwarted a few state efforts to sidestep ACA requirements.
"[T]he ACA remains largely in place," Jost writes. Through the president’s first 18 months in office, premiums and insurer margins are stabilizing and new insurers are entering some markets. The number of uninsured people remains well below 2013 levels, as well. "But if Congress fails to take action to consolidate those gains . . . and if administration policies continue to undermine insurance markets, those gains may soon erode," he says.
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