Obamacare held hostage: What the Trump administration wants in exchange for protecting health care

A right-wing agenda is on the table for Trump, according to a new list of demands

By Matthew Rozsa

Staff Writer

Published March 7, 2018 11:05AM (EST)

Barack Obama; Donald Trump (Getty/Scott Olson/AP/Evan Vucci)
Barack Obama; Donald Trump (Getty/Scott Olson/AP/Evan Vucci)

President Donald Trump is willing to protect the Affordable Care Act markets — provided that he is allowed to push through a conservative agenda in the process.

An administration memo was sent to Congress which intended to offer a political tit-for-tat to Republicans thinking of supporting subsidies for insurance companies to help them support low-income buyers’ cost-sharing, according to The Wall Street Journal. While federal courts are still debating whether Congress should even have the authority to subsidize those insurers, given that the subsidies weren't explicitly included in the original 2010 law, the Trump administration memo laid out conservative goals that could be turned into policy in return for the subsidies. If Congress doesn't arrive at some sort of deal to restore the subsidies by May, insurance companies in certain states will begin establishing their 2019 rates at much higher amounts.

One of those policies would be to allow insurance companies to charge elderly customers up to five times as much as they do younger customers. Presently, these companies are only allowed to charge their elderly customers up to three times as much as they do younger customers — insurers have said they've had to raise prices for younger customers as a result, deterring them from buying insurance in the first place. Another proposed policy would grant a permanent appropriation for subsidies to insurance companies that reduce deductibles and copays for low-income Americans, in return for guarantees that they would exclude abortion coverage.

It is worth remembering: The reason why special legislation needs to be passed propping up the subsidies is that Trump himself decided to cut off those payments in October. It is analogous to Trump ending the Deferred Action for Childhood Arrivals program and then using the fate of the millions of Dreamers who could potentially be deported as leverage to pass stricter immigration laws.

"Although congressional efforts to provide taxpayer money to prop up the exchanges is understandable, any such efforts must also provide relief to middle-class families harmed by the law and protect life," the memo insisted.

Despite the multiple attacks on the Affordable Care Act by both Trump and the Republican Party, 54 percent of respondents to a Kaiser Health tracking poll had a favorable view of the legislation. That is the highest number the law has received since 2010.

By Matthew Rozsa

Matthew Rozsa is a staff writer at Salon. He received a Master's Degree in History from Rutgers-Newark in 2012 and was awarded a science journalism fellowship from the Metcalf Institute in 2022.

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