President Trump says the administration will no longer pay key Affordable Care Act subsidies. The result could be some consumers pay more for insurance coverage and the cost to the government rises.
NPR’s Robert Siegel talks to Congressman Charlie Dent, R-Pa., about the impact of the White House ending cost-sharing reductions.
The Trump administration says it will end cost-sharing payments designed to help low-income Americans get health care. Trump is also expected to make an announcement on the future of the Iran deal.
The White House says the government will no longer make subsidy payments to health insurers. The change could cause premiums to spike and drive insurers out of the marketplace.
NPR’S Robert Siegel talks with Sabrina Corlette, a professor at Georgetown University and expert on the health insurance market, about President Trump’s executive order on health associations and the impact they will have on the health care system.
President Trump issued an executive order on health care today. The order would remove requirements for basic benefits that are part of the Affordable Care Act, or Obamacare. He is telling federal agencies to permit wider use of so-called “association health plans” which currently do not meet the requirements for basic benefits like maternity care.
President Trump hands a pen that he used to sign an executive order on health care to Sen. Rand Paul, R-Ky., in the Roosevelt Room of the White House on Thursday.
Evan Vucci/AP
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Evan Vucci/AP
President Trump signed an executive order Thursday that is intended to provide more options for people shopping for health insurance. The president invoked his power of the pen after repeated Republican efforts to repeal the Affordable Care Act, also known as Obamacare, have failed.
“The competition will be staggering,” Trump said. “Insurance companies will be fighting to get every single person signed up. And you will be, hopefully, negotiating, negotiating, negotiating. And you will get such low prices for such great care.”
The order directs the Labor Department to make it easier for groups of employers to band together for the purpose of offering insurance. In some cases, groups might purchase coverage across state lines — a move that Republicans have long advocated as a way to lower costs.
Trump described his action as a response to reduced insurance offerings and rising premiums in Obamacare’s individual market.
Critics complain the president’s move could make matters worse — offering a cheaper option for younger, healthier insurance customers but driving up prices for those who need coverage most.
Broader access to so-called association health plans, or AHPs, is an idea that has been promoted by Sen. Rand Paul, R-Ky.
“President Trump is doing what I believe is the biggest free-market reform of health care in a generation,” Paul said during a signing ceremony in the White House Roosevelt Room. “This reform, if it works and goes as planned, will allow millions of people to get insurance across state lines at an inexpensive price.”
State regulators and some insurance companies warn that association plans might cherry-pick the healthiest customers, offering discounted insurance to those who don’t use a lot of medical care but driving up costs for others. Administration officials downplayed that concern, noting that association plans must offer coverage to any employee in a participating group.
The president’s order also calls for expanding access to short-term insurance policies, which are not subject to some of Obamacare’s coverage requirements. And it directs the Health and Human Services, Labor and Treasury departments to make it easier for employers to offer tax-free reimbursement to employees to help cover deductibles, copayments and other health care expenses.
All of the changes will be subject to a formal rule-making process, including a public comment period. Administration officials said any new insurance offerings would come in months, not weeks.
Trump said Thursday’s order is not a substitute for congressional action, and he vowed to continue to press lawmakers to repeal the Affordable Care Act.
“Today is only the beginning,” Trump said. “In the coming months, we plan to take new measures to provide our people with even more relief and more freedom.”
Critics argue that the Trump administration has deliberately tried to sabotage the Obamacare exchanges. Trump has repeatedly threatened to withhold cost-sharing subsidies from insurance companies, and he has slashed spending on marketing efforts to bring more customers into the exchanges.
President Trump signs an executive order Thursday that is expected to roll back Obama-era health care policies. Also, wildfires continue to race across parts of northern California.
We look at what’s expected to change in health care markets with President Trump’s executive order he’s expected to sign Thursday.
Roughly 80 percent of all first strokes arise from risks that people can influence with behavioral changes, doctors say — risks like high blood pressure, smoking and drug abuse.
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For years, doctors have been warning us that high cholesterol, cigarette smoking, illegal drug use and diabetes increase our chances of having a potentially fatal stroke.
And yet, most of the stroke patients showing up at hospitals from 2004 to 2014 had one or more of these risk factors. And the numbers of people at risk in this way tended to grow among all age groups and ethnicities in that time period.
That’s according to an analysis of the charts of more than 900,000 people admitted to U.S. hospitals for stroke within that decade. The study was published Wednesday in the journal Neurology.
“An estimated 80 percent of all first strokes are due to risk factors that can be changed — such as high blood pressure — and many efforts have been made to prevent, screen for and treat these risk factors,” says neurologist and study author Dr. Fadar Oliver Otite of the University of Miami Miller School of Medicine. “Yet we saw a widespread increase in the number of stroke patients with one or more risk factors.”
Most surprising, researchers say, was the high rate of Hispanic stroke patients who also had diabetes — about 50 percent— and African-American stroke patients, 44 percent of whom also had diabetes.
“Those rates are really very alarming” for a variety of complex reasons, says Dr. Seemant Chaturvedi, who also worked on the study and is a professor of clinical neurology at the Miller School of Medicine. Poor diet, less access to health care, lack of exercise and other factors all can contribute to risk, he says.
“Those are populations that need to be looked at,” Chaturvedi adds.
But not all of the risk factors increased equally, or can be attributed to the same causes, he notes. Diabetes increases many of the other risk factors, and this country is still in the midst of a diabetes epidemic, although recent studies suggest it may have reached a plateau.
Other risk factors may simply appear to be increasing because doctors have become more tuned in to checking for them.
For example, stroke patients with dislipidemia (a fancy way of saying an imbalance of fat and other substances in the blood) nearly doubled during that decade, although that is probably because doctors are testing for the condition and treating it more often. High cholesterol has become an increasingly important factor in stroke risk, Chaturvedi notes.
Given the demographics of the opioid epidemic the U.S. is struggling with, it’s probably not too surprising that stroke risks are rising among younger people. The prevalence of drug abuse among stroke patients doubled from 1.4 percent in 2004 to 2.8 percent by 2014, the study shows.
It’s really important that younger and middle-aged people understand that “these behaviors do put them at risk” for stroke, and that stroke is no longer just a disease for older people, Chaturvedi says.
The findings add to a growing list of recent studies showing stroke is an increasing problem among young to middle-aged adults.
The study also found that the prevalence of diabetes across stroke patients of all ages and ethnicities increased by 22 percent — from 31 percent of patients in 2004 to 38 percent in 2014. And the prevalence of high blood pressure increased by 15 percent — from 73 percent of patients at the beginning of the study period to 84 percent by the end.
According to the American Heart Association, stroke is the second-most-common cause of death from cardiovascular disease, although rates of stroke deaths decreased between 2004 and 2014 by almost 29 percent. However, if stroke risk factors are increasing, that’s a trend to watch.
Chaturvedi says the authors would next like to study data coming in from 2011 to 2016 to see if the risk factor rates change.
