Trump's Cuts To Insurance Companies Impacts Arkansans

Oct 17, 2017

Marquita Little, Health Policy Director for Arkansas Advocates for Children and Families.
Credit AACF / AACF

President Trump is ending some federal insurance subsidies for people covered under the Affordable Care Act. KUAR’s David Monteith spoke with Marquita Little, Health Policy Director for Arkansas Advocates for Children and Families, about what the cuts will mean for Arkansans’ access to healthcare.

DAVID MONTEITH: President Trump announced he’s cutting cost-sharing reductions, or subsidies for some people insured under the Affordable Care Act. Can you tell us what’s getting cut and who will be impacted?

HEALTH POLICY DIRECTOR, MARQUITA LITTLE: Basically the President announced last week that we would see some immediate cuts to cost-sharing reduction payments. Those essentially are payments to insurance companies that help lower the out-of-pocket costs and deductibles for low- to moderate-income individuals. So essentially what’s happening is that the federal government is reimbursing the insurers for lowering those out-of-pocket costs or those deductibles or other related expenses.

But here’s where it gets a little bit complicated. Under the current law those insurers have to offer those lower cost plans regardless of whether those payments [from the Federal Government] are made or not, so reducing or eliminating those payments essentially leaves the insurer in a situation where they have to figure out how to adjust for no longer being reimbursed. So it’s most likely that they’ll respond in one of two ways, or both. One is by actually raising premiums across the board. We certainly would all be impacted by seeing those increased premiums across the board. The other way that insurers might respond is by dropping out of the insurance marketplace altogether.

Here in Arkansas our healthcare model covers low-income people, and everyone else, through private insurers, which is different from many states, so how are we in Arkansas in particular going to feel these cuts?

This will essentially affect the great majority of Arkansans who are enrolled in a marketplace plan and purchasing it themselves because the great majority of Arkansans do have those silver-level plans. But another issue that is very unique in Arkansas is our Medicaid expansion program, or Arkansas Works. We actually expanded coverage to low-income adults by using Medicaid dollars, federal Medicaid dollars, to offset the cost of enrolling individuals in private insurance plans, so these individuals are not enrolled in traditional Medicaid, but they are actually enrolled in the very plans that we’re talking about that will be impacted. That’s anywhere from 250,000 to 300,000 Arkansans.

So this will pose an immediate threat to what has been a wildly successful program in Arkansas. Because of this model we saved hospitals that might have gone under. In Arkansas we’ve also kept premiums low because we have so many people enrolled in the marketplace. Certainly I think it increases the urgency that we should feel as a state in hopes that congress will actually take action to correct this issue, because here we are less than three weeks away from the open enrollment.

I think we have a lot of people who are confused about what to expect. And we also see that insurers, insurance companies are responding immediately to the uncertainty. We’ve already seen that our insurers on the marketplace submitted rate changes that’ll increase premiums for the upcoming year.

What do you think Arkansans need to remember during all the confusion?

The good news that’s still out there and available for people is that you can get help free of charge. Locally in Arkansas we do have an organization called Enroll the Ridge that people can look up and contact. They provide enrollment assistance to Arkansans. And if you need help, people can still get help through the Healthcare.gov hotline or reach out directly.

Open enrollment for the Affordable Care Act runs Nov. 1 through Dec. 15.