State, county shielded from brunt of White House health decisions, officials say

Oct. 14--The 16,600 Ventura County residents who receive government aid in paying insurance deductibles and co-pays will still get that help despite President Donald Trump's decision to stop subsidies to the insurers who offer the assistance, Covered California officials said Friday.

The White House announced late Thursday that it would immediately halt the payment to insurance companies designed to help low-income people cover out-of-pocket costs in insurance plans created through the Affordable Care Act.

"ObamaCare is a broken mess," the president said in a Friday morning tweet. "Piece by piece we will now begin the process of giving America the great HealthCare it deserves."

The announcement triggered predictions that the change could in many parts of the country accelerate the unraveling of Affordable Care Act programs and bring more premium increases, inequities in access to care and insurers pulling out of exchanges.

Read more: Covered California prices to rise 6.1% in Ventura County, 12.5% across state

Ventura County and the rest of the state will be somewhat insulated, said Peter Lee, executive director of the Covered California exchange.

"It will not affect any consumer benefits that they receive in 2017 and 2018," he said in a Friday news conference. "It will not affect the prices that are online today."

All 11 insurance companies that provide coverage through Covered California have committed to staying through 2018, Lee said. One of the insurers, Anthem Blue Cross, announced previously it will offer 2018 plans only in Santa Clara County and parts of Northern California, pulling out of Ventura County and other regions.

The subsidies to insurers are different from the tax credits received by some 32,000 Ventura County residents to defray the costs of premiums in Covered California plans. Those tax credits aren't affected by the White House's announcement Thursday.

The exchange announced this week -- before the president's plan emerged -- that the possibility of funding being severed meant an average of an about 12 percent surcharge for 2018 will be added to plans in the exchange's silver tier but not other tiers. Even in silver plans, most consumers will be shielded from paying the surcharge, officials said.

The surcharge comes on top of premium increases estimated in August at about 12 percent across all Covered California plans. In Ventura County, the premium rise was estimated at about 6 percent. Final ratescan be found at www.coveredca.com.

The surcharge is designed to offset the increased costs to insurers in providing the cost-sharing reductions for co-pays and deductibles. That extra burden is about $800 million in Califonia in 2018, Lee said.

The announcement that what Trump has called bailout payments will end immediately means insurers in California could absorb $188 million in extra costs over the rest of 2017 before the surcharge kicks in, Lee said.

"This action will make the health insurance market unprofitable by definition," he said.

In Ventura County, nearly 36,000 people receive insurance through Covered California. A little less than half of those people at the lower end of exchange's income scale receive the cost-sharing reductions for out-of-pocket costs.

With open enrollment in Covered California beginning Nov. 1, some advocates worry that confusion over the changes will scare people away from the exchange. Anthony Wright of Health Access California worries that people will see the prices on silver plans and decide they can't afford it, not realizing many of them will be shielded.

"The workaround is hard to explain to people," he said. "Some people will get confused and lose coverage in the process."

The White House called ACA payments to insurance companies illegal and said they had to end. Mike Osborn, chairman of the Ventura County Republican Party, echoed the sentiment.

"The whole way that was put together was illegal," he said Friday. "There's nowhere in the (ACA) bill where the subsidies were provided for. You can't just walk over and pick up a bag of money and hand it to someone."

The announcement of the funding's end came on the same day Trump signed an executive order designed to allow for short-term insurance plans exempt from the Affordable Care Act's requirements, meaning they might be less expensive and offer fewer protections. The order is also aimed at opening the door to allowing employers to cross state lines to buy insurance.

"The time has come to take action to IMPROVE access, INCREASE choices and LOWER COST for HEALTHCARE," the president tweeted.

California Attorney General Xavier Becerra announced Friday that he will lead a coalition of states suing the federal government over the end of the subsidies to insurers.

Erik Cho of the Ventura County Healthcare Agency worries the White House plans will increase the burden on safety net health systems like the county's. He said it's likely that fewer people will be insured and others will have less comprehensive coverage.

"This would negatively affect their health outcomes now and for years to come," emailed Cho, worrying also that protections against linked coverage rates to pre-existing conditions could be in jeopardy.

Kaye Feller, president of the Camarillo Republican Women Federated, said the Affordable Care Act isn't affordable and doesn't offer enough choices. She said the end of the cost-sharing reduction subsidies will push Congress to come up with a long-term health plan.

Opening the door to out-of-state insurance will create more competition among insurers, she said.

"It will allow the average person or family to select the insurance they need rather than a mandated package," she said.

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