.@somuchweirdness suggests I explain how Trump stopping CSR payments actually effects ppl.

Because I always listen, will tweet that soon.1/
CSR payments reduce the size of deducts & co-pays for low income exchange consumers.

Insurers who participate must continue 2 pay them.2/
In the remainder of 2017, insurers will pay them as required-- approx $2 billion+-- but govt won't pay them back as promised. 3/
While it's cute to call it an insurer "bailout", its no more a bailout than the govt paying back a govt bond is to a saver. 4/
Everyone who calls it a bailout knows it's notning more than a talking point. Insurers will make the pmt 4 2017 & sue to recover. 5/
In 2018, CSR payments must still be made AS LONG AS A POLICY IS BEING OFFERED.

So the first question is what will insurers do? 6/
Insurers in ~38 states will likely stay. They were allowed 2 increase premiums on the rest of their policies 2 make up 4 no govt funding.7/
(I will explain how it works so skip ahead if you like. Will also get to what happens in the ~12 states soon.)
The amount of subsidies in ACA policies ⬆️ as the "silver plan" increases. In 38 states, insurers were able 2 ⬆️ premiums in those plans.8/
So in those 38 states, lower income buyers get a subsidy bump that keeps the costs the same & even makes other plans seem cheaper. 9/
All Trump did was load the cost of paying the CSR payments 2 places: consumers wout subsidies & the Federal government. 10/
The CBO estimated that Trump's maneuver just cost the Federal taxpayer $200 billion. And middle class families a 20% rate hike. 11/
Yes, cutting CSR payments is a double middle class tax increase. A good way to usher in Trumpcare.

#ThanksTrump
In these 38 states, one would hope the insurers stay. But losing $2B+ because the govt reneged on a promise could cause them not to.13/
Now there are ~7 states (check me @LouiseNorris) where states haven't allowed rates to increase for the govts action. 14/
There are 2 states-- Indiana and Colorado-- that didn't permit rate increases to all go to the silver plan. There are a few I don't know.15/
If they don't change-- these 9 states are ones where plans could pull out or consumers could pay more. 16/
To summarize:
1- Trump chose to do this, didn't have to
2- Did it at a time to create most damage
3- if insurers leave, hurts everyone 17/
Summary-
4- Taxpayers definitely get hurt. The deficit gets worse.
5- Bad 4 middle income buyers
6- Bad 4 competition 18/
On an ongoing basis this just makes insurance more expensive, unless Congress addresses (payment reduces premiums & the deficit. 19/
There is a sideshow ? of if this gets addressed by Congress, but his has been long enough so will hit that later but I will say this...20/
This is a problem of Trump's making & effects his constituents the most.

Don't expect the Dems to give him a Mexico wall to fix this. 21/

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More from @ASlavitt

Sep 7, 2018
BREAKING: I have had some conversations about the ACA repeal vote and the Arizona Senate seat which I will attach as a thread here shortly.

Follow if interested.
On ACA repeal, everyone from Trump to Senate leaders have made it clear that as soon as they have the votes to repeal the ACA, they will do it.

As of a year ago, they had 49 votes for a repeal vote— one short with Pence as the tiebreaker. 2/
Since then, two things have changed. The Republicans lost a repeal vote in Alabama and the anti-repeal side lost a no vote when John McCain passed away.

Doug Jones is a clear no vote. What about Arizona...? 3/
Read 10 tweets
Sep 5, 2018
Trump wants health insurers not to have to cover pre-existing conditions. It’s cheaper.

Explaining this to people who don’t remember insurance before ACA is difficult. A young man last night asked me why he would buy a bus ticket if the bus company didn’t have to have busses. 1/
My explanation: insurance before the ACA was designed for the needs of insurance companies. The principal design was how to protect their profits.

The principal change of the ACA was to reverse it— to protect consumers w standard benefits, no lifetime caps & pre-ex. 2/
This makes sense to the majority of Americans.👇 3/

Read 7 tweets
Aug 28, 2018
September 6, 2018 is setting up to be D-Day in Trump’s war to take health care protections from millions of Americans.

Amidst the distractions, no major news outlet is focusing on it.

1/
Two major things happen September 6 both highly connected.

-President Trump has instructed his Justice Department to not contest a case that would make the ACA illegal. (See next tweet...)
-The Supreme Court Justice who could likely decide this case begins his hearings.

2/
The court case will be heard by a former staffer of TX Senator John Cornyn. The impact is pretty straightforward. 👇

Read 9 tweets
Aug 22, 2018
NEW HEALTH CARE NEWS: Today we unite with 280 hospitals to transform care delivery for underserved Americans— focusing on bringing the country’s best resources to meet their health & social needs.

forbes.com/sites/michelat…
These hospitals represent 5% of our care delivery and will expand to more and have a focus on treating vulnerable populations.

Work is getting started in key areas: improving care to women & infants, mental health, substance abuse, and creating care sources outside the ER.
Many places are already doing some great innovative things that work. But it doesn’t spread around the country to touch everyone. That’s part of the goal.

This is something @GeisingerHealth does to keep people healthier. They don’t prescribe drugs. They prescribe healthy food.👇
Read 5 tweets
Aug 7, 2018
It has been 6 months since we launched @USofCare. Today we celebrate by visiting our 4th state: UT, NC, NM. Now MN.

We begin the same in every state— meeting families and health care advocates this AM.

Thank you for all the support & encouragement to get everyone health care.
@USofCare We met with the @ThisIsMedicaid to kick off our 2 days in Minnesota where we will meet with over 200 people across the state.

@usofcare always starts with patients and families.

We met with the Chambwr leaders from around the state of Minnesota. Small business owners in the state want to provide good coverage but, like the rest of us, feel victim to health care costs and politics they can’t control.

Read 4 tweets
Aug 1, 2018
BREAKING: If you missed it, Trumpcare plans were announced today.👇 They are a flashback set to bring us back to pre-ACA days and damage the ACA in the process.

Been collecting inout all day so now will cover this. Follow if interested. 1/

THE MOST UNDER-REPORTED SIGNIFICANT FACT:

-ACA requires 80% of your premiums to cover your medical expenses.

-Trumpcare has NO requirement. Expect about half of your premium to cover health care. The difference— marketing and profits.

This is a boon to insurance companies.2/
The big advertised benefit of these plans is they cost less.

Trump Administration brags they could cost 50, even 80% less. Gee, I wonder how they do that? While spending 1/2 as much on medical care?

Let me think. Might they be providing only 10-25% on insurance benefits?... 3/
Read 12 tweets

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