Trump Set To Propose Framework To Halt “Surprise” Obamacare Price Hikes

President Trump is expected to announce a general framework to address health care costs, and wants Congress to send a bill to his desk that would halt Affordable Care Act premium spikes, according to MS Now, citing two White House officials familiar with the plans. 

Trump’s proposed framework – the “Healthcare Price Cuts Act,” would seek to terminate what White House officials referred to as “surprise premium hikes” due to the ACA, and would eliminate “zero-premium” subsidies currently offered under the ACA – as well as stopping “ghost beneficiaries” – which would require a small premium payment as a means to verify eligibility to receive benefits in order to minimize fraudulent recipients. 

The plan also features a deposit program that would incentivize lower-premium options on the ACA exchange. For those who downgrade coverage, the difference in costs would be distributed to a “Health Savings Account” that would be funded by the taxpayers. 

The move comes as pandemic-era ACA subsidies are set to expire at year’s end, which will send prices back up for nearly 22 million Americans. News of Trump’s plan comes amid a bipartisan proposal from the House for a two-year extension of Obamacare subsidies. If premiums expire, premiums are expected to more than double next year, while an estimated 2 million more people will become uninsured, the Congressional Budget Office found. 

The announcement, which could come as soon as today, is slated to feature remarks from Trump and Dr. Mehmet Oz – administrator for the Centers for Medicare and Medicaid Services, the officials said, adding that Senate Majority Leader John Thune (R-SD) and House Speaker Mike Johnson (R-LA) were expected to have been briefed Sunday afternoon. As CNN reports, however, “ a White House official said that “until President Trump makes an announcement himself, any reporting about the Administration’s healthcare positions is mere speculation.”“

But the framework under discussion envisions temporarily extending the ACA subsidies in some form, while incorporating a series of guardrails aimed at limiting their scope — potentially including new income limits and a requirement that all enrollees pay some form of premium.

Those provisions would address two of the main critiques that Republicans have about the enhanced subsidies, including that so-called zero premium plans drive fraudulent behavior. But it would also set up the ACA for a more fundamental overhaul down the road along the lines of what Trump has been demanding in recent weeks. 

Democrats notably kept the government shut down for more than a month over their demand for an extension of the enhanced ACA subsidies. In exchange for their vote to finally reopen through January, Senate Republicans agreed to hold a mid-December vote on an extension, spurring Trump and his team to develop their own competing proposal.

Republicans, meanwhile, have wanted to restore an income cap for the Obamacare subsidies, which had been at 400% of the federal poverty level before the enhancement took effect in 2021. The elimination of that cap made plans more affordable for the middle class.

According to recent polling from KFF, almost 75% of Americans support extending the ACA tax credit, including 50% of Republicans. 

GOP Sens. Rick Scott of Florida and Bill Cassidy of Louisiana have rolled out their own proposals that would allow consumers to take at least part of their federal subsidies and put that money into health savings accounts – with Scott’s plan calling for allowing enrollees to use all the aid to buy coverage, including potentially less comprehensive and less expensive plans outside the ACA. Cassidy wants to shift the enhanced subsidies to HSAs and allow enrollees to use the funds to pay for health care services, including doctors visits, prescriptions and glasses. 

Question: If the plan allows some people to choose a lower-tier insurance plan on the exchanges to redirect some federal aid into a health savings account, why can’t we also have cheap catastrophic coverage that kicks in after someone’s spent, say $25,000 out of pocket?