Delay in court case deepens health insurance uncertainty

WASHINGTON (AP) — The Trump administration and House Republicans on Monday asked a federal appeals court for an extension in a case that's casting a shadow of uncertainty over health insurance for millions of consumers. Democrats immediately called the move a cynical ploy.

The case involves federal payments that insurers use to lower deductibles and copayments for people with modest incomes who purchase individual policies under the Affordable Care Act, or ACA. About $7 billion is at stake this year in the lawsuit, originally filed by House Republicans.

The prolonged indecision comes at a critical time for insurers, who are trying to finalize their proposed premiums for 2018. BlueCross BlueShield insurer Anthem, which covers more than 1 million people in the ACA marketplaces, has told the government it needs to know for sure by June. Without the so-called "cost-sharing subsidies," experts say premiums could jump by about 20 percent.

"In merely delaying their suit, Republicans cynically continue to sow uncertainty in the health coverage of millions of Americans," House Democratic Leader Nancy Pelosi of California said in a statement. "At a critical period when insurers are deciding premiums for next year, Republicans are pouring uncertainty into the health insurance marketplaces."

In requesting a new 90-day extension, lawyers for the Trump administration and the U.S. House of Representatives said lawmakers are working on a solution. "The parties continue to discuss measures that would obviate the need for judicial determination of this appeal, including potential legislative action," the court filing said. Such requests for extensions are usually routinely granted.

The case is on appeal after a lower court ruled that the government lacks constitutional authority to make the payments because Congress failed to specifically approve them in the Obama-era health overhaul legislation. Democrats argue that conclusion is based on a faulty reading of the law.

Both the Obama and Trump administrations have kept making monthly payments while the case is pending.

But President Donald Trump at times has suggested he'd stop, and publicly mused that could be a tactic to force congressional Democrats to negotiate over health care.

"You know when people say, 'Oh, Obamacare is so wonderful,' there is no Obamacare, it's dead," Trump said in a recent interview with The Economist magazine. "Plus we're subsidizing it and we don't have to subsidize it. You know if I ever stop wanting to pay the subsidies, which I will."

Asked about such statements, White House officials have said no final decisions have been made and the issue remains under evaluation. Critics say dragging out a decision could drive premiums higher next year. Some states are allowing companies to propose two sets of premiums for 2018, with and without the subsidies.

The cost-sharing subsidies are available to customers with incomes up to two-and-a-half times the federal poverty level, or about $30,150 for an individual, $61,500 for a family of four. All consumers have to do is purchase a standard silver-level plan, and no additional paperwork is required. The cost-sharing help can reduce deductibles of several thousand dollars to just a few hundred.

The House-passed health care bill now being considered by the Senate would eliminate the subsidies after a transition period. However, on Monday the BlueCross BlueShield Association said consumers will need continued financial assistance with deductibles and copayments in order to maintain affordable coverage.

The case is known as House v. Price.