Just like the Zombie in popular folklore, the Affordable Care Act (ACA) refuses to die despite the best efforts of the Trump Administration to kill it off.
Despite GOP-led congressional action to axe the ACA’s individual mandate coupled with White House moves to torpedo the federal health law, more health insurers are signing up to sell coverage in 2019 while premium increases will be the lowest in years.
And even as the Administration acted to expand both the availability of short-term health plans and alternative coverage options for small businesses plus halt payments to insurers for low income customers and slash funds for ACA outreach, public support for the health law has reached its highest levels ever over the past year.
Most recently, CMS has resumed paying $10.4 billion in risk- adjustment payments to insurance companies with plans on the individual market after halting such payments last month based on a federal judge’s ruling that the agency had not adequately justified its payment methodology.
Having been stymied on Capitol Hill to repeal the ACA and running out of administrative actions to dilute the law, the Administration may now be pining its hopes to strike a clear knockout blow against the health law on a pending federal lawsuit in Texas. The White House has partially sided with the legal action filed by 20 Republican state attorneys general to strike down the ACA’s insurance premiums, including its prohibition on denying coverage with individuals with pre-existing conditions. Oral arguments in the case have been scheduled for September 10.
But make no mistake, the White House has largely succeeded in transforming the ACA into a weaker and more dysfunctional version of itself with enrollment among unsubsidized customers in the individual market shrinking nearly 30% between 2015 and 2017 as premiums rose according to the Kaiser Family Foundation.